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{{CMG}} {{RA}}
{{CMG}} {{RA}}
==Overview==
==Overview==
The most common [[symptoms]] of [[menopause]] include [[hot flashes]], [[night sweats]], [[Headache|headach]], [[palpitations]], [[dyspareunia]], [[stress incontinence]], [[urgency]], [[frequency]], [[dysuria]], [[Anxiety Disorder|anxiety]], [[sleep disturbance]], [[depression]]. In addition to some less common [[symptoms]] of [[menopause]] include loss of [[Concentrations|concentration]], and loss of self confidence.
The hallmark of [[menopause]] is [[amenorrhea]]. The most common [[symptoms]] of [[menopause]] include [[hot flashes]], [[night sweats]], [[Headache|headach]], [[palpitations]], [[dyspareunia]], [[stress incontinence]], [[urgency]], [[frequency]], [[dysuria]], [[Anxiety Disorder|anxiety]], [[sleep disturbance]], [[depression]]. Less common [[symptoms]] of [[menopause]] include loss of [[Concentrations|concentration]], and loss of self confidence.


==Symptoms of perimenopause==
==History==
The [[perimenopausal]] symptoms are caused by an overall drop in the levels of [[Estrogen|estrogens]], [[progestin]]. Some of these [[symptoms]] may be associated with the hormonal [[withdrawal]] process and as the [[body]] adapts to the changing levels of natural [[hormones]], the [https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397 menopausal symptoms] appear. Most of the [[symptoms]] happen in the [[menopausal]] transition period, together with these [[symptoms]], the woman may also have increasingly erratic [[menstrual periods]]. 
Obtaining a patient's history is an important aspect of making the [[diagnosis]] of [[menopause]]. It provides an insight into precipitating factors and associated comorbid [[conditions]]. A complete history will help determine the correct [[therapy]] and helps in determining the [[prognosis]]. Specific histories about the [[symptoms]] (duration, onset, progression), associated [[symptoms]]. Specific areas of focus when obtaining the history, are outlined below:


'''Vasomotor symptoms:''' Approximately, 75% of women have a positive history of [https://www.contemporaryobgyn.net/view/managing-menopause-part-1-vasomotor-symptoms vasomotor symptoms]
*Onset, duration, and progression of [[symptoms]] especially ( [[Hot flashes]], [[urinary symptoms]], [[joint pain]]).
*History of the [[menstrual cycle]]
*Associated symptoms such as [[depression]], [[sleep disturbance]].
*History of Co-morbid conditions such as  [[Hypertension]], [[Heart disease]], [[Diabetes mellitus|Diabetes Mellitus]].
*[[Medications]]
*History of [[smoking]] and tobacco.


*[[Hot flashes]] are a sudden feeling of heat in [[face]] and [[neck]] may with red blotches on the [[chest]], [[back]], and [[arm]]<ref>https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief</ref> that are happened three to four minutes,<ref>https://www.ncbi.nlm.nih.gov/books/NBK507826/#!po=10.0000</ref> associated with [[sweating]]. [[Hot flash|Hot flashes]] are the most common [[symptom]] and most women have [[hot flashes]] for 6 months to 2 years, but some [[women]] may experience them for 10 years or longer.<ref>http://www.menopause.org/docs/default-source/2014/nams-recomm-for-clinical-care.pdf</ref>
==Symptoms of Menopause==
 
The [https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397 menopausal symptom] happens in the [[Perimenopausal|menopausal transition period]]. The most common [[symptom]] is the increasingly erratic [[menstrual period]] together with these [[symptoms]] the woman may also have.<ref name="pmid17666595">{{cite journal| author=Freeman EW, Sammel MD, Lin H, Gracia CR, Pien GW, Nelson DB | display-authors=etal| title=Symptoms associated with menopausal transition and reproductive hormones in midlife women. | journal=Obstet Gynecol | year= 2007 | volume= 110 | issue= 2 Pt 1 | pages= 230-40 | pmid=17666595 | doi=10.1097/01.AOG.0000270153.59102.40 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17666595  }} </ref><ref name="pmid29393299">{{cite journal| author=Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T| title=Symptoms of menopause - global prevalence, physiology and implications. | journal=Nat Rev Endocrinol | year= 2018 | volume= 14 | issue= 4 | pages= 199-215 | pmid=29393299 | doi=10.1038/nrendo.2017.180 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29393299  }} </ref>
 
