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Menopausa

最后审阅: 21 Sep 2025
最后更新: 04 Dec 2024

小结

定义

病史和体格检查

关键诊断因素

  • presença de fatores de risco
  • amenorreia
  • ciclo menstrual irregular
  • fogachos e sudorese noturna
  • sintomas vaginais
  • alterações no humor
完整详情

其他诊断因素

  • perturbação do sono
  • comprometimento leve da memória
  • Sangramento menstrual intenso
完整详情

危险因素

  • idade entre 40 e 60 anos
  • tratamento de câncer
  • tabagismo
  • cirurgia ovariana
  • idade da mãe na menopausa
完整详情

诊断性检查

首要检查

  • teste de gravidez
完整详情

需考虑的检查

  • hormônio folículo-estimulante (FSH)
  • estradiol sérico
完整详情

治疗流程

急症处理

apresentação inicial com sintomas vasomotores leves

持续性治疗

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

撰稿人

作者

Heather Currie, MB BS, FRCOG, DRCOG, MRCGP

Clinical Director Women and Sexual Health

NHS Dumfries and Galloway

Dumfries and Galloway Royal Infirmary

Scotland

UK

Declarações

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

Declarações

HH declares that he has no competing interests.

Bradford W. Fenton, MD, PhD, FACOG

Independence Park Medical Services

Anchorage

AK

Declarações

BWF declares that he has no competing interests.

Agradecimentos

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.

Declarações

RWC declares that she has no competing interests.

Revisores

Nan Gillespie O’Connell, MD

Assistant Professor

Department of Obstetrics and Gynecology

Virginia Commonwealth University

Richmond

VA

Раскрытие информации

NGOC declares that she has no competing interests.

Carolyn Simpkins, MD, PhD

Internist

Daniel Island

SC

Раскрытие информации

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

Раскрытие информации

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

Раскрытие информации

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.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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. Аннотация

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.Полный текст  Аннотация

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. Аннотация

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. Аннотация

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.Полный текст  Аннотация

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. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Diagnósticos diferenciais

    • Gestação
    • Síndrome do ovário policístico
    • Hipertireoidismo
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Menopause: diagnosis and management
    • Non-hormone therapy position statement
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Sintomas de menopausa: quais são as opções de tratamento?

    Menopausa: o que é?

    Mais Folhetos informativos para os pacientes
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