A multifactorial approach to complaints during the climacteric

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Abstract
Besides somatic experiences such as vasomotor symptoms, and sexual difficulties related to atrophy of the vagina, the climacteric is frequently associated with psychological symptoms. However, no evidence exists that psychological symptoms are directly related to hormonal changes during the climacteric. Psychological and social factors not specifically related to the climacteric appear to be an important predictor of psychological complaints during this period. Menopause has for long been regarded as a deficiency disease, requiring medical attention and hormone replacement therapy. However, it may be concluded that oestrogen is only a specific treatment for hot flushes and dyspareunia, but has no clear role in the management of psychological symptoms in menopausal women. A multifactorial approach, paying attention simultaneously to biological, psychological and social factors supposed to influence complaints during the climacteric may be more appropriate. A description of an integration of medical and cognitive‐behavioural treatment procedures in case of climacteric symptoms is given.