Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- presencia de factores de riesgo
- amenorrea
- ciclo menstrual irregular
- sofocos y sudores nocturnos
- síntomas vaginales
- cambios en el estado de ánimo
Otros factores de diagnóstico
- alteración del sueño
- deterioro leve de la memoria
- sangrado menstrual abundante
Factores de riesgo
- 40 a 60 años de edad
- tratamiento del cáncer
- tabaquismo
- cirugía ovárica
- edad de la madre en la menopausia
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- prueba de embarazo
Pruebas diagnósticas que deben considerarse
- hormona foliculoestimulante (FSH)
- estradiol sérico
Algoritmo de tratamiento
presentación inicial con síntomas vasomotores leves
mujeres no histerectomizadas, sofocos de moderados a graves con/sin reducción de la libido
mujeres histerectomizadas o con dispositivo intrauterino liberador de levonorgestrel colocado en los últimos 5 años, sofocos moderados a severos, con/sin libido reducida
solo atrofia urogenital
solo incontinencia urinaria de estrés
Colaboradores
Autores
Heather Currie, MB BS, FRCOG, DRCOG, MRCGP
Clinical Director Women and Sexual Health
NHS Dumfries and Galloway
Dumfries and Galloway Royal Infirmary
Scotland
UK
Divulgaciones
HC declares that she has no competing interests.
Haitham Hamoda, MBChB, MD, FRCO
Consultant Gynaecologist
Clinical Lead for Menopause Service
King's College Hospital NHS Trust
London
UK
Divulgaciones
HH declares that he has no competing interests.
Bradford W. Fenton, MD, PhD, FACOG
Independence Park Medical Services
Anchorage
AK
Divulgaciones
BWF declares that he has no competing interests.
Agradecimientos
Dr Heather Currie, Dr Haitham Hamoda, and Dr Bradford W. Fenton would like to gratefully acknowledge Dr Rebekah Wang-Cheng, a previous contributor to this topic.
Divulgaciones
RWC declares that she has no competing interests.
Revisores por pares
Nan Gillespie O’Connell, MD
Assistant Professor
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Divulgaciones
NGOC declares that she has no competing interests.
Carolyn Simpkins, MD, PhD
Internist
Daniel Island
SC
Declarações
CS declares that she has no competing interests.
Edward Morris, MD
Consultant
Honorary Senior Lecturer and Clinical Director
Department of Obstetrics and Gynaecology
Norfolk and Norwich University Hospital
Norwich
UK
Declarações
EM declares that he has no competing interests.
Michelle Warren, MD
Professor of Medicine and Obstetrics & Gynecology
Obstetrics and Gynecology
Columbia University in New York Medical Center
New York
NY
Declarações
MW has received research funding from Ferring and Pfizer Wyeth; has acted as an advisory board consultant for Pfizer Wyeth, QuatRx, and Yoplait; and is on the speakers' bureau of Amgen, Upsher Smith, and Warner Chilcott. MW is also an author of a reference cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Barnabei VM, Cochrane BB, Aragaki AK, et al. Menopausal symptoms and treatment-related effects of estrogen and progestin in the Women's Health Initiative. Obstet Gynecol. 2005 May;105(5 Pt 1):1063-73. Resumo
Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015 Apr;175(4):531-9.Texto completo Resumo
North American Menopause Society. Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society. Menopause. 2021 Sep 1;28(9):973-97. Resumo
The North American Menopause Society Advisory Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022 Jul 1;29(7):767-94. Resumo
Marjoribanks J, Farquhar C, Roberts H, et al. Long-term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2017 Jan 17;(1):CD004143.Texto completo Resumo
Manson JE, Aragaki AK, Rossouw JE, et al. Menopausal hormone therapy and long-term all-cause and cause-specific mortality: the women's health initiative randomized trials. JAMA. 2017 Sep 12;318(10):927-38. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Embarazo
- Síndrome del ovario poliquístico
- Hipertiroidismo
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