Menopause natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Rahmah Al-Edresi, M.D.[2]
Overview
If left untreated, women with menopause may progress to develop hypertension, hyperlipidemia, and atherosclerosis. Common complications of menopause includecardiovascular disease, osteoporosis, Stroke. The complication that is happened with hormonal replacement therapy includes ovarian cancer, breast cancer, and endometrial cancer. Generally, the prognosis of menopause is good with treatment and a healthy lifestyle. In the late postmenopause stage, most menopausal symptoms relieved in most women. but untreated menopausal symptoms are poor prognosis in women who have high-risk factors to develop complications of menopause.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of menopause usually develop in the menopausal transition years (perimenopause) and start with irregular mense and vasomotor symptoms such as hot flashes, night sweats, palpitations, and headache. These symptoms continued until reach to postmenopause, in this stage a woman has amenorrhea for on year and vasomotor symptoms in addition to other symptoms such as vaginal atrophy, decreased libido, stress incontinence, frequency, depression and sleep disturbance.[1]
- Without treatment, the patient will develop symptoms of hypertension, atherosclerosis, and hyperlipidemia which may eventually lead to cardiovascular disease and coronary heart disease and osteoporosis.[2]
Complications
Complications that can develop as a result of menopause include:[2][3][4][5]
- Cardiovascular Disease, because of estrogen deficiency has an effect on cardiovascular system due to hyperlipidemia, hypertension, increased sympathetic activity.
- Osteoporosis is a disease of the bones that causes bones to become weak and break easily, estrogen deficiency increases osteoclastic activity
- Stroke, the risk of stroke increased in women after 10 years post menopause and associated with hormonal replacement therapy.[6]
- Obesity
- Urinary incontinence
Complications that can develop as a result of the treatment of menopause by hormone replacement therapy include[7]
Prognosis
- Generally, the prognosis of menopause is good with treatment and healthy lifestyle include stop smoking and a healthy diet and exercise. In the late post-menopause stage, most menopausal symptoms relieved in most women. But untreated menopausal symptoms are a poor prognosis among women who have high-risk factors to develop complications that are associated with menopause.[8]
References
- ↑ Xu J, Bartoces M, Neale AV, Dailey RK, Northrup J, Schwartz KL (2005). "Natural history of menopause symptoms in primary care patients: a MetroNet study". J Am Board Fam Pract. 18 (5): 374–82. doi:10.3122/jabfm.18.5.374. PMID 16148247.
- ↑ 2.0 2.1 Marten SK (1993). "Complications of menopause and the risks and benefits of estrogen replacement therapy". J Am Acad Nurse Pract. 5 (2): 55–61. doi:10.1111/j.1745-7599.1993.tb00844.x. PMID 8323825.
- ↑ Teede HJ, Lombard C, Deeks AA (2010). "Obesity, metabolic complications and the menopause: an opportunity for prevention". Climacteric. 13 (3): 203–9. doi:10.3109/13697130903296909. PMID 19863456.
- ↑ Okeke T, Anyaehie U, Ezenyeaku C (2013). "Premature menopause". Ann Med Health Sci Res. 3 (1): 90–5. PMC 3634232.
- ↑ Rosano GM, Vitale C, Marazzi G, Volterrani M (2007). "Menopause and cardiovascular disease: the evidence". Climacteric. 10 Suppl 1: 19–24. doi:10.1080/13697130601114917. PMID 17364594.
- ↑ Lisabeth L, Bushnell C (2012). "Stroke risk in women: the role of menopause and hormone therapy". Lancet Neurol. 11 (1): 82–91. doi:10.1016/S1474-4422(11)70269-1. PMC 3615462. PMID 22172623.
- ↑ Stuenkel CA, Davis SR, Gompel A, Lumsden MA, Murad MH, Pinkerton JV; et al. (2015). "Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline". J Clin Endocrinol Metab. 100 (11): 3975–4011. doi:10.1210/jc.2015-2236. PMID 26444994.
- ↑ Schiefeling M (1996). "Prognostic features of menopausal and postmenopausal applicants for life insurance". J Insur Med. 28 (1): 27–34. PMID 10172866.