Menopause or Climacteric
Menopause or climacteric, just a semantic discussion or has it clinical implications?
ABSTRACT Climacteric and menopause are terms indistinctly used to name clinical expected events related with declination and ceasing of natural ovarian function (ovarian aging or senescence). Thus, in the literature and in the day to day conversation in clinical settings we read and hear “menopausal” or “climacterics” symptoms. Globally, the term menopause is much more frequently used than climacteric, but before we use either one we should consider that menopause is referring to a specific event, the ceasing of menses, and climacteric to gradual changes of the ovarian function that start many years before the menopause itself and continue thereafter for a while. In the pre-menopause period hormonal changes will take place associated with symptoms that deteriorate quality of life, and to metabolic changes that increases the risk of chronic diseases. Therefore, the word climacteric (steps in Greek) seems more adequate to refer to symptoms and chronic diseases associated with the gradually decrease of the natural ovarian function, and we should leave the term “menopause” only for naming the menstruations ceasing event that will happen later as the consequence of the almost total declination of the ovarian activity (at least follicle growth and follicle hormones production). This differentiation has clinical importance; because it implies that during the pre-menopausal period the impact that the estrogenic declination has on the health status of women must be assessed and if it is pertinent, we should indicate or prescribe life style changes, hormonal therapy, hypolipidemic drugs, etc. It does not seem proper to wait for the cease of menstrual bleeding (last menstrual episode) to start with some clinical or quality of life related intervention. The decay of women’s health starts many years before menopause and prevention of its consequences is a must for us the clinicians.