Menopause
Diagnose clinically after 45, test FSH only in younger women, offer menopausal hormone therapy as the most effective treatment for vasomotor symptoms when started before 60, protect the endometrium, prefer transdermal oestradiol when VTE risk is raised, and know the non-hormonal options.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Menopause is the final menstrual period, confirmed after 12 months of amenorrhoea. Mean age is about 51. Early menopause is 40 to 45; premature ovarian insufficiency (POI) is under 40.
- About 75 to 80% of women have vasomotor symptoms, lasting a median of about 7 years. A quarter have severe symptoms.
- Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and prevents bone loss. The ACP guideline (October 2026) made it first line, with SNRIs second; third line is an SSRI, gabapentin or a neurokinin receptor antagonist (fezolinetant or elinzanetant).
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Sources
- Australasian Menopause Society information sheets and practitioner resourcesAU/NZAustralasian Menopause Society, accessed November 2026
- Menopause: identification and management (NG23)National Institute for Health and Care Excellence, 2015, updated November 2024
- Qaseem A, Mackey K, Yost J et al. Pharmacologic treatments for females with menopausal vasomotor symptoms: a clinical guideline from the American College of Physicians. Ann Intern Med 2026 (online ahead of print)American College of Physicians, October 2026
- The 2022 hormone therapy position statement of The North American Menopause Society. Menopause 2022;29:767-94The North American Menopause Society, 2022
- Australian Public Assessment Report for Lynkuet (elinzanetant)AU/NZTherapeutic Goods Administration, 2026 (registration date and PI liver wording not re-checked; TGA site unreachable November 2026)
- Fezolinetant: PBS medicine status, November 2025 PBAC meeting (recommended; listing not yet occurred)AU/NZPharmaceutical Benefits Scheme, 2026
- Fezolinetant: PBS medicine status, March 2025 PBAC meeting (not recommended)AU/NZPharmaceutical Benefits Scheme, 2025
- Veozah (fezolinetant) prescribing information, boxed warning for hepatotoxicityUS Food and Drug Administration (DailyMed), accessed November 2026
- Lynkuet (elinzanetant) prescribing informationUS Food and Drug Administration (DailyMed), accessed November 2026
- Australian Government strengthening Medicare with over $500 million for women's health (PBS listing of Prometrium, Estrogel and Estrogel Pro)AU/NZAustralian Government Department of Health and Aged Care, February 2025
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy