obsolete symptomatic menopausal or female climacteric state

Definition of Climacteric State

The climacteric state refers to a transitional period in women's lives, marking the passage from reproductive to non-reproductive stage. This phase encompasses premenopause, perimenopause (menopause), and postmenopause.

• Premenopause: The period leading up to menopause, characterized by hormonal changes and potential symptoms such as hot flashes, sleep disturbances, and mood changes [1].
• Perimenopause: The transition period around the time of menopause, during which hormone levels fluctuate, and symptoms like hot flashes, night sweats, and vaginal dryness become more pronounced [2].
• Postmenopause: The stage after menopause, where ovarian function has ceased, and hormone levels have stabilized. However, some women may still experience residual symptoms or new issues such as osteoporosis, cardiovascular disease, or cognitive decline [3].

Key Symptoms of Climacteric State

Common symptoms associated with the climacteric state include:

• Hot flashes and night sweats
• Sleep disturbances
• Vaginal dryness and dyspareunia (painful sex)
• Mood changes and depression
• Weight gain or redistribution
• Osteoporosis and bone density loss
• Cardiovascular disease risk increase

References

[1] Context result 5: "In general, the menopause is considered a mark of the climacteric, although climacteric symptoms frequently precede the cessation of menstruation by months..."

[2] Context result 9: "Vasomotor symptoms (VMS), more commonly known as hot flushes or flashes and night sweats, are the cardinal symptoms of menopause, occurring in..."

[3] Context result 6: "Other climacteric symptoms include sleep disturbance (6, 7), arthralgia (7–9), and vaginal dryness and dyspareunia (7, 10, 11)."

Menopause Symptoms: A Comprehensive Overview

Menopause, also known as the female climacteric state, is a natural biological process that occurs in women, typically between the ages of 45 and 55. During this transition, hormone levels fluctuate, leading to various physical and emotional symptoms.

Common Signs and Symptoms:

• Irregular periods: Changes in menstrual cycle length or heaviness [1][2]
• Hot flashes: Sudden feelings of warmth that spread over the body [2][4]
• Vaginal dryness: Decreased estrogen levels can cause vaginal dryness and discomfort [3][5]
• Mood changes: Irritability, anxiety, and depression are common emotional symptoms [1][3]
• Sleep problems: Difficulty sleeping or insomnia due to hot flashes and other symptoms [2][5]
• Night sweats: Hot flashes that occur at night, disrupting sleep patterns [4][9]
• Vaginal and bladder problems: Decreased estrogen levels can cause vaginal dryness, itching, and urinary incontinence [3][5]

Other Symptoms:

• Cardiac effects: Increased risk of heart disease due to hormonal changes [4]
• Hair growth: Some women experience hair growth on the face or body during menopause [4]
• Mental health: Menopause can lead to anxiety, depression, and mood swings [1][3]

Perimenopause: A Transition Phase

Perimenopause is a transitional phase that occurs before menopause, where hormone levels fluctuate, leading to symptoms similar to those experienced during menopause. These symptoms can include irregular periods, hot flashes, and mood changes [7].

Menopause Diagnosis

A healthcare professional can diagnose menopause based on the absence of menstrual periods for 12 months or more, combined with other symptoms [8][9].

Diagnosing Menopause: A Review of Diagnostic Tests

Menopause is a natural biological process in women, typically occurring between the ages of 45 and 55. The diagnostic tests for menopause are primarily based on clinical symptoms and hormonal changes.

• Clinical Symptoms: The diagnosis of menopause is often made based on typical complaints such as vaginal dryness, discomfort, itching, or dyspareunia (painful intercourse) in women undergoing the menopausal transition or older.
• Hormonal Changes: Measuring serum levels of anti-mullerian hormone (AMH), day 3 follicle-stimulating hormone (FSH), and estrogen can help evaluate ovarian reserve during menopause. However, these tests are not always necessary for diagnosis.

Diagnostic Tests

The following diagnostic tests may be used to confirm a diagnosis of menopause:

• Endometrial Biopsy: Typically recommended as the initial diagnostic test for women with abnormal postmenopausal bleeding due to its high sensitivity and specificity.
• Blood Tests: Blood tests, such as measuring FSH or AMH levels, can help evaluate ovarian reserve during menopause. However, these tests are not always necessary for diagnosis.