'''Vasomotor symptoms:'''<ref name="pmid19002017">{{cite journal| author=Crandall CJ, Zheng Y, Crawford SL, Thurston RC, Gold EB, Johnston JM | display-authors=etal| title=Presence of vasomotor symptoms is associated with lower bone mineral density: a longitudinal analysis. | journal=Menopause | year= 2009 | volume= 16 | issue= 2 | pages= 239-46 | pmid=19002017 | doi=10.1097/gme.0b013e3181857964 | pmc=2695505 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19002017  }} </ref>
 
*[[Hot flashes]] are a sudden feeling of heat in [[face]] and [[neck]] may with red blotches on the [[chest]], [[back]], and [[arm]] that are happened three to four minutes associated with [[sweating]]. [[Hot flash|Hot flashes]] are the most common [[symptom]] and most [[women]] have [[hot flashes]] for 6 months to 2 years, but some [[women]] may experience them for 10 years or longer.
*[[sleep hyperhidrosis|night sweats]]
*[[sleep hyperhidrosis|night sweats]]
*[[palpitations]]
*[[palpitations]]
*[[migraines]]
*[[migraines]]


'''Urogenital symptoms''': Approximately 60% of [[women]] have a positive history of [[urogenital]] symptoms include [[vaginal]] symptoms because of [[vaginal atrophy]] and [[urinary symptoms]] because of [[Urethra|urethral]] atrophy as well as [[sexual dysfunction]] symptom.
'''Urogenital symptoms''':


*[[Vaginal]] symptoms
[https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/vagina/art-20046562 Vaginal symptoms]<ref name="pmid30601037">{{cite journal| author=Cagnacci A, Xholli A, Sclauzero M, Venier M, Palma F, Gambacciani M | display-authors=etal| title=Vaginal atrophy across the menopausal age: results from the ANGEL study. | journal=Climacteric | year= 2019 | volume= 22 | issue= 1 | pages= 85-89 | pmid=30601037 | doi=10.1080/13697137.2018.1529748 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30601037  }} </ref>


#[[Pruritus]]
*[[Pruritus]]
#[[Vaginal dryness|Dryness]]
*[[Vaginal dryness|Dryness]]
#[[Vaginal bleeding|Irregular bleeding]]
*[[Vaginal bleeding|Irregular bleeding]]
#[[Dyspareunia]] ([[painful intercourse]])
*[[Dyspareunia]] ([[painful intercourse]])


*Urinary symptoms
[[Urinary symptoms]]<ref name="pmid26366796">{{cite journal| author=Calleja-Agius J, Brincat MP| title=The urogenital system and the menopause. | journal=Climacteric | year= 2015 | volume= 18 Suppl 1 | issue=  | pages= 18-22 | pmid=26366796 | doi=10.3109/13697137.2015.1078206 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26366796  }} </ref>


#[[Polyuria]]
*[[Polyuria]]
#[[Urinary urgency|Urgency]]
*[[Urinary urgency|Urgency]]
#[[Stress incontinence]]
*[[Stress incontinence]]
#[[Dysuria]]
*[[Dysuria]]


*Sexual dysfunction symptom
[[Sexual dysfunction|Sexual dysfunction symptom]]<ref name="pmid26316248">{{cite journal| author=Thornton K, Chervenak J, Neal-Perry G| title=Menopause and Sexuality. | journal=Endocrinol Metab Clin North Am | year= 2015 | volume= 44 | issue= 3 | pages= 649-61 | pmid=26316248 | doi=10.1016/j.ecl.2015.05.009 | pmc=5994393 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26316248  }} </ref>


