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Menopause - a Primer

A succinct, up to date summary of the menopause.


Menopause is an inevitable component of ageing and encompasses the loss of ovarian reproductive function, either occurring spontaneously or secondary to other conditions. It is not yet possible to accurately predict the onset of menopause, especially early menopause, to give women improved control of their fertility.

The decline in ovarian oestrogen production at menopause can cause physical symptoms that may be debilitating, including hot flushes and night sweats, urogenital atrophy, sexual dysfunction, mood changes, bone loss, and metabolic changes that predispose to cardiovascular disease and diabetes. The individual experience of the menopause transition varies widely. Important influential factors include the age at which menopause occurs, personal health and wellbeing, and each woman's environment and culture.

Management options range from lifestyle assessment and intervention through to hormonal and non-hormonal pharmacotherapy, each of which has specific benefits and risks. Decisions about therapy for perimenopausal and postmenopausal women depend on symptomatology, health status, immediate and long-term health risks, personal life expectations, and the availability and cost of therapies. More effective and safe therapies for the management of menopausal symptoms need to be developed, particularly for women who have absolute contraindications to hormone therapy.

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Menopause Primer

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Author contributions

  • Introduction (Susan R. Davis - School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Victoria 3004, Australia.)
  • Epidemiology (Gita D. Mishra)
  • Mechanisms and pathophysiology (Tommaso Simoncini and Irene Lambrinoudaki)
  • Diagnosis, screening and prevention (Nanette Santoro and Susan R. Davis)
  • Management (Margaret Rees, Lubna Pal and Susan R. Davis)
  • Quality of life (Maryann Lumsden)
  • Outlook (Susan R. Davis)
  • Overview of Primer (Susan R. Davis)


Davis SR, Lambrinoudaki I, Lumsden M, Mishra GD, Pal L, Rees M, Santoro N, Simoncini T. Menopause, Nature Reviews Disease Primers. Article number: 15004 (2015) ​doi:10.1038/nrdp.2015.4 Published online 23 April 2015 

Content updated April 2015