Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- amenorreia
- ciclo menstrual irregular
- fogachos e sudorese noturna
- sintomas vaginais
- alterações no humor
Other diagnostic factors
- perturbação do sono
- comprometimento leve da memória
- Sangramento menstrual intenso
Risk factors
- idade entre 40 e 60 anos
- tratamento de câncer
- tabagismo
- cirurgia ovariana
- idade da mãe na menopausa
Diagnostic tests
1st tests to order
- teste de gravidez
Tests to consider
- hormônio folículo-estimulante (FSH)
- estradiol sérico
Treatment algorithm
apresentação inicial com sintomas vasomotores leves
mulheres com útero, fogachos moderados a graves, com/sem redução da libido
mulheres histerectomizadas ou com dispositivo intrauterino com liberação de levonorgestrel colocado nos últimos 5 anos, fogachos moderados a intensos, com ou sem redução da libido
apenas atrofia urogenital
apenas com incontinência urinária de esforço
Contributors
Authors
Heather Currie, MB BS, FRCOG, DRCOG, MRCGP
Clinical Director Women and Sexual Health
NHS Dumfries and Galloway
Dumfries and Galloway Royal Infirmary
Scotland
UK
Disclosures
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
Disclosures
HH declares that he has no competing interests.
Bradford W. Fenton, MD, PhD, FACOG
Independence Park Medical Services
Anchorage
AK
Disclosures
BWF declares that he has no competing interests.
Acknowledgements
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.
Disclosures
RWC declares that she has no competing interests.
Peer reviewers
Nan Gillespie O’Connell, MD
Assistant Professor
Department of Obstetrics and Gynecology
Virginia Commonwealth University
Richmond
VA
Disclosures
NGOC declares that she has no competing interests.
Carolyn Simpkins, MD, PhD
Internist
Daniel Island
SC
Disclosures
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
Disclosures
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
Disclosures
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.
References
Key articles
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. Abstract
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.Full text Abstract
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. Abstract
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. Abstract
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.Full text Abstract
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. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Gestação
- Síndrome do ovário policístico
- Hipertireoidismo
More DifferentialsGuidelines
- Menopause: diagnosis and management
- Non-hormone therapy position statement
More GuidelinesPatient information
Sintomas de menopausa: quais são as opções de tratamento?
Menopausa: o que é?
More Patient information
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