Early Postmenopause
- Estrogen stabilising at a low postmenopausal baseline
- FSH and LH plateau at high levels
- Androgen levels also declining
Menstrual Changes
No periods (>12 months)
Primary Symptoms
- • Vasomotor symptoms (may persist or even worsen initially)
- • Genitourinary syndrome of menopause (GSM) — vaginal dryness, urgency, recurrent UTIs
- • Mood: often improves unless vasomotor symptoms are severe
- • Joint pain
- • Skin and hair changes accelerating
Clinical Protocol
- Ask about genitourinary symptoms proactively — women often do not volunteer these
- Do not assume HRT is no longer needed
- Assess bone density (DEXA scan) — especially if HRT not taken
- Cardiovascular risk reassessment
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