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Author: Vanessa Ngan, Staff Writer, 2002.
Strictly speaking, menopause is defined as the day a woman has been diagnosed as not having a menstrual period for 12 consecutive months. This signifies the permanent cessation of menstruation. The period leading up to menopause is described in several ways, menopausal transition, peri-menopause or climacteric. During this time, which may precede several years before menopause, fluctuations in menstrual cycles and hormonal changes occur. This is evident from the signs and symptoms that a woman may experience.
Common peri-menopausal signs and symptoms include:
The term genitourinary syndrome of menopause describes:
On average menopause occurs as women reach early to mid-50 years. Leading into this time changes in hormone production occur, most notably a decline in oestrogen levels (hypo-oestrogenism).
Oestrogen affects every organ system of the body including the skin. Oestrogen receptors are most abundant around the genital area, face and lower limbs. Therefore these areas are especially vulnerable to reduced amounts of circulating oestrogen and are the reason for certain skin conditions involving these areas to be more common in peri- and post-menopausal women than in women of other age groups.
Vulvar lichen sclerosus
Hirsutism (abnormal hair growth in women)
Alopecia (hair loss from areas where it is normally present)
Hormone replacement therapy (HRT) has been shown to prevent many of the signs and symptoms experienced in peri- and post-menopause, including urogenital and general skin and hair problems. Systemic HRT may consist of oestrogen tablets, patches, vaginal rings, implants, or a combination of oestrogen and progestogen as patch or tablet.
HRT is no longer recommended for healthy asymptomatic women.
Oestrogen cream is particularly useful for atrophic vulvovaginitis, and systemic absorption and side effects are minimal.
Other treatments for the genitourinary syndrome of menopause may include:
Vulvovaginal Disorders: an algorithm for basic adult diagnosis and treatment — ISSVD
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