Counseling Patients About Hormones and Alternatives for Menopausal Symptoms

Menopause is the process of permanent cessation of menstrual periods in women.1 For the majority of women, menopause begins in the early fifties, although some women experience menopause earlier due to surgery, chemotherapy or other causes. The onset of menopause is usually heralded by the slowing and eventual cessation of menses, as well as other physical and mental symptoms which vary widely (Table 1). Hot flash is the most common complaint in women in the US and UK, while joint pain is more common among Asian women.2 Most women report spontaneous resolution of symptoms within about five years. Women with menopause induced by surgery, chemotherapy, or other causes tend to report more severe, prolonged symptoms. Treatment for any woman with bothersome symptoms should be offered to improve quality of life.