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Latest revision as of 15:59, 2 August 2020

Menopause Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Editor-In-Chief: Rahmah Al-Edresi, M.D.


Overview

Menopause is typically beginning between the ages of 51 and 52, age at menopause is also higher in the West as compared to the range of 45-47 years in developing countries. About 25 million women pass through menopause each year, In the United States, approximately 1.3 million women become menopausal each year. By 2030, the world population of menopausal and postmenopausal women is projected to increase to 1.2 billion."Symptomatically of menopause differs in different areas of the world e.g In West - hot flush, in Japan shoulder pain and India low vision are the hallmarks of menopause. HRT use rate is high in the West while it is low or negligible in countries like India".85 % of postmenopausal women have experienced a menopause-related symptom in their lifetime, 15% increased the risk of causes mortality among women at an early age at menopause. The ethnic differences in the symptoms experienced during the menopausal transition were noted. Asian women had experienced the smallest number of menopausal symptoms compared with all other ethnic groups, but African American women had experienced the largest number of menopausal symptoms compared with other ethnic groups.


Epidemiology and Demographics

Prevalence and Incidence

  • "About 25 million women pass through menopause each year and were estimated that in 1990 there were 467 million post-menopausal women in the world, with an average age of about 60 years. By 2030, the world population of menopausal and postmenopausal women is projected to increase to 1.2 billion, with 47 million new entrants each year. In the United States, approximately 1.3 million women become menopausal each year".[1][2]
  • "To assess the prevalence of menopausal symptoms among women prescribed hormone therapy (HT) using electronic medical record data from a regional healthcare organization, the mean age of patients was 54 years. The most common menopausal symptoms were: hot flushes (40 %), night sweats (17 %), insomnia (16 %), vaginal dryness (13 %), mood disorders (12 %), and weight gain (12 %). Among the 102 patients, 163 individual visits listing menopausal symptoms were identified, of which hot flushes (71 visits) were the most common symptom identified. 85 % of postmenopausal women have experienced a menopause-related symptom in their lifetime, and the Prevalence of vasomotor symptoms( hot flushes and/or night sweats) alone is estimated at approximately 40 to 50 million women in the United States".[3]
  • "Symptomatically of menopause differs in different areas of the world e.g In West - hot flush, in Japan shoulder pain and India low vision are the hallmarks of menopause. HRT use rate is high in the West while it is low or negligible in countries like India".[4]



Age

  • "Menopause is typically beginning between the ages of 51 and 52. However, about 5% of women experience early menopause between the ages of 40 and 45. Additionally, 1% of women experience premature menopause before the age of 40, due to permanent ovarian failure that may be associated with sex chromosome abnormalities".[5]
  • "Age at menopause is also higher in the West as compared to the range of 45-47 years in developing countries like India. Historically also a lower age at menopause was range documented in earlier times. This rose to the range of 50-51 years in the present era".[4]


Mortality rate

15% increased the risk of causes mortality among women at an early age at menopause. The relationship between menopause and mortality is unclear, Increased causes of mortality risk in women that never using postmenopausal hormones with natural menopause at ages <40. This study indicates that HRT use among women who experienced menopause at <45 years of age may increase the risk of mortality, women that are using estrogen and estrogen plus progestin therapy become have more increased risk for stroke. Another review reported a low risk of stroke for oral estrogen use among women who began HRT before age 65.[6]

Race

  • Data regarding racial differences in age at menopause have been mixed with several small studies reporting that menopause occurs approximately six months earlier in Black women when compared to age-matched White women, while other larger studies have reported no racial difference. The ethnic differences in the symptoms experienced during the menopausal transition were noted. Asian women had experienced the smallest number of menopausal symptoms compared with all other ethnic groups, but African American women had experienced the largest number of menopausal symptoms compared with other ethnic groups. Brazilian women had experienced highly prevalent and similar vasomotor symptoms like Western women.[7]




References

  1. Hill K (1996). "The demography of menopause". Maturitas. 23 (2): 113–27. doi:10.1016/0378-5122(95)00968-x. PMID 8735350.
  2. https://www.ncbi.nlm.nih.gov/books/NBK507826/#article-24984.s11
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542113/#:~:text=With%20the%20aging%20of%20the,the%20year%202030%20%5B1%5D.
  4. 4.0 4.1 Singh A, Kaur S, Walia I (2002). "A historical perspective on menopause and menopausal age". Bull Indian Inst Hist Med Hyderabad. 32 (2): 121–35. PMID 15981376.
  5. https://www.ncbi.nlm.nih.gov/books/NBK507826/#article-24984.s11
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651856/#:~:text=Increased%20all%2Dcause%20mortality%20risk%20was%20reported%20in%20the%20BWHS,associations%20were%20found%20for%20ever%2D
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670463