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Health professionals Menopause and breast cancer 3 Definitions
3. Definitions
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The definitions of menopause and related terms are shown in Table: Definitions and terms related to menopause. Menopause is diagnosed retrospectively following 12 months of amenorrhea and is associated with elevated gonadotrophins and low estradiol levels (WHO, 1996). There is a lack of consensus regarding terminology and definition of ovarian failure/amenorrhoea associated with chemotherapy with both chemotherapy-induced amenorrhea (CIA) (Walshe, Denduluri et al. 2006)and chemotherapy induced ovarian failure (Stearns, Schneider et al. 2006) used. The College of Obstetricians and Gynaecologists defines amenorrhea as cessation of menses for 6 months; however, the breast cancer literature defines CIA as cessation of menses from greater than 2 months to one year of amenorrhea (Walshe, Denduluri et al. 2006). The consensus of medical literature suggests that spontaneous premature ovarian failure should be considered as a diagnosis after 4 months of amenorrhea (Nelson 2009).
Table: Definitions and terms related to menopause
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Menopause |
Permanent cessation of menstruation resulting from loss of ovarian follicular activity (World Health Organisation [WHO]) |
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Premature menopause |
Menopause occurring before the age of 40 years. It may occur spontaneously (premature ovarian failure) or as a result of therapeutic intervention. |
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Early menopause |
Menopause occurring before the age of 45 years |
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Surgical menopause |
Menopause as a result of bilateral oophorectomy |
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Menopausal transition |
Period of time immediately before menopause when the endocrinological, biological and clinical features of approaching menopause commence (WHO) |
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Perimenopause |
Time period beginning with the first symptoms of the approaching menopause and ending 12 months after the final menses |
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Climacteric |
Synonymous with perimenopause |
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Chemotherapy-induced amenorrhea or chemotherapy induced ovarian failure |
Cessation of menses after chemotherapy which may be permanent or temporary |
Key Points: Definitions
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Selected References:
Glossary of terms (Australasian Menopause Society: http://www.menopause.org.au/glossary)
Soules MR , Sherman S et al., Executive summary: Stages of reproductive aging workshop (STRAW). Fertil Steril. (2001) 76:874-878.
WHO Scientific group. Research on the menopause in the 1990’s. WHO (1996) 866: 1-79
4. PhysiologyContent updated May 16, 2011
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