Defination Of Menopause : Permanent of cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity cycle is called menopause.

We will describe :

Common cause of delayed menopause:

What are the clinical features of menopause?

post- menopausal and complication?

Management of menopausal syndrome


What are the common cause of delayed menopause?

Common cause of delayed menopause: 

  • Constitutional
  • Fibroid uterus
  • Diabetes mellitus.
  • Oestrogenic tumor of the ovary.

What are the clinical features of menopause?

Clinical Features:

A. Vasomotor symptoms:

  1. Hot Flushes.
  2. Night sweats.
  3. Insomnia
  4. Weakness.

B. Uro- genital symptoms:

  • Urinary incontinence
  • Dysuria
  • Recurrent urinary tract infection.
  • Dyspareunia
  • Vaginal dryness
  • Genital prolapse

C. Neuro- endocrine symptoms:

  • Dizziness
  • Headache
  • Insomnia
  • Irritability

D. Skeletal disease:

  • Osteoporosis.
  • Bone pain
  • Fracture of bones.

E. Cardiovascular disease:

  • Coronary heart disease.
  • Ischemic heart disease.

F. Skin Changes: 

  • Decreased in elasticity.
  • Skin becomes dry as a result, decreasing sweats and sebaceous glands.
  •  Decrease melanophore activity
  • Decrease thermal insulting capacity.

How will you manage a women with menopausal syndrome?


Management of menopausal syndrome : 


History : 

  • Assessment of mental build up of the patient.
  • Her social and economical status.
  • Sexual life.
  • Any gynecological problem.
  • Obstetrics history.
  • Family history.
  • Smoking history
  • Dietary habit


Diagnosis : 

  • Cessation of menstruation for consecutive 12 months during climacteric.
  • Appearance of menopausal symptoms hot flush and night sweats.
  • Serum oestradiol; <20pg/ml

Treatment : 

A. Non hormonal treatment : 

  • Nutritious diet.
  • Supplementary calcium.
  • Exercise
  • Vitamin-D supplementation
  • Cessation of smoking and alcohol
  • Bisphosphonates prevents osteoclastic bone resorption
  • Fluoride prevents osteoporosis.
  • Calcitonin inhibits bone resorption
  • Clonidine reduce urinary calcium excretion
  • Paroxetine is effective to reduce hot flushes
  • Gabapentine.
  • Phytoestrigens.
  • Soy protein

B. Hormonal Replacement therapy  : 

  • Oestrogen.
  • Combined oestrogen and progesterone preparation
  • Mixed oestrogen and androgenic preparation.


How will you prevent post- menopausal and complication?


 Prevent of post – menopausal symptoms and complication:

  • Spontaneous menopause is unavoidable. However, artificial menopause induced by surgery (bilateral-oophorectomy) or by radiation (gonadal) during reproductive period can to some extant be preventable or delayed.
  • Counseling: Every woman with posmenopausal symptoms should be adequately explained about the physiologic events. This will remove the fears, and minimize or dispel the symptoms of anxiety, depression and insomnia.
  • Reassurance is essential.


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