1. Background and Purpose
Climacteric and postmenopausal syndrome refers to a variety of mental and physical symptoms that occur perimenopause and post menopause. though many patients use Korean medical institutions, adequate clinical guidelines have yet to be developed. therefore, NIKOM (National Institute for Korean Medicine Development) and the Korea Clinical Guideline Development Committee (the Society of Korean Medicine Obstetrics and Gynecology) agreed on the necessity of developing a clinical guideline for menopausal symptoms and the postmenopausal syndrome. these Clinical Practice Guidelines were developed with the aim of helping objective and reasonable judgments and treatments in clinical settings based on the best evidence currently available.
the guidelines focus on facial flushing (hot flashes) ― a typical acute symptom of menopausal disability and postmenopausal syndromes ― along with vaginal atrophy and urinary symptoms (frequency and incontinence), which are subacute symptoms of menopausal disability and postmenopausal syndromes.
the related diagnostic codes from the KCD (Korean Standard Classi cation of Diseases) are listed below.
• Menopausal and female climacteric states N95.1
• Senile (atrophic) vaginitis N95.2
• Conditions related to artificial menopause (post-artificial menopause syndrome N95.3)
• Other specified menopausal and postmenopausal disorders N95.8
• Menopausal and postmenopausal disorder, unspecified N95.9
• Stress urinary incontinence N39.3
• Overactive bladder N32.81
2. Overview of disease
the aging of women involves the decline of ovarian functions, resulting in an end of the menstrual cycle, ovulation, and menstruation. In clinical terms, menopause is defined as beginning from one year after a woman’s last menstrual period has finished. the timeline that begins before and after menopause is referred to as the climacteric period. thus, menopausal disorder and postmenopausal syndromes encompass various mental and physical disorders that occur during perimenopause and post-menopause. In Korean
medicine, it is difficult to find cases where related symptoms were identied unilaterally as ‘menopausal disorder’ or ‘postmenopausal syndromes’ as it has been the case in Western medicine.
However, there have been descriptions of symptoms that often occur during this period, including ‘Cheongyegwagibujibanglon (天癸過期不止方論)’, ‘Yeonnogyeongsuboghaeng (年老經水復行)’, ‘Yeonnogyeongdanboglae (年老經斷復來)’, ‘Bunglu (崩漏)’, ‘Nonyeonhyeolbung (年老血崩)’, ‘Jangjo (臟躁)’, ‘Baeghabbyeong (百合病)’.
Facial flushing (hot flashes), which is a specific symptom of menopausal disorder and postmenopausal syndromes, can be found in descriptions of ‘Myeonyeol (面熱)’ in Korean medicine. Vaginal atrophy can be found in the symptoms of ‘Daeha (帶下)’, ‘Eumtong (陰痛)’, and ‘Eumyang (陰癢)’ in Korean medicine.
Urinary frequency and urinary incontinence are comparable to ‘Sobyeonsag (小便數)’, ‘Sobyeonbinsag (小便頻數)’, ‘Sobyeonbulgeum (小便不禁)’, ‘Sobyeonlida (小便利多)’ and ‘Sobyeonjali (小便自利)’ in Korean medicine.
