更年期医療における検査と手順

The examination procedure for climacteric medicine

更年期症状を主訴として来院する患者の特徴として“訴え”が多いことが挙げられる．“訴え”の背景に精神的ストレスが起因している場合も多いため，十分な問診が必要である．婦人科癌検診，乳癌検診を経時的に行うとともに，更年期以後は，更年期障害だけでなく，脂質異常症，糖代謝異常，高血圧症，骨粗鬆症など内科的疾患も増加してくるため，婦人科的アプローチだけでなく，総合的な診療を心がけることが重要である．

Menopause is associated with climacteric disorders, and it is well known that cardiovascular disease and osteoporosis increase after menopause.　The management of postmenopausal women requires strategies for treating the climacteric disorders and improving quality of life.　Before starting hormone replacement therapy, cervical and endometrial smears and screening mammography should be carried out.　Smoking, diabetes and hypertension are risks for cardiovascular disease in Japanese women.　Hypertension and insulin resistance increase, and bone mineral density decreases after menopause.　Measurement of blood pressure, blood sugar and BMD is recommended as a comprehensive management in climacteric medicine.