E.J. Mayeaux, Jr., M.D.
Assistant Professor Departments of Family Medicine and Obstetrics and Gynecology
Louisiana State University Medical Center Shreveport, Louisiana
We live in a society that is slowly getting older. Two hundred years ago, 30% of women lived long enough to reach menopause, whereas 90% of today's women will experience the climacteric. 1 Although menopause is not a disease, it is an estrogen-deficient state. There are many consequences of a relative lack of estrogen that may adversely affect health. Estrogen replacement therapy (ERT) and combination estrogen and progesterone therapy, also known as hormone replacement therapy (HRT), will ameliorate many of these adverse effects but may in tern increase other risks.
The postmenopausal period is more than just the cessation of menses. It is a period in a woman's life that extends from the cessation of menses until her death and has its own evolving health issues. Menopause is diagnosed by amenorrhea in a woman over age 40 or amenorrhea combined with a FSH level over 40 pg/ml. The effects of ovarian failure become apparent slowly over time. Hot flashes and emotional lability may become apparent soon after cessation of menses. Other changes such as bone loss, c