The Menopause Transition: Signs, Symptoms, and Management Options

Nanette Santoro; Cassandra Roeca; Brandilyn A. Peters; Genevieve Neal-Perry


J Clin Endocrinol Metab. 2021;106(1):1-15. 

In This Article


The search strategy utilized Medline-indexed journals of human studies published in English. Search terms used were: menopausal transition, perimenopause, epidemiology, ovarian and pituitary hormones, hot flashes, kisspeptin, treatment and management (the latter 2 were used in combination with perimenopause and menopause transition terms only). Epidemiologic studies utilized review articles when possible to avoid redundancy. All were reviewed for adequate sample size (minimum 300 women) and needed to be community- or population-based to be included. Review articles of major, ongoing cohort studies were cited whenever possible to provide summative data. Clinical trials with fewer than 30 women per study arm were not included. Studies of reproductive hormones were not restricted to a minimum sample size. Articles describing treatment included either reviews or clinical trials; case reports were excluded. All relevant articles were considered, regardless of date of publication. A total of 758 items were accessed through this search strategy; duplicates were eliminated, and ultimate decisions about inclusion were based on relevance to the topic areas, given the large amount of material retrieved.