Clinical practice guideline. Diagnosis and treatment of postmenopausal and perinemopausia

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Alberto Alvarado-García
Tomás Hernández-Quijano
Marcelino Hernández-Valencia
Miriam Concepción Negrín-Pérez
Brendha Ríos-Castillo
Gregorio Urbano Valencia-Pérez
Víctor Saúl Vital-Reyes
Ma. Antonia Basavilvazo-Rodríguez
Laura del Pilar Torres-Arreola
Guillermo Federico Ortiz-Luna
Fernando Sánchez-Aguirre
Armando Montaño-Uscanga

Keywords

Menopause, Postmenopausal, Aging

Abstract

Post-menopause is the period of life where a deep decline occurs in circulating estrogen levels, inducing the appearance of psycho and somatic symptoms. The classification to understand the chronology of reproductive aging in women (known as STRAW) determines the clinical and endocrine changes contemplating menstrual cycles, symptoms, measurements of FSH, LH, inhibin B, anti-Mullerian hormone , and follicular account. The diagnosis of menopause is established by the absence of menstruation for 12 months or more. The most frequent clinical manifestations of the climacteric syndrome transition to menopause are: menstrual disorders, vasomotor symptoms (flushes and/or sweats) and genitourinary manifestations. The assessment of women in the peri- or postmenopause aims to develop: cervicovaginal cytology, lipid profile , serum glucose, basal Mammography at least a year before, pelvic ultrasound, urinalysis, serum TSH, Densitometry in patients older than 60 years if there is no recourse can be applied and FRAX. Drug therapy for the treatment of disorders of the transition to menopause or menopause is divided into: Hormone Therapy (HT) based estrogens and progestin hormone not being the most recommended the serotonin reuptake inhibitors and norepinephrine , clonidine, gabapentin or veralipride.

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