Ovarian function, therapy-oriented definition of menopause and climacteric

Abstract

The lack of uniformity in descriptive terminology applied to the cessation of human female menstruation and events related thereto has retarded scientific progress and resulted in confusion and, perhaps, therapeutic mismanagement. Inevitably, many published clinical studies do not clearly define the population being tested, and conclusions drawn are misleading or invalid. Although menopause refers to the final menstrual period (often defined retrospectively by 6-12 months amenorrhea) and climacteric to the transition from reproductive to nonreproductive stage of life, the event is not necessarily associated with any obvious symptom except amenorrhea. When symptoms do occur, collectively referred to as the climacteric syndrome, they are generated by an interaction between endocrine, sociocultural, and psychological factors, and perhaps concurrent aging phenomena as well. Based on the premise that some women with intact ovaries demonstrate endocrine compensatory mechanisms after menopause (i.e., that there are two types of postmenopausal ovary--one active and one essentially inert) and that women whose menses cease because of surgery (ovariectomy) or chemotherapy, they should not be included with those undergoing a natural menopause (i.e., represent an atypical group), an ovarian function, therapy-oriented definition for climacteric is proposed.