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Menopausia

  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 20 Aug 2025
Última actualización: 04 Dec 2024

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
Todos los datos

Otros factores de diagnóstico

  • alteración del sueño
  • deterioro leve de la memoria
  • sangrado menstrual abundante
Todos los datos

Factores de riesgo

  • 40 a 60 años de edad
  • tratamiento del cáncer
  • tabaquismo
  • cirugía ovárica
  • edad de la madre en la menopausia
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • prueba de embarazo
Todos los datos

Pruebas diagnósticas que deben considerarse

  • hormona foliculoestimulante (FSH)
  • estradiol sérico
Todos los datos

Algoritmo de tratamiento

Agudo

presentación inicial con síntomas vasomotores leves

En curso

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

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

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.

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