#[[Libido|Decreased libido]]
*[[Libido|Decreased libido]]
#Problems reaching [[orgasm]]
*Problems reaching [[orgasm]]
*[[Dyspareunia]]


'''Skeletal''' <ref>https://pubmed.ncbi.nlm.nih.gov/17666595/</ref>
'''Skeletal symptoms:'''  


*[[Osteoporosis]] gradually developing over time<ref></ref>
*[[Osteoporosis]] gradually developing over time.<ref name="pmid29583083">{{cite journal| author=Watts NB| title=Postmenopausal Osteoporosis: A Clinical Review. | journal=J Womens Health (Larchmt) | year= 2018 | volume= 27 | issue= 9 | pages= 1093-1096 | pmid=29583083 | doi=10.1089/jwh.2017.6706 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29583083  }} </ref>
*[[Arthralgia|Joint pain]], [[myalgia|muscle pain]]
*[[Arthralgia|Joint pain]], [[myalgia|muscle pain]]
*[[Back pain]]
*[[Back pain]]


'''Skin, soft tissue'''
'''Skin, soft tissue symptoms:'''


*[[Breast]] atrophy
*[[Breast]] atrophy
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*Decreased [[Elasticity (economics)|elasticity]]
*Decreased [[Elasticity (economics)|elasticity]]


'''Psychological: Approximately 45% of women have a positive history of [[psychogenic]] symptoms. '''
'''Psychological symptoms:'''<ref name="pmid21971211">{{cite journal| author=Oppermann K, Fuchs SC, Donato G, Bastos CA, Spritzer PM| title=Physical, psychological, and menopause-related symptoms and minor psychiatric disorders in a community-based sample of Brazilian premenopausal, perimenopausal, and postmenopausal women. | journal=Menopause | year= 2012 | volume= 19 | issue= 3 | pages= 355-60 | pmid=21971211 | doi=10.1097/gme.0b013e31822ba026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21971211  }} </ref>


*[[Mood disturbances|Mood disturbance]]
*[[Mood disturbances|Mood disturbance]]
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*[[Irritability]]
*[[Irritability]]
*[[Anxiety Disorder|Anxiety]]
*[[Anxiety Disorder|Anxiety]]
*Poor [[Memory]]: as a result of [[depression]] and loss of [[sleep]] but not due to deficiency of [[estrogen]] hormone'''.'''
*Poor [[Memory]]: as a result of [[depression]] and loss of [[sleep]] but not due to deficiency of [[Estrogen|estrogen hormone]]'''.'''
*[[Depression]]
*[[Depression]]
*Loss of [[concentration]]
*Loss of [[concentration]]
*Loss of self-confidence
*Loss of self-confidence


A [[cohort study]] found that [[menopause]] was associated with [[hot flash|hot flushes]]; [[joint pain]] and [[muscle pain]]; and [[Depression (mood)|depressed mood]].<ref name="pmid17666595">{{cite journal |author=Freeman EW, Sammel MD, Lin H, ''et al'' |title=Symptoms associated with menopausal transition and reproductive hormones in midlife women |journal=Obstetrics and gynecology |volume=110 |issue=2 Pt 1 |pages=230-40 |year=2007 |pmid=17666595 |doi=10.1097/01.AOG.0000270153.59102.40}}</ref> [[Menopause]] was not associated with poor [[sleep]], [[decreased libido]], and [[vaginal lubrication|vaginal dryness]], and happens of these [[symptoms]] in the late [[menopausal]] transition years.
A [[cohort study]] found that [[menopause]] was associated with [[hot flash|hot flushes]], [[joint pain]], [[muscle pain]], and [[Depression (mood)|depressed mood]]. [[Menopause]] was not associated with poor [[sleep]], [[decreased libido]], and [[vaginal lubrication|vaginal dryness]], and happens of these [[symptoms]] in the late [[menopausal]] transition years.
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 00:41, 3 March 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Rahmah Al-Edresi, M.D.[2]

Overview

The hallmark of menopause is amenorrhea. The most common symptoms of menopause include hot flashes, night sweats, headach, palpitations, dyspareunia, stress incontinence, urgency, frequency, dysuria, anxiety, sleep disturbance, depression. Less common symptoms of menopause include loss of concentration, and loss of self confidence.

