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Previous Volume 355:2338-2347 November 30, 2006 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 51-year-old woman has frequent and distressing hot flushes that interfere with her work and sleep, and vaginal dryness that makes sexual intercourse with her husband uncomfortable. She is otherwise healthy. How should her case be managed?

The Clinical Problem

Menopausal Transition

All healthy women transition from a reproductive, or premenopausal, period, marked by regular ovulation and cyclic menstrual bleeding, to a postmenopausal period, marked by amenorrhea . . . [Full Text of this Article]

Vasomotor Symptoms

Vaginal Symptoms

Strategies and Evidence

Evaluation

            Vasomotor Symptoms

            Vaginal Atrophy

Treatment of Vasomotor Symptoms

            Behavioral and Alternative Therapies

            Estrogens

            Nonestrogenic Hormonal Therapies

            Other Prescription Drugs

Treatment of Vaginal Symptoms

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Women's Health Clinical Research Center, University of California, San Francisco, and the San Francisco Veterans Affairs Medical Center — both in San Francisco.

Address reprint requests to Dr. Grady at the Women's Health Clinical Research Center, 1635 Divisadero St., Suite 600, San Francisco, CA 94115.

Related Letters:

Menopausal Symptoms
Bouts B. A., Koratamaddi L. P., Prasad M., Grady D.
Extract | Full Text | PDF  
N Engl J Med 2007; 356:1176-1178, Mar 15, 2007. Correspondence

This article has been cited by other articles:

• Silverman, B. G, Kokia, E. S (2009). Use of Hormone Replacement Therapy, 1998-2007: Sustained Impact of the Women's Health Initiative Findings. The Annals of Pharmacotherapy 43: 251-258 [Abstract] [Full Text]  
• Anders, C. K., Hsu, D. S., Broadwater, G., Acharya, C. R., Foekens, J. A., Zhang, Y., Wang, Y., Marcom, P. K., Marks, J. R., Febbo, P. G., Nevins, J. R., Potti, A., Blackwell, K. L. (2008). Young Age at Diagnosis Correlates With Worse Prognosis and Defines a Subset of Breast Cancers With Shared Patterns of Gene Expression. JCO 26: 3324-3330 [Abstract] [Full Text]  
• Gast, G.-C. M., Grobbee, D. E., Pop, V. J.M., Keyzer, J. J., Wijnands-van Gent, C. J.M., Samsioe, G. N., Nilsson, P. M., van der Schouw, Y. T. (2008). Menopausal Complaints Are Associated With Cardiovascular Risk Factors. Hypertension 51: 1492-1498 [Abstract] [Full Text]  
• Bouts, B. A., Koratamaddi, L. P., Prasad, M., Grady, D. (2007). Menopausal Symptoms. NEJM 356: 1176-1178 [Full Text]