Defining Menopause Through Symptom Clusters

Menopause has an official definition, a definition that patient's use, and a definition that is useful for treatment purposes. And for treatment, looking at clusters of symptoms has allowed for more customized therapy. Defining the menopause has been easy in terms of last period: a year with no bleeding in a woman who has stopped ovulating: you are menopausal.It is not necessarily a quick process

the definitions also vary as to when a woman moves beyond menopause to post menopause. Or in another way of asking : how long does your menopause last? There are some standard definitions, and then there are ones in more flux. The current thinking is that in your mid 40s you have about a 4-7 year period of transition. But another way to define menopause is to look at how the periods are, menstrual change is pretty much a given for those with a uterus.
And defining menopause by flashes or other changes has been easy to define as per the symptoms groups of menopausal women experience.  Only 75% of all women will have hot flashes. But if you look a bit beyond the hot flash what was discovered by the newest study from the Seattle Midlife Women's Health Study that there are actually clusters of symptoms that women have that define their unique situations.  These workers went at this study doggedly, studying 19 different symptoms in women over a 20 year span of time. So there are women that have primarily mood symptoms, or primarily pain symptoms, or primarily cognitive symptoms. If we focus on hot flashes alone, the realization by researchers is that we are possibly not going to be getting to the real physiological roots of these more varied symptoms. Pain, nausea, and fatigue may have a completely different origin of symptoms than does sleep loss. The Seattle researchers also think that women can be further codified by separating them into groups of low level bother verses more disruptive symptoms. They separated women into a hot flash group, a Sleep group, a pain group, a mood group, a cognitive group, and a tension group. And they also think that as women age through menopause they may move from the lesser symptoms into the more bothersome symptoms into other classifications. And having their patients data split into groups, they can answer questions we have not been able to really get at. For instance, in menopausal transition,  whether sleep disruption produces the pain that the women report, or whether it really is a separate complaint all together. And then we can use this to guide counseling and therapy.


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