This is the current release of the guideline.

Menopause is the permanent cessation of menstrual periods that occurs naturally in women, usually in their early 50s. Many women have few or no symptoms; these women are not in need of medical treatment.

Premenopausal or perimenopausal women who have menopause induced by surgery, chemotherapy, or radiation are more likely to experience bothersome and even disabling symptoms. These women need safe and effective treatment.

It is difficult to differentiate those symptoms that are truly associated with menopause from those due to aging. Hot flashes, night sweats, and vaginal dryness are clearly tied to the menopausal transition, and there is some positive evidence of a menopausal link for sleep disturbance.

Vasomotor symptoms are reported with high frequency during the menopausal transition.

Estrogen, either by itself or with progestins, is the most consistently effective therapy for these symptoms. However, the Women's Health Initiative (WHI) has identified important risks associated with use of these therapies. Decision making for women regarding treatment for menopausal symptoms requires personal knowledge and balancing of these risks.

There are many potential alternatives to estrogen. However, their effectiveness and long-term safety need to be studied in rigorous clinical trials in diverse populations of women.

To address the charge to this panel, much more research is needed to clearly define the natural history of menopause, associated symptoms, and effectiveness and safety of treatments for bothersome symptoms. Natural histories are important for both science and policy. Knowing how many women transit menopause with few or no symptoms, and how many manage menopause largely on their own, can lead to public health information that empowers women and increases their self-reliance. Medical care and future clinical trials are best focused on women with the most severe and prolonged symptoms.

The state of the science in management of menopausal symptoms should be reassessed periodically.

Menopause is "medicalized" in contemporary U.S. society. There is great need to develop and disseminate information that emphasizes menopause as a normal, healthy phase of women's lives and promotes its demedicalization. Medical care and future clinical trials are best focused on women with the most severe and prolonged symptoms. Barriers to professional care for these women should be removed.

None provided

The type of supporting evidence is not specifically stated for each recommendation.

Not applicable: The guideline was not adapted from another source.

2005 Mar

National Institutes of Health (NIH) State-of-the-Science Panel - Independent Expert Panel

United States Government

National Institutes of Health State-of-the-Science Panel

Panel Members: Carol M. Mangione, M.D., M.S.P.H., (Conference and Panel Chairperson), Director, Resource Center for Minority Aging Research, Professor of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; Deborah Briceland-Betts, J.D., Senior Vice President, Sutton Group—Solutions for Social Change, Washington, DC; Susan S. Ellenberg, Ph.D., Professor of Biostatistics, Center for Clinical Epidemiology and Biostatistics, Associate Dean for Clinical Research University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania; Scott S. Emerson, M.D., Ph.D., Professor and Graduate Program Coordinator, Department of Biostatistics, University of Washington, Seattle, Washington; David V. Espino, M.D., Vice Chair for Community Geriatrics, Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Rose S. Fife, M.D., Associate Dean for Research, Professor of Medicine and Professor of Biochemistry and Molecular Biology; Barbara F. Kampen Professor of Women's Health, Indiana University School of Medicine, Indianapolis, Indiana; Susan Folkman, Ph.D., Professor of Medicine, Osher Foundation Distinguished Professor in Integrative Medicine, Director, Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, California; Cassandra E. Henderson, M.D., Associate Professor of Obstetrics and Gynecology, New York Medical College, Medical and Laboratory, Director at MIC–Women's Health Services, Chief of Maternal Fetal Medicine, Our Lady of Mercy Medical Center, Bronx, New York; Susan H. McDaniel, Ph.D., Professor of Psychiatry and Family Medicine; Director, Wynne Center for Family Research, Associate Chair Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; Lois M. Verbrugge, Ph.D., M.P.H., Visiting Professor, Asia Research Institute, National University of Singapore, Singapore Research Professor and Senior Distinguished Research Scientist, Institute of Gerontology, University of Michigan, Ann Arbor, Michigan; Donna L. Washington, M.D., M.P.H., Associate Professor of Medicine, VA Greater Los Angeles Healthcare System and University of California, Los Angeles, Los Angeles, California; Paul D. Woolf, M.D., M.B.A., F.A.C.P., Chairman, Department of Medicine, Crozer Chester Medical Center, Upland, Pennsylvania

All of the panelists who participated in this conference and contributed to the writing of this statement were identified as having no financial or scientific conflict of interest, and all signed forms attesting to this fact. Unlike the expert speakers who present scientific data at the conference, the individuals invited to participate on NIH Consensus and State-of-the-Science panels are reviewed prior to selection to assure that they are not proponents of an advocacy position with regard to the topic and are not identified with research that could be used to answer the conference questions.

This is the current release of the guideline.

None available

This summary was completed by ECRI on December 11, 2008.

No copyright restrictions apply.