WOMEN 'S HEALTH AND MENOPAUSE : - National Heart, Lung ...

CHAPTER 3: SYMPTOMS AND THE MENOPAUSE
Lorraine Dennerstein, A.O., M.B.B.S., Ph.D., F.R.A.N.Z.C.P., D.P.M.;* Janet Guthrie, M.Sc., Dip. Ed. Ph.D.; † Martin
Birkhäuser, M.D.; ‡ Sherry Sherman, Ph.D. §
KEY POINTS a
1. Conflicting findings regarding which symptoms are related to hormonal
changes of menopause reflect different research methodologies and their
limitations.
2. When symptom checklists are used, middle-aged women are highly
symptomatic.
3. Age related symptoms may be differentiated from those related to the
menopausal phase.
4. Only vasomotor symptoms, vaginal atrophic symptoms, and breast tenderness
consistently vary with the phase of the menopause transition and are
significantly affected by the administration of hormones in double blind
RCTs [A].
5. Other symptoms, such as insomnia and mood, may be affected by the
presence of bothersome vasomotor symptoms.
6. Symptoms are influenced by psychosocial and lifestyle factors.
* From the Office for Gender and Health, Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Australia.
† From the Office for Gender and Health, Department of Psychiatry, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne,
Australia.
‡ From the Division of Gynaecological Endocrinology, Department of Obstetrics and Gynaecology, University of Bern, Switzerland.
§ From the Clinical Endocrinology and Osteoporosis Research Branch, National Institute on Aging, NIH, Bethesda, MD U.S.A.
Conflicting findings
regarding which
symptoms are related
to hormonal changes
of menopause reflect
different research
methodologies and
their limitations.
a Evidence categories are given in square brackets. A = randomized controlled trials (rich body of data); B = randomized controlled trials (limited data);
C = nonrandomized trials and observational epidemiologic studies; D = Panel expert judgement. (See also table 1–1).
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