Menopause and HRT glossary

The stages

Perimenopause. The transition leading up to the final period, during which cycles become irregular and symptoms commonly begin. It can last several years and is where most symptom burden sits.

Menopause. Defined retrospectively — the point twelve months after the final menstrual period.

Postmenopause. The period after that point.

Premature ovarian insufficiency (POI). Ovarian function ceasing before age 40. Managed differently from typical menopause, and a reason not to assume general guidance applies.

Surgical menopause. Menopause caused by removal of the ovaries. Onset is immediate rather than gradual, and symptoms are frequently more abrupt.

Symptom domains

Clinical thinking groups symptoms into domains. These are categories, not anyone's intellectual property, and HormoneLog uses them because clinicians do.

Vasomotor. Hot flushes and night sweats.

Psychological. Mood change, anxiety, low mood, irritability, and the cognitive symptoms usually described as brain fog.

Somatic. Physical symptoms not in the other groups — joint and muscle pain, headaches, palpitations, fatigue.

Urogenital. Vaginal dryness, urinary symptoms, discomfort — the domain most under-reported in consultations and most treatable.

Sleep disruption. Frequently entangled with vasomotor symptoms, which is why recording both is more informative than recording either.

Treatment

HRT / MHT. Hormone replacement therapy, also called menopausal hormone therapy. An umbrella term covering several hormones, doses and delivery routes.

Systemic versus local. Systemic treatment acts throughout the body; local treatment acts at the site applied, most commonly for urogenital symptoms.

Formulation. The physical form — patch, gel, spray, tablet, pessary, ring. Changing formulation is a real change and belongs in a log with its date.

Titration. Adjusting dose over time to find what works. The reason a dated record matters more here than anywhere else: the useful question is always what changed after the change.

Regimen. The whole picture — what you take, at what dose, in what form, on what schedule, since when.

Adherence. Whether treatment was actually taken as prescribed. Ordinary information, and useful context for whether something appeared not to work.

Washout. The interval after stopping a treatment before its effects have fully cleared. Relevant when interpreting whether a symptom change followed a change.

Instruments

Symptom scale / instrument. A structured questionnaire producing a score. Used in research to compare groups.

The 21-item scale. A published menopause symptom instrument. Licensed. Its licence holder administers permissions, states it is available to academic researchers without fee while pharmaceutical companies pay per patient enrolled, and notes the instrument cannot retain its official name if items are altered or removed and was validated only for paper administration. There is a genuine conflict in the record, because a NIH-funded toolkit publishes it as one of its standard protocols and states permission is not required — a conflict we are not going to resolve in our own favour.

The 11-item scale. Its licence holder permits non-commercial research use without formal permission and requires contact for commercial licensing.

Validated. Means an instrument has been formally tested for its measurement properties in defined populations. It describes the instrument, not an app that mentions it, and the 21-item scale's own licence holder takes the position that digital adaptations have not been validated.

Severity band. A published cut-off classifying a score as mild, moderate or severe. Derived from research populations. Displaying your number against one is an assessment, which is why HormoneLog does not do it.

Care and records

Clinical diagnosis. NICE NG23's position is that in women over 45 with typical symptoms, menopause can be diagnosed on symptoms without laboratory tests.

HRT review. NICE NG23 sets out a review cadence including a review after starting or changing treatment and annual review thereafter. Check the current guideline text for exact wording.

Symptom diary. A record of symptoms over time. NICE NG23 does not recommend one — it contains no mention of symptom diaries, scores or questionnaires. The Menopause Society is the source that advises making a list of symptoms with frequency and timing.

Appointment summary. A one-page record you can hand over. A 2023 systematic review of 28 UK menopause apps found most lacked any mechanism for sharing data with a provider or exporting structured records.

Local-first storage. Records kept on the device rather than on a server. Relevant in this category specifically: the same review found 32 percent of the apps it assessed indicated third-party data sharing.

ORCHA certification. An independent health-app assessment used by some NHS trust libraries. Several menopause apps carry it.