Contemporary Clinical Research on Menopause

Abstract

To the present time, knowledge about menopause has accumulated largely because of observational and epidemiological studies in postmenopausal women. The challenge for the years ahead is to utilize the information learned from several large epidemiological studies, including the Postmenopausal Estrogen-Progestin Intervention (PEPI) trial, the Women's Health Initiative (WHI), and the Study of Women's Health across the Nation (SWAN), to develop testable hypotheses. Studies of pharmacological agents have also provided information that may be of use in this regard. Some women with so-called premature ovarian failure may form another appropriate experimental group. Appropriate questions for future study are abundant. Why do some women develop vasomotor instability, whereas others never complain of any associated symptoms? Can we predict which women will develop osteoporosis and which will not? Which changes occurring after menopause are related to the cessation of ovarian function and which changes are related to aging? Investigation of these and other such questions will require a return to clinical research that is not population based. This presentation will review some of the advances that have been made by clinical investigation and suggest approaches and questions for the years ahead.