Following menopause, the organs of the reproductive system shrink in size; there is loss of bone mass by about 3-5% per year. The women become susceptible to osteoporosis. Risk of cardiovascular disease is high in postmenopausal women. The characteristic symptom of menopause is hot flushes. Hot flush is characterized by sudden feeling of heat followed by profuse sweating. There may be anxiety, headache, insomnia, irritability, and depression.
Other symptoms include painful sexual intercourse, lack of sexual drive, vaginal infections and dryness, painful urination, stress incontinence, and recurrent urinary tract infections. All these changes occur due to estrogen deficiency following menopause.
Vaginal symptoms are best treated by topical hormonal therapy (HT), since it is associated with fewer adverse effects.
Vasomotor symptoms may require systemic HT with recommended guidelines being strictly followed. Therapy must be given for the shortest duration possible in the lowest dose to avoid serious side effects such as clot formation (venous thromboembolism) and breast cancer.