Abstract

Menopause "s a phys"olog"cal l"fe stage def"ned by at least 12 consecut"ve months of amenorrhea, most commonly occurr"ng between 45 and 55 years of age (med"an $ 51 years). W"th "ncreas"ng l"fe expectancy, th"s post-reproduct"ve per"od can extend to one-th"rd of a woman’s l"fe, ampl"fy"ng "ts cl"n"cal and soc"etal "mpact. B"olog"cally, the process "s dr"ven by l"felong atres"a and deplet"on of a f"xed, non-renewable oocyte/foll"cle pool establ"shed "n fetal l"fe. Th"s mechan"sm renders reproduct"ve age"ng earl"er and steeper than somat"c age"ng. Although evolut"onary b"ology po"nts to several potent"al advantages of menopause at the populat"on level, "t rema"ns a challeng"ng per"od for many women. In cl"n"cal pract"ce, the ma"n concerns cluster around vasomotor symptoms, sleep and mood d"sturbances, cogn"t"ve compla"nts, gen"tour"nary syndrome of menopause (GSM), bone loss/osteoporos"s, and "ncreased card"ometabol"c r"sk. For management, hormone replacement therapy (HRT) "s the most effect"ve opt"on for vasomotor symptoms "n appropr"ately selected pat"ents; when HRT "s contra"nd"cated or not preferred, SSRIs/SNRIs, gabapent"no"ds, and behav"oral "ntervent"ons are reasonable alternat"ves.

Keywords: menopause; ovar"an reserve, hormone replacement therapy