Change in menstrual pattern
Mood disorders (labile mood, depression)
Altered sexual function
Fatigue
Vasomotor symptoms
(hot flushes/night sweats)
Urogenital symptoms
Sleep disturbance
Problems with memory /concentration
Prescribing information and Adverse event reporting can be found at the bottom of the page
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Menopause, Perimenopause and endometrial protection
Menopause is a natural process when menstruation stops permanently because of loss of ovarian follicular activity. It coincides with follicular depletion and a drop in oestrogen and progesterone levels. A diagnosis is usually made after 12 months of amenorrhoea. The mean age of natural menopause is 51 years.
- Before the menopause, patients undergo a period of irregular cycles of ovulation and menstruation. This is called perimenopause.
- Some patients may undergo menopause earlier between the ages of 40-45 years. This is defined as early menopause. However before the diagnosis is made the causes of secondary amenorrhoea (i.e. pregnancy, cushing's syndrome, hormone secreting tumours etc) need to be excluded.
- If ovarian function is lost before the age of 40, this is referred to as premature ovarian insufficiency.
Symptoms
Diagnosis
Diagnosis is usually made clinically based on symptoms. A blood test is not usually indicated.
Serum follicle-stimulating hormone (FSH) levels may be considered in the following patients:
- over 45 years with atypical symptoms.
- suspected early menopause (i.e. menopausal symptoms between 40–45 years).
- suspected premature ovarian insufficiency (i.e. menopausal symptoms before age 40).
On average, most symptoms last around 4 years from when a woman’s periods end, however, around 1 in every 10 women experience them for up to 12 years1
History Taking
Important questions to consider during initial assessment are:
Symptoms and impact on quality of life
Past medical history
Contraception
Smear status
Previous treatment
Drug history
Family history including history of early menopause
Lifestyle
These questions will all help determine which treatment is necessary for the patient.
Menopause by Numbers1
51
Average age of menopause. Premature menopause affects 1 in 100 women under 40
4Yrs
Menopause symptoms typically continue around 4 years after last period
1.5M
Are estimated to be going through the menopause in the UK right now
80%
of those going through menopause experience common symptoms such as hot flushes and night sweats
How can Mirena® provide endometrial protection with oestrogen therapy
This video was delivered by Dr Diana Mansour, exploring how Mirena® IUS provides endometrial protection with oestrogen therapy.
Speaker: Dr Diana Mansour
Duration: 19 minutes 44 seconds
Perimenopause
An overview of what healthcare professionals need to know about the perimenopause and the considerations of fertility and dysfunctional bleeding during this part of a woman’s life course.
Learning Objectives:
- Definition of the perimenopause
- Fertility during the perimenopause, and the need for contraception
- Possible dysfunctional uterine bleeding and also HMB
- Brief overview of the role of HRT in the management of menopausal symptoms including endometrial protection in preparation for menopause
Speaker: Dr Sarah Gray
Duration: 33 minutes 54 seconds
Menopause – back to basics
An overview of what clinicians need to know about the menopause and hormone replacement therapy in the primary care setting based on NICE guideline:
[NG23] Menopause: diagnosis and management Published November 2015 (Last updated: December 2019) Available at: https://www.nice.org.uk/guidance/ng23/resources/menopause-diagnosis-and-management-pdf-1837330217413
Learning Objectives:
- Definition of menopause and premature menopause
- Physiology of the menstrual cycle and menopause
- The role of FSH levels in menopause and when to test
- Symptomology of menopause, the treatment options available and their associated risks
- Developing menopause understanding in the wider clinical setting
- Support groups available for patients undergoing the menopause
Speaker: Dr Julie Oliver
Duration: 31 minutes 28 seconds
RP-PF-WHC-GB-1291 June 2023
Case Studies
The following case studies have been designed to support healthcare professionals with their ongoing education on the topic of the menopause. Our expert menopause panel, Dr Diana Mansour, Dr Sarah Gray and Dr Julie Oliver will cover the diagnosis, investigations, treatments, referral and next steps in eight frequently seen cases.
Latest content
RP-PF-WHC-GB-0983 May 2022
Reporting adverse events and quality complaints
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Bayer plc.
If you want to report an adverse event or quality complaint, reports can be directed to: Tel: 01182063500 or email: pvuk@bayer.com
Further information is available on the “contact” tab at www.bayer.co.uk.
