Menopause natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Rahmah Al-Edresi, M.D.[2]

If left untreated, women with menopause may progress to develop hypertension, hyperlipidemia, and atherosclerosis. Common complications of menopause includecardiovascular disease, osteoporosis, Stroke. The complication that is happened with hormonal replacement therapy includes ovarian cancer, breast cancer, and endometrial cancer. Generally, the prognosis of menopause is good with treatment and a healthy lifestyle. In the late postmenopause stage, most menopausal symptoms relieved in most women. but untreated menopausal symptoms are poor prognosis in women who have high-risk factors to develop complications of menopause.

• The symptoms of menopause usually develop in the menopausal transition years (perimenopause) and start with irregular mense and vasomotor symptoms such as hot flashes, night sweats, palpitations, and headache. These symptoms continued until reach to postmenopause, in this stage a woman has amenorrhea for on year and vasomotor symptoms in addition to other symptoms such as vaginal atrophy, decreased libido, stress incontinence, frequency, depression and sleep disturbance.^[1]
• Without treatment, the patient will develop symptoms of hypertension, atherosclerosis, and hyperlipidemia which  may eventually lead to cardiovascular disease and coronary heart disease and osteoporosis.^[2]

Complications that can develop as a result of menopause include:^[2][3][4][5]

• Cardiovascular Disease, because of estrogen deficiency has an effect on cardiovascular system due to hyperlipidemia, hypertension, increased sympathetic activity.
• Osteoporosis is a disease of the bones that causes bones to become weak and break easily, estrogen deficiency increases osteoclastic activity
• Stroke, the risk of stroke increased in women after 10 years post menopause and associated with hormonal replacement therapy.^[6]
• Obesity
• Urinary incontinence

Complications that can develop as a result of the treatment of menopause by hormone replacement therapy include^[7]

• Breast cancer
• Ovarian cancer
• Endometrial cancer

• Generally, the prognosis of menopause is good with treatment and healthy lifestyle include stop smoking and a healthy diet and exercise. In the late post-menopause stage, most menopausal symptoms relieved in most women. But untreated menopausal symptoms are a poor prognosis among women who have high-risk factors to develop complications that are associated with menopause.^[8]

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