Conference Report From the 10th World Congress on the Menopause

Professor Lorraine Dennerstein, AO MBBS, PHD, DPM, FRANZCP


July 03, 2002

In This Article

The Seven Stages of Menopause

Dr. Sherman presented this new staging system of menopause.[5] The STRAW workshop had been convened to address the absence of a relevant staging system for female reproductive aging and to discuss the confusing current nomenclature for the years before reaching final menstruation. Changes in menstrual cyclicity, endocrinology, pelvic anatomy, symptoms, and fertility were considered. It was noted that while there is a well-established system for staging puberty (Tanner/Marshall system), a similar staging system for the dynamic period approaching final menstruation was lacking.

Consensus was reached for a 7-stage model.[6] This consists of early, peak, and late reproductive phases; early and late menopausal transition phases; and early and late postmenopause phases. Features of early menopausal transition are the onset of variable cycle length, with increasing follicle-stimulating hormone (FSH), whereas late menopausal transition is characterized by at least 2 skipped menstruations, with elevated FSH and increased likelihood of vasomotor symptoms. The early postmenopausal phase comprises the first 5 years after the FMP. Women continue to be at risk for vasomotor symptoms. FSH continues to be elevated through this phase and the subsequent late phase of postmenopause. Dr Sherman emphasized that these proposed definitions now need to be operationalized and should be considered to be a "work in progress." The definitions should be validated using prospectively acquired, population-based data.


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