‘Patient’s history should guide treatment of perimenopause ’

Menstrual disorder is common in perimenopausal women but it is rare to have a sinister cause, said Mary Ann Lumsden, chief executive of International Federation of Gynaecology and Obstetrics (FIGO).

She was delivering the Second Esther Memorial Oration virtually on Sunday at the continuing medical education programme organised by Chennai Menopause Society. “Investigation is generally straightforward and effective treatment options are available even during a COVID pandemic,” she assured the participating gynaecologists. Since anaemia affects a woman’s life from the early reproductive years till their menopause and in India anaemia could be as high as 40%-60%, she said a patient’s complaints of abnormal uterine bleeding should alert the doctor to go through the patient’s history always keeping in mind the need to maintain a healthy level of haemoglobin.

With India not offering routine screening for cervical cancer, gynaecologists should be alert when a woman comes with complaints of irregular bleeding and should examine the cervix, she said.

Careful investigation of the women’s history, especially if they are entering menopause early, would provide a clue, she said.

She advised against hysterectomy, particularly in women with large fibroids.

History and routine examination would provide information about whether the woman was at risk of complications. Doctors should take into view factors such as obesity, genetic predisposition and history of Polycystic ovary syndrome (PCOS). The oration was instituted by Hepzibah Kirubamani N., vice-president of the society, in memory of her mother, said Jaiashree Gajaraj, who presided over the event.

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