Vasomotor Symptoms as a Vital Sign: Cardiovascular, Metabolic, and Mental Health Risk in Menopause Care-Engaging the Patient in the Decision

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Video Summary

Dr. Shepard argues that menopause care should extend beyond hot flashes to address women’s long-term cardiovascular, metabolic, bone, sleep, and mental health. Because symptoms can begin in the early 40s and vary in severity and duration—including across ethnic groups—clinicians should ask detailed, practical questions rather than rely on a simple yes-or-no checklist.<br /><br />She recommends using midlife visits as opportunities for prevention: assess blood pressure, family history, lipids and other relevant markers, body composition, sleep, mood, and lifestyle. Wearables and digital tools may help track symptoms and progress. She also emphasizes distinguishing age-related changes from the effects of hormonal transition.<br /><br />Treatment should be individualized and based on shared decision-making. Hormone therapy may be appropriate for many women, while nonhormonal options remain available for those who cannot or prefer not to use it. Nutrition, exercise, resistance training, sleep, and stress management are essential foundations of care. Clinicians should ask what matters most to each patient, what outcomes they hope to achieve, and what success would look like, then reassess and adjust treatment over time.

Keywords

menopause care

cardiovascular health

individualized treatment

hormone therapy

preventive screening

shared decision-making

lifestyle management