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Menopause
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Menopause

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Contributors: Mitchell Linder MD
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Synopsis

Menopause is the time in a woman's reproductive lifecycle when she undergoes multiple changes related to hormone shifts, causing cessation of ovulation and menstruation. The average age of occurrence is at 51.2 years. It is clinically defined as 1 year without menses.

Periods can stop abruptly, or the transition can occur with irregular-length cycles over many months to years. Often, women experience symptoms of hot flashes, night sweats, vulvovaginal dryness, difficulty sleeping, mood symptoms, and a change in energy levels. Factors that may contribute to an earlier age of menopause are smoking, alcohol use disorder, certain autoimmune disorders, chemotherapy, surgery, and some genetic disorders.

The time directly preceding menopause is called perimenopause and sometimes can last 4-8 years. Perimenopause begins with the first irregular menses (usually a change in cycle length) and culminates at menopause with the final menses.

Codes

ICD10CM:
Z78.0 – Asymptomatic menopausal state

SNOMEDCT:
161712005 – Menopause

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Premature ovarian insufficiency – Age 40 or younger with absence of menstruation. Check lab work to rule out other causes of secondary amenorrhea.
  • Medical menopause – Usually secondary to chemotherapy; often happens at younger ages. If periods are to return, it usually happens within the first year of finishing chemotherapy. If ovulation occurs during this time, it is possible to become pregnant.

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 05/15/2017
Last Updated: 06/06/2017
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Menopause
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Menopause (Menopausal Transition) : Night sweats, Sleep disturbance
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