Effects of Estrogen Deprivation: Vasomotor Symptoms, Urogenital Atrophy, and Psychobiologic Effects

Vasomotor symptoms, or hot flashes, are the classic symptom of menopause and respond more reliably to estrogen than do other symptoms. Estrogen deprivation causes vaginal dryness and atrophy, which may lead to dyspareunia and possibly to frequent urinary track infections (UTIs) or urinary incontinence. Although there is no clearly defined menopausal depression, there may be a syndrome of depression and mood changes that occur in a small subset of the menopausal population. Mood changes, if they occur, happen most frequently in the perimenopause, or just before menopause. Sexual problems in menopause are complex and include partner factors, dyspareunia, decreased frequency, and decreased libido. Sleep problems include fatigue and disturbed sleep, and have been correlated with awakenings from hot flashes. Some evidence to support that estrogen maintains cognition in women, especially in areas of verbal memory.