Differential diagnosis of menopause

During a woman's life, she will enter old age after a period of normal fertility and sexual activity, during which her fertility and sexual activity gradually decline. This process is generally called "menopause". This period lasts from 5 to 10 years before menopause to 5 to 10 years after menopause, usually 8 to 12 years, and up to 20 years for the elderly. The important event of this stage is the cessation of menstruation. Menopause is defined as the cessation of menstruation for more than one year since the last menstrual period.

The specific stages before and after menopause are also called premenopause and postmenopause, or collectively referred to as perimenopause. In June 1994, the WHO Special Committee on Human Reproduction, 25 reproductive medicine experts from 15 countries around the world, discussed the research progress on menopause in the 1990s at this meeting and revised the definitions of terms related to menopause.

1. Natural menopause is permanent menopause (cessation of menstruation for more than one year) due to exhaustion of ovarian follicles and ovarian failure.

2. The perimenopause period includes endocrine disorders and clinical manifestations that occur before menopause to within 1 year after menopause. It is recommended to stop using the term "menopause", and the menopausal transition period should be a stage before the final menstruation when the menstrual cycle changes.

3. Premenopause should refer to the entire reproductive period before menopause.

4. Artificial menopause includes surgical removal of both ovaries with or without removal of the uterus, or other methods of terminating ovarian function such as chemotherapy and radiotherapy. Patients who only undergo hysterectomy while retaining one or both ovaries are not included because they still retain a certain degree of ovarian function.

5. After menopause, whether natural or artificial, the date of the last menstrual period is used as the starting point.

6. Premature menopause refers to the cessation of menstruation in women before the age of 40.

Whether ovarian function has ceased must be determined based on the levels of FSH, LH and E2 in the blood.