(Adapted from 12)
The strongest indicator that menopause will occure in the next year is an interval of amenorrhea of at least 60 days. This commonly occurs in the setting of vasomoto symptoms or hot flashes. Estrogen levels, although sometimes quite high in the occasional ovulatory cycle, decline overall. Follicle stimulating hormone rises as a consequence of lower estrogen levels. Because of the oscillating nature of these hormones, it is rarely useful to evaluate them to assist in management of symptoms. They can be high one week and low the next. However, if one is unsure if menopause is imminent, e.g. hysterectomized women, FSH and estradiol should be obtained on day 3 of anatural cycle (off all hormonal supplements for at least 7 days). If FSH and estradiol are normal repeat in the next cycle.
Menopause is the time of the final menstrual period. The menopause transition is the time when a woman is experiencing symptoms prior to her final menstrual period. It lasts 4 years on average and may be as long as 10 years. 90% of women experience menopause between the ages of 45-55 years.
The percentage of women experiencing symptoms during the menopausal transition is:
The staegs of reproduction are shown in the figure below. The STRAW criteria established in 2001 were modified to include the ReSTAGE criteria (shown in orange).
(Adapted from 12)