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March 28, 1986

Estrogen Withdrawal Syndrome

Author Affiliations

University of California, San Diego School of Medicine La Jolla

JAMA. 1986;255(12):1614-1615. doi:10.1001/jama.1986.03370120092029

Nearly a decade ago, I proposed the term "estrogen withdrawal syndrome" to emphasize the importance of health and well-being and socioeconomic impacts during and after the transition of menopause.1 While menopause is a component of the complex process of aging, a well-recognized set of functional changes is attributable to estrogen withdrawal, such as hot flushes and accelerated bone loss. Women with gonadal dysgenesis, who have never had normal levels of endogenous estrogen, do not experience flushes even at an advanced age. However, when estrogen is administered for several months and then treatment is discontinued, these women experience classic menopausal flushes for the first time.1 This observation suggests that menopausal flushes are a manifestation of a classic withdrawal syndrome, mediated through functional changes of estrogen-sensitive neurons within the brain, which are linked to thermoregulation.2,3

The long-term and more serious consequence of estrogen deficiency is the accelerated bone loss,