Other Considerations

It's essential to note that local estrogen therapy is preferred for vulvovaginal symptoms due to its excellent therapeutic response. Additionally, bone mineral density screening should be considered in postmenopausal women to assess the risk of osteoporosis.

References

• [1] Diagnosis is primarily based on typical complaints of vaginal dryness, discomfort, itching, or dyspareunia in women undergoing the menopause transition or older.
• [2] by SR Lee · 2020 · Cited by 76 — To evaluate the ovarian reserve during menopausal transition, measuring the serum level of anti-mullerian hormone (AMH), day 3 follicle-stimulating hormone (FSH) ...
• [4] by SS RAO · 2008 · Cited by 38 — Local estrogen is preferred for vulvovaginal symptoms because of its excellent therapeutic response.
• [9] Apr 7, 2009 — Endometrial biopsy is typically recommended as the initial diagnostic test for women with abnormal postmenopausal bleeding because of its high ...

The differential diagnosis of menopause, also known as the female climacteric state, involves identifying and ruling out other conditions that may present with similar symptoms.

Conditions to consider:

• Hyperthyroidism: This condition can cause hot flashes, sweating, weight loss, and irregular menstrual cycles, which are similar to menopausal symptoms [2].
• Hypothyroidism: On the other hand, hypothyroidism can lead to fatigue, weight gain, and changes in menstrual cycle, which may be mistaken for menopause [2].
• Hyperprolactinemia: This condition can cause irregular menstrual cycles, amenorrhea (absence of menstruation), and hot flashes, similar to menopausal symptoms [9].
• Pregnancy: Although rare, pregnancy can present with irregular menstrual cycles and hot flashes, which may be mistaken for menopause [9].
• Multiple sclerosis: This autoimmune disease can cause autonomic disorders, including hot flashes, insomnia, and weight gain, which are similar to menopausal symptoms [4].

Other conditions:

• Autonomic disorders: Certain conditions like multiple sclerosis, tumors, or other diseases can present with symptoms similar to menopause, such as hot flashes, insomnia, and mood changes [4].
• Genitourinary syndrome of menopause: This condition is a result of estrogen deficiency and can cause vaginal dryness, pain during sex, and urinary symptoms, which may be mistaken for menopausal symptoms [1].

Key diagnostic factors:

• Amenorrhea (absence of menstruation)
• Irregular menstrual cycle
• Hot flashes and night sweats
• Vaginal symptoms
• Mood changes

It's essential to consult a healthcare professional for an accurate diagnosis, as these conditions can have different treatment approaches.

References:

[1] by RF Casper · Cited by 57 — Hot flashes · Depression · Sleep disturbance · Cognitive changes · Genitourinary syndrome of menopause · Other. [2] by KA Martin · 2008 · Cited by 117 — Hyperthyroidism should always be considered in the differential diagnosis of menopausal symptoms because irregular menses, sweating (although ... [3] Feb 17, 2021 — Differential diagnosis of menopause from other diseases · Hot flashes · Insomnia · Weight gain and bloating · Mood changes. [4] Jul 22, 2024 — A variety of symptoms commonly associated with menopause may actually indicate autonomic disorders such as multiple sclerosis, tumors, such as ... [5] Dec 8, 2023 — Key diagnostic factors · amenorrhea · irregular menstrual cycle · hot flashes and night sweats · vaginal symptoms · mood changes. [6] Aug 7, 2024 — Most people can tell by the symptoms that they've started menopause. If you have worries about irregular periods or hot flashes, talk with your ... [7] by D Mohyi · 1997 · Cited by 134 — The purpose of this study is to present the physiology and differential diagnosis of hot flashes, other than associated with menopause. [8] The following menopausal symptoms may also be caused by other conditions: Secondary amenorrhoea, Irregular vaginal bleeding, Hot flushes. [9] The differential diagnosis for irregular or absent menstrual periods include: Pregnancy; Hyperthyroidism or hypothyroidism; Hyperprolactinaemia. The skin ...