Approach to the Perimenopausal Patient

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Applied Evidence

Approach to the Perimenopausal Patient

J Fam Pract. 2002 March;51(3):271-276

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References

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Other effects

A meta-analysis⁶⁷ of trials of HRT for urinary incontinence showed no benefit. The HERS study⁶⁸ showed an increase in urinary incontinence episodes with combined HRT for women with incontinence at baseline (NNH = 8). HRT also increases the risk of gallbladder disease⁶⁹ and may worsen cognitive function for women with mild to moderate dementia.⁷⁰

Prognosis

The symptoms of perimenopause are not life threatening and are usually limited in time. Climacteric symptoms are generally more severe and difficult to treat in women who have undergone bilateral oophorectomy before experiencing natural menopause.⁷¹ Women with multiple chronic medical conditions,^13,72,73 psychiatric illnesses,^15,74 or a history of premenstrual syndrome^11,12,75 are also likely to experience more difficulty with symptoms attributed to the menopausal transition. Table 3 provides a list of resources for patient education regarding menopause.

TABLE 3
RESOURCES FOR PATIENT EDUCATION ABOUT MENOPAUSE

Organization	Contact Information	Description
Ottawa Health Decision Centre	ldrake@civich.Ottawa.on.ca 613-798-5555	Making Choices: Hormones After Menopause (audiotape and workbook)
American Academy of Family Physicians	www.aafp.org 1-800-274-2237	Brochures: “Menopause: What to Expect When Your Body Is Changing”; “Osteoporosis: Keeping Your Bones Healthy and Strong”
American College of Obstetricians and Gynecologists	www.acog.org 1-800-410-ACOG	Brochures: “Midlife Transitions: A Guide to the Menopause Years”; “Hormone Replacement Therapy”