Authors' objectives:

This report aims to describe the evidence about symptoms associated with menopause, factors that influence them, benefits and adverse effects of therapies, factors that influence therapies, and future research needs.

Authors' results and conclusions: Forty-eight studies conducted among 14 cohorts and 22 studies from other populations provide data about symptoms. Vasomotor symptoms and vaginal dryness are most consistently associated with menopause; sleep disturbance, somatic complaints, urinary complaints, sexual dysfunction, mood, and quality of life are inconsistently associated. No studies provide data on cognition and uterine bleeding problems, duration and severity of specific symptoms, or conclusive data on the influence of race/ethnicity, age of onset of menopause, body mass index, oophorectomy status, depression, or smoking. Results of 192 randomized controlled trials of therapies indicate that for vasomotor symptoms, estrogen is effective; tibolone demonstrates benefit, but most studies are poor-quality; paroxetine, veralipride, gabapentin, soy isoflavones, and other phytoestrogens report benefit in some trials. Results for other symptoms are mixed, adverse effects are inadequately reported, and placebo effects are large. No trials describe the influence of bilateral oophorectomy, premature ovarian failure, use of potentially interacting agents, lifestyle and behavioral factors, recent discontinuation of hormones, or body mass index. For women with breast cancer, clonidine, venlafaxine, and megestrol acetate improve vasomotor symptoms, and results for other symptoms are mixed.

Authors' recommendations: Vasomotor symptoms and vaginal dryness are most consistently associated with the menopausal transition. Results of treatment trials are consistent and conclusive only for estrogen. For other agents, the evidence base is limited by lack of studies demonstrating effectiveness, poor quality of existing studies, and incomplete information on adverse effects.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/tp/menopstp.htm

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)