Definition of Menopause

Rodrigo Arrangoiz MS, MD, FACS, FSSO

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  • The definition of menopause is defined as the permanent cessation of menses.
    • The use of the term in breast cancer clinical trials has resulted in a variety of definitions:
      • Including a profound and permanent decrease in ovarian estrogen synthesis.
  • According to the NCCN guidelines, reasonable criteria for determining menopause includes the following:
    • History of bilateral oophorectomy
    • Age greater than or equal to 60
    • Age less than 60 and:
      • Amenorrheic for 12 or more months in the absence of chemotherapy, tamoxifen, toremifene, or ovarian suppression and follicle-stimulating hormone (FSH) and estradiol in the postmenopausal range
    • If taking tamoxifen or toremifene, and age less than 60:
      • Then FSH and plasma estradiol level in postmenopausal ranges
  • It is not possible to assign menopausal status to women who are receiving an LHRH agonist or antagonist.
  • In women premenopausal at the beginning of adjuvant chemotherapy, amenorrhea is not a reliable indicator of menopausal status, as ovarian function may still be intact or resume despite anovulation / amenorrhea after chemotherapy:
    • For these women with therapy-induced amenorrhea:
      • Oophorectomy or serial measurement of FSH and / or estradiol are needed to ensure postmenopausal status if the use of  is being considered as endocrine therapy.
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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