History

Obtaining a patient's history is an important aspect of making the diagnosis of menopause. It provides an insight into precipitating factors and associated comorbid conditions. A complete history will help determine the correct therapy and helps in determining the prognosis. Specific histories about the symptoms (duration, onset, progression), associated symptoms. Specific areas of focus when obtaining the history, are outlined below:

Symptoms of Menopause

The menopausal symptom happens in the menopausal transition period. The most common symptom is the increasingly erratic menstrual period together with these symptoms the woman may also have.[1][2]

Vasomotor symptoms:[3]

Urogenital symptoms:

Vaginal symptoms[4]

Urinary symptoms[5]

Sexual dysfunction symptom[6]

Skeletal symptoms:

Skin, soft tissue symptoms:

Psychological symptoms:[8]

A cohort study found that menopause was associated with hot flushes, joint pain, muscle pain, and depressed mood. Menopause was not associated with poor sleep, decreased libido, and vaginal dryness, and happens of these symptoms in the late menopausal transition years.

References

  1. ↑ Freeman EW, Sammel MD, Lin H, Gracia CR, Pien GW, Nelson DB; et al. (2007). "Symptoms associated with menopausal transition and reproductive hormones in midlife women". Obstet Gynecol. 110 (2 Pt 1): 230–40. doi:10.1097/01.AOG.0000270153.59102.40. PMID 17666595.
  2. ↑ Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T (2018). "Symptoms of menopause - global prevalence, physiology and implications". Nat Rev Endocrinol. 14 (4): 199–215. doi:10.1038/nrendo.2017.180. PMID 29393299.
  3. ↑ Crandall CJ, Zheng Y, Crawford SL, Thurston RC, Gold EB, Johnston JM; et al. (2009). "Presence of vasomotor symptoms is associated with lower bone mineral density: a longitudinal analysis". Menopause. 16 (2): 239–46. doi:10.1097/gme.0b013e3181857964. PMC 2695505. PMID 19002017.
  4. ↑ Cagnacci A, Xholli A, Sclauzero M, Venier M, Palma F, Gambacciani M; et al. (2019). "Vaginal atrophy across the menopausal age: results from the ANGEL study". Climacteric. 22 (1): 85–89. doi:10.1080/13697137.2018.1529748. PMID 30601037.
  5. ↑ Calleja-Agius J, Brincat MP (2015). "The urogenital system and the menopause". Climacteric. 18 Suppl 1: 18–22. doi:10.3109/13697137.2015.1078206. PMID 26366796.
  6. ↑ Thornton K, Chervenak J, Neal-Perry G (2015). "Menopause and Sexuality". Endocrinol Metab Clin North Am. 44 (3): 649–61. doi:10.1016/j.ecl.2015.05.009. PMC 5994393. PMID 26316248.
  7. ↑ Watts NB (2018). "Postmenopausal Osteoporosis: A Clinical Review". J Womens Health (Larchmt). 27 (9): 1093–1096. doi:10.1089/jwh.2017.6706. PMID 29583083.
  8. ↑ Oppermann K, Fuchs SC, Donato G, Bastos CA, Spritzer PM (2012). "Physical, psychological, and menopause-related symptoms and minor psychiatric disorders in a community-based sample of Brazilian premenopausal, perimenopausal, and postmenopausal women". Menopause. 19 (3): 355–60. doi:10.1097/gme.0b013e31822ba026. PMID 21971211.


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