What is menopause?
Point at which menstruation has stopped for at least 12 months
What is perimenopause?
Time around menopause with irregular periods and vasomotor symptoms
What is the physiology of menopause?
Reduced development of ovarian follicles
Reduced oestrogen levels
Raised LH + FSH - due to lack of negative feedback
What causes perimenopausal symptoms?
Lack of oestrogen
What are perimenopausal symptoms?
Hot flushes Emotional lability Irregular periods Reduced libido Joint pain Vaginal dryness
How are perimenopausal symptoms managed?
HRT
Tibolone = synthetic steroid hormone
Clonidine = agonist of alpha-adrenergic receptors
CBT
Vaginal oestrogen