EMAS Position Statements and Clincial Guides
- Life expectancy has considerably increased since 1970 , and now >50% of women are expected to break the 90-year barrier by 2030 . Growing older rather than old means spending almost half of life after the menopause, challenging the concept of healthy ageing . Iatrogenic menopause may be induced by cancer treatment or bilateral salpingo-oophorectomy for benign disease and may occur before the average age of natural menopause, which is around the age of 50 [4,5]. The sudden fall in estrogen levels with iatrogenic menopause may lead to rapid onset of vasomotor symptoms .
- Women's health is increasingly recognized as a global health priority . The menopause, or the cessation of menstruation, is a stage of the life cycle which will occur in all women. The average age at menopause is 51 years. With increasing life expectancy many women will live for several decades after the menopause. However, the menopause can occur much earlier, either naturally, with no identifiable underlying cause , or as a consequence of disease, surgery, radiotherapy or chemotherapy. The resulting estrogen deficiency may lead to menopausal symptoms which, for some, can present considerable difficulties in their working lives, discrimination in the workplace and even unemployment .
- The European Menopause and Andropause Society (EMAS) aims to provide holistic consensus advice on the clinical management of menopausal women through its position statements and clinical guides . EMAS’s healthcare model for healthy menopause covers physical, psychological and social functioning, and incorporates disability and disease . This position statement sets out a model of care for the management of depressive symptoms and depressive episodes in peri- and postmenopausal women, integrating services provided by healthcare and allied professionals.
- Timing of menopause is an indicator of ovarian function and has important health implications. Natural menopause is commonly defined as the time when a woman has experienced 12 consecutive months of amenorrhoea without obvious cause , such as removal of both ovaries (bilateral oophorectomy), chemotherapy or radiotherapy for cancer. The International collaboration on the Life course Approach to reproductive health and Chronic disease Events (InterLACE)  recently reported that the average age at natural menopause across 21 studies from 10 countries ranged from 47 to 53 years, varying across ethnic groups from 48 years for women of South Asian background to 50 years for Caucasian women living in Australia and Europe, and 52 years for Japanese women .
- Estrogen deficiency due to menopause affects a woman on all levels, from subcellular structures, organs, regulatory systems to bio-mental-psycho-social functioning . Accordingly, various (non)specific symptoms may occur, called climacteric syndrome. Despite its multidimensional phenotype is has been classified only unidimensionally so far using the ICD-10 (N95) . Recently, the European Menopause and Andropause Society (EMAS) proposed a new Healthy Menopause Health Care Model which aims to set up a personalized care plan for short-, mid- and long-term goals in the context of physical, psychological and social functioning .
- Diabetes mellitus (DM) is a public health problem, especially in developed countries. It affects about 9.1% of the adult population in Europe and 13.3% in the United States of America . The greater prevalence of DM in developed countries is broadly associated with ageing of the population . Between 2015 and 2030, the world population aged over 60 years is projected to increase by 56%, from 901 million to 1.4 billion; by 2050 it is expected to reach nearly 2.1 billion . These data suggest that the number of postmenopausal women with DM will grow substantially.
- Pelvic floor disorders include pelvic organ prolapse (POP), urinary incontinence (UI), fecal incontinence, pelvic pain and sexual dysfunction.