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
其他诊断因素
- perturbação do sono
- comprometimento leve da memória
- Sangramento menstrual intenso
危险因素
- idade entre 40 e 60 anos
- tratamento de câncer
- tabagismo
- cirurgia ovariana
- idade da mãe na menopausa
诊断性检查
首要检查
- teste de gravidez
需考虑的检查
- hormônio folículo-estimulante (FSH)
- estradiol sérico
治疗流程
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
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
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 diferenciaisDiretrizes
- Menopause: diagnosis and management
- Non-hormone therapy position statement
Mais DiretrizesFolhetos informativos para os pacientes
Sintomas de menopausa: quais são as opções de tratamento?
Menopausa: o que é?
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