Menopause: diagnosis and management

Menopause is the permanent cessation of menstruation that results from loss of ovarian follicular activity. It marks the end of a woman's reproductive years and a fall in circulating oestrogen, progesterone and testosterone produced by the ovaries. The decrease in oestrogen affects multiple organs systems and can affect the management or course of medical co-morbidities. Hormone replacement therapy is an effective treatment for menopausal symptoms but is not without risk. With an increasingly ageing population with co-morbid conditions, it is essential for physicians to understand the physiological changes that occur during menopause and how to manage difficult or high-risk scenarios effectively. This article provides a review of the menopause, including diagnostic approaches, treatments and strategies for managing complex cases.