CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Menopause - Management
How can I manage women with a premature menopause?
- Offer lifestyle advice.
- Refer women who are younger than 40 years of age to a gynaecologist.
- Offer systemic hormone replacement therapy (HRT) or the combined oral contraceptive pill (COC):
- HRT: the HRT regimens used will depend on whether or not the woman has undergone a hysterectomy, still has some ovarian activity and still has periods.
- For women who are still having periods offer oral or transdermal, combined cyclical HRT (a 3-monthly regimen may be preferred).
- For women who have had a hysterectomy offer oral or transdermal oestrogen replacement therapy.
- COC: whether or not the woman can be prescribed the COC will depend upon the woman's age and associated risk factors (e.g. smoking).
- Decreased libido: testosterone implants and patches may be considered (especially in oophorectomized women); however, seek specialist advice before prescribing.
- Advise the woman that she may still become pregnant if contraception is not used.
- See the CKS topic on Contraception for a detailed discussion on the use of contraception in perimenopausal women.
In depth
© NHS Institute for Innovation and Improvement