Menopause
Menopause
How is Menopause Defined?
Natural menopause is a normal biological process, associated with reduced levels of estrogen due to declining ovarian function. Menopause is confirmed after the absence of menstruation for twelve consecutive months. It occurs, on average, at age 51.1
Induced menopause refers to menstrual periods that stop after surgical removal of the ovaries, chemotherapy or radiation damage to the ovaries, or from the use of other medications to intentionally induce menopause as part of the treatment of certain diseases.2
What Symptoms are Associated with Menopause?
Declining estrogen results in multiple symptoms which may be experienced during menopause.
Reference: https://www.who.int/news-room/fact-sheets/detail/menopause. Accessed Dec 2023.
Does Patient Ethnicity Affect Symptom Burden?
The Study of Women’s Health Across the Nation (SWAN) is a multi-site longitudinal, epidemiologic study in the United States designed to examine the health of women during their middle years.1
This study administered a cross-sectional survey to more than 15,000 mid-life women of various ethnicities inquiring about their menopausal symptoms. The pie chart shows the distribution of different ethnic groups included in the study.1,2
Analysis of data from SWAN has shown that ethnic background influences a woman’s perception of her symptoms, as summarized in the chart below.2
African Americans experienced the highest VMS burden, while Hispanic women experienced vaginal symptoms, trouble falling asleep and early/premature menopause more often than other ethnic groups. Caucasians and Asian Americans experienced symptoms less frequently, except for depressive symptoms which were experienced most by Japanese.2
Relationship of Ethnicity and Common Menopausal Symptoms
Shown as % women experiencing that symptom or odds ratio (vs Caucasian)
References: 1. https://www.swanstudy.org/ [Accessed Dec 2023]. 2. Green & Santoro, 2009, Women’s Health 5(2), p127–133.
What is the Most Common Symptom of Menopause?
Vasomotor Symptoms
(hot flashes and/or night sweats)
Up to 80% of women will have some VMS as they go through menopause
- VMS most commonly begins in perimenopause, and/or menopause
- 30% of women have VMS when they are still getting regular periods (reproductive phase)
Are VMS Experienced with Other Symptoms?
Data from the MsFLASH trial (n=797 women, mean age 54.5 years) demonstrated that menopause symptoms occur in distinct clusters, some of which experience more VMS (clusters 1 and 2), with others experience more sleep symptoms (cluster 3) or mood problems (cluster 4).
Reference: Woods NF, Hohensee C, Carpenter JS, et al. Menopause. 2016;23(2):158–65. doi:10.1097/GME.0000000000000516.
Neuroendocrine Changes of Menopause
This video illustrates how declining estrogen affects hypothalamic neurons that mediate vasomotor symptoms.
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