Treatment and Guidance of the Climacteric Woman

Abstract

Physicians are easily led to reduce problems of the menopause to an endocrinological dysfunction. But, even if hormonal change is the causal factor, the menopause itself remains the experience of the individual woman. Physicians may be able to understand this very personal reaction of the woman if they are able to relate her reactions to her social environment and her personal perspective. Hormonal treatment may be the first and essential step, but it is not the only one. That hormonal replacement therapy nowadays consists primarily of combined or cyclical estrogen-progestogen preparations is taken for granted. The modalities of hormonal replacement therapy will not be discussed here. The experiences of a female nonmenopausal gynecologist, working for 2 years parttime in a menopause clinic are presented. As the hormones, together with the neurotransmitters and the nerves, are the mediators between the body and the psyche, the menopause clinic is regarded as a model of specialized psychosomatic consultation. With what sort of problems do women come to the menopause clinic? Although we started recently to compile a computerized inventary of the patients of the menopause clinic, I will not present statistical data. The computer program is designed for easily measurable data (e.g., biochemical values or number of night sweats) rather than for psychological data. As to the setting: women are seen one morning in the week in a university hospital in the gynecological unit.