Menopause and beyond

Key facts

There is much confusion about management of the menopause and although it is an inevitable occurrence for women many continue to suffer in silence. An estimated 40% of women reported that the symptoms were worse than they had anticipated¹ with 45% reporting that menopause symptoms had a negative impact on their work².

Premature ovarian insufficiency is classified as menopause in women aged less than 40. The risk of cardiovascular disease, osteoporosis and dementia is increased in this cohort of women and HRT is recommended as ‘replacement’ therapy as well as for symptom control³.

Female urinary incontinence becomes increasingly problematic in women postmenopausally and as they age, caused by pelvic floor muscle weakness and/or detrusor muscle over activity. The recently updated NICE guidance⁴ clearly outlines management and includes a section on management of pelvic floor prolapse for the first time.

Ovarian cancer has low survival rates because the vague symptoms result in late presentation. Earlier diagnosis and a low threshold for considering testing are required to make significant difference to the poor outcomes⁵.

Vulval disorders become more problematic as women age and require examination and early treatment to reduce the long-term consequences of scarring and malignant transformation.

References:

1. British Menopause Society, National Survey
2. European Society of Human Reproduction and Embryology Guideline on the management of premature ovarian insufficiency. Published date: December 2015.
3. NICE guideline: Urinary incontinence and pelvic organ prolapse in women: management (NG 123) Updated June 2019.
4. NICE guideline. Ovarian cancer: recognition and initial management (CG122) Published 2011