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The average age of menopause is 51 years, with a range of 41-55. Menopause occurs before age 40 in about 5% of women. The onset of menopause is signaled by irregular menses accompanied by hot flashes and an elevated follicle-stimulating hormone (FSH) level. In the period before cessation of menses, the intermenstrual period shortens and then lengthens.

Climacteric Syndromes

Hot Flashes

Hot flashes are the most estrogen, hormone replacement therapy, hormones, Premarin frequently occurring climacteric symptom, characterized by sudden, episodic skin flushing and perspiration.

Hot flash frequency varies from less than one daily to 3 episodes per hour, with a duration.

Lower Urinary Tract Atrophy

Atrophic changes occur in the urethra and periurethra, and there is loss of pelvic tone and prolapse.

Dysuria, urgency, frequency, suprapubic discomfort, bleeding stress, and urge incontinence frequently occur.

Genital Changes

Shortening of the vaginal canal, loss of rugae, bleeding, epithelial thinning and friability, and bacterial vaginoses are common.

Atrophic vaginitis, dyspareunia, or vaginal bleeding estrogen may occur.

Osteoporosis. Menopause is associated with bleeding decreased bone mass and increased susceptibility to fractures; estrogen supplementation decreases hormone replacement therapy Premarin fracture risk by menopause.

Laboratory Tests

Menopause may be confirmed by a FSH serum level greater than 40 mIU/mL.

Laboratory tests are sometimes also indicated to exclude other diagnoses that may cause amenorrhea (thyroid disease, hyperprolactinemia, pregnancy).

A lipid profile, Pap smear, mammogram, and stool guaiac are indicated for routine screening.

Bone density measurements.