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Pre-Menopause, Menopause and Beyond pp 43–75Cite as

Climacteric Symptoms: Importance and Management

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Part of the book series: ISGE Series ((ISGE))

Abstract

Menopausal symptoms concern the majority of women, but their expression varies greatly between different populations. E.g., the incidence of hot flashes/vasomotor symptoms (VMS, hot flashes, sweating, palpitations) may reach 80% in western perimenopausal women. On the other hand, VMS have been found to be as low as 5% in Japan where musculo-skeletal symptoms are predominant. These differences illustrate the impact of social, cultural and other factors on the expression of climacteric symptoms such as VMS, sleeping problems, mood changes, musculo-skeletal symptoms, urogenital symptoms or sexual dysfunction. Health related quality of life (HRQL) decreases, too, in symptomatic women (in particular VMS) with menopause. The more and the heavier the symptoms are, the lower is HRQL.

As they are a direct consequence of a decrease in oestrogen levels, treatment with oestrogen is logical and has been shown to be superior to alternatives such as phytotherapy, SSRI/SNRI and others. Therefore, oestrogen administration is the therapy of choice and should be recommended as the first option. Oestrogens not only improve VMS and somatic symptoms, but also mood, wellbeing and quality of life. New data show that in many cases low-dose and ultralow-dose oestrogens are sufficient for a significant amelioration of climacteric symptoms, allowing to maintain the benefits and to lower the risks. Choosing transdermal instead of oral administration of MHT allows to minimize further the risks. The risks and benefits of MHT for the treatment of climacteric symptoms as well as non-hormonal alternatives will be discussed.

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Birkhaeuser, M. (2018). Climacteric Symptoms: Importance and Management. In: Birkhaeuser, M., Genazzani, A. (eds) Pre-Menopause, Menopause and Beyond. ISGE Series. Springer, Cham. https://doi.org/10.1007/978-3-319-63540-8_4

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