Management Strategies of the Symptomatology and Pathology Associated with Menopause – An Overview

Abstract

Menopause is a physiological period, considered to be installed after at least 12 months without menstruation. The mean age at menopause is 51 years. This condition is the consequence of hormonal imbalance that produces a series of general manifestations, which have become increasingly important and in most of the cases require treatment to improve. This paper aims to analyze all the therapeutical strategies applied for the improvement of the menopausal symptomatology. After a review of the last five years literature, we identified epidemiological studies, clinical cases, guidelines, and meta-analysis regarding the proper management strategies for the symptoms and pathologies associated with menopause. Fifty-three studies have been included in this paper that provides an overview of the impact of various menopause therapies. Vasomotor symptoms (VMS), hormonal replacement therapy (HRT), consisting of the administration of estrogen, alone or combined with progesterone, have been demonstrated to reduce their frequency and severity. Also, systemic estrogen therapy has shown its efficiency in depression, genito-urinary syndrome, cognitive disorders, and postmenopausal migraine syndrome. Non-hormonal treatments, including alimentary supplements, proved their efficacy with low rates of adverse effects. Among nonhormonal therapeutical alternatives, antidepressants such as venlafaxine, paroxetine, or fluoxetine (selective serotonin reuptake inhibitors - SSRI), and the anticonvulsant gabapentin have shown their utility for treating depressive disorders and vasomotor symptoms.