1. The Menopause Transition A Developmental Phase A Biological Event

2. Definition Menopause - the complete or permanent cessation of menstruation. Interval of 12 months of amenorrhea necessary to establish the diagnosis Menopause - the complete or permanent cessation of menstruation. Interval of 12 months of amenorrhea necessary to establish the diagnosis Climacteric - phase during which a transition is made from the reproductive stage of life to the nonreproduction stage Climacteric - phase during which a transition is made from the reproductive stage of life to the nonreproduction stage

3. Hot Flashes Are the most common early manifistations Are the most common early manifistations Dizziness, Headaches, pounding heart, sweating and night sweats Dizziness, Headaches, pounding heart, sweating and night sweats Affecting 85% of women Affecting 85% of women

4. Options Hot Flashes / Night Sweats Prescription approaches Hormone Therapy Hormone Therapy Is the most effective therapy Is the most effective therapy Decrease symptoms by 70% Decrease symptoms by 70% Oral, patch or gel Oral, patch or gel Smallest dose for the shortest duration Smallest dose for the shortest duration

5. Osteoporosis In Canadian Women 100,000 fractures annually 1/3 are hip fractures - 20% mortality - 30-50% disability 25% over age 60 - vertebral crush fractures - vertebral crush fractures - pain, loss of height

6. Options Osteoporosis Bisphosphonates Bisphosphonates SERMs SERMs Hormone Therapy Hormone Therapy Calcitonin Calcitonin