Decision making at menopause

Dr Amanda Vincent

Menopause is the final menstrual period and diagnosed after 12 months of amenorrhoea. The average age of menopause is 51 years. The final menstrual period is preceded by the perimenopause which is often a time of chaotic hormonal swings which are troublesome to the patient and the treating clinician. Although vasomotor symptoms (hot flushes) and urogenital symptoms are the characteristic symptoms associated with the menopause there are other multiple symptoms which women may experience. Decreased oestrogen concentration with menopause is associated with metabolic changes and bone loss contributing to increased cardiovascular and osteoporosis risk. The diagnosis of menopause is usually made on the clinical history in a woman experiencing these symptoms at the average age, but a careful history is required to exclude the possibility of other pathology. Clinicians need to be aware of the possibility of premature ovarian insufficiency in younger women. Since the publication of the WHI studies, the use of menopausal hormone therapy has been associated with confusion and controversy. Publication of the global consensus statement(1)  which sets out the appropriate use of MHT in peri and post-menopausal women, including risks, benefits and contraindications has provided much needed guidance and will be discussed in this presentation.


Dr Amanda Vincent is a Consultant Endocrinologist with the Department of Endocrinology, Monash Health, Clayton, working in the Menopause Clinic, Osteoporosis clinic and the Clinical Nutrition and Metabolism Unit. She also works as an Endocrinologist at The Women’s Specialist Menopause Clinic, Melbourne.

Dr Vincent is a Postdoctoral Research Fellow with the Monash University’s Centre for Health Research and Implementation, School of Public Health Preventive Medicine. Her research interests include both clinical research and education projects with a particular interest in early/premature menopause and Turner’s syndrome.

She is an Associate Editor of Climacteric.