Menopause: Resource Overview

Menopause occurs when a woman’s ovaries stop producing hormones, resulting in the end of her menstrual periods. It is defined as having no menstrual period for 12 months. The months or years leading up to menopause are called perimenopause.

The most common symptoms of menopause and perimenopause are hot flashes and vaginal dryness; as many as 75% of women experience hot flashes. During perimenopause, many women also experience irregular bleeding or spotting. After menopause, the risk of chronic diseases including osteoporosis, heart disease and risk increases. Ob-gyns, physicians whose primary responsibility is women’s health, play a leading role in helping treat the symptoms of menopause and the prevention of chronic disease.

Here are the key publications and resources for ob-gyns, other women’s health care providers, and patients from the American College of Obstetricians and Gynecologists (ACOG) and other sources.

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Resources for Ob-Gyns and Women’s Health Care Providers
Resources for Women and Patients

Resources for Ob-Gyns and Women’s Health Care Providers

Practice Bulletin: Management of Menopausal Symptoms (members only)

“Management of Menopausal Symptoms,” issued by ACOG in January 2014, provides evidence-based guidelines for the treatment of menopausal symptoms, including hot flashes and vaginal atrophy, the thinning, drying, and inflammation of the vaginal walls. Hormone therapy, nonhormonal therapy, and other alternative treatments are reviewed.

Committee Opinion: Compounded Bioidentical Menopausal Hormone Therapy

“Compounded Bioidentical Menopausal Hormone Therapy,” issued by the ACOG in August 2012 (reaffirmed 2014), discusses compounded bioidentical hormone therapy for menopausal symptoms and gives recommendations for patient counseling. Compounding is the creation of an individualized medication for a specific patient, based on a physician’s prescription.

Committee Opinion: Hormone Therapy and Heart Disease

“Hormone Therapy and Heart Disease,” issued by ACOG in June 2013, includes practice recommendations relating to hormone replacement therapy and its impact on heart disease. The guideline concludes that hormone therapy should not be used for prevention of heart disease. The guideline notes that hormone therapy does not increase heart disease risk for healthy women in early menopause and can be used for the relief of menopausal symptoms.

Committee Opinion: Postmenopausal Estrogen Therapy: Route of Administration and Risk of Venous Thromboembolism

“Postmenopausal Estrogen Therapy: Route of Administration and Risk of Venous Thromboembolism,” issued by ACOG in April 2013, reviews the evidence on the safety of hormone therapy for menopause symptoms. Hormone therapy is associated with an increased risk of blood clots, called venous thromboembolism, the guideline notes; however, the risk is low in healthy women who do not have additional risk factors.

Committee Opinion: The Role of Transvaginal Ultrasonography in the Evaluation of Postmenopausal Bleeding

“The Role of Transvaginal Ultrasonography in the Evaluation of Postmenopausal Bleeding” issued by ACOG in August 2009 (reaffirmed 2013), provides guidelines for ob-gyns about the use of transvaginal ultrasound, versus biopsy, to evaluate a patient with bleeding after menopause for possible endometrial cancer. It concludes that ob-gyns can initially evaluate with either biopsy or transvaginal ultrasound.

Practice Bulletin: Osteoporosis (members only)

“Osteoporosis,” issued by ACOG in September 2012, reviews the prevention, screening, diagnosis, and treatment of osteoporosis. The evidence-based guideline recommends that ob-gyns address bone health with all their patients, including lifestyle factors that may affect bone density and fracture risk. It includes updated recommendations for calcium and vitamin D levels for women.


Resources for Women and Patients

Patient FAQ: The Menopause Years

“The Menopause Years,” issued by ACOG in May 2015, was developed for patients who have questions about menopausal signs, symptoms, and treatments, including hormone replacement therapy.

Patient FAQ: Osteoporosis

“Osteoporosis,” issued by ACOG in September 2013, address patient questions about risk factors, symptoms, testing, treatment, and prevention of osteoporosis. At menopause, the rate of bone loss increases and can lead to osteoporosis.

Patient FAQ: Perimenopausal Bleeding and Bleeding After Menopause

“Perimenopausal Bleeding and Bleeding After Menopause,” issued by ACOG in May 2011, answers patient questions about causes, diagnosis, and treatment of the irregular bleeding or spotting that often occurs during perimenopause and after menopause.


The American College of Obstetricians and Gynecologists (ACOG), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 57,000 members, ACOG strongly advocates for quality women’s health care, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care.

ACOG eModules

PROLOG eModules

ACOG eModules is an online self-evaluation and learning program. Each module offers testing, rich discussion, and CME. See our module on Menopause.

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998