MENOPAUSE

A   53-year-old woman   visits  the gynecologist’s  office  complaining of  hot

flashes,    vaginal dryness,    and irritability.   She states  that    her symptoms

started one year    ago and have    progressively   been    getting worse.  Her last

gynecologic examination was two years   ago,    at  which   time    her

mammogram   was normal.

Menopause is a retrospective diagnosis and is defined as 12 months of
amenorrhea. It is associated with the elevation of gonadotropins (FSH and LH).
The mean age of 51 years is genetically determined and unaffected by
pregnancies or use of steroid contraception. Smokers experience menopause up
to two years earlier.