The Importance of “extragenital Symptoms” during Menopause

Focusing more closely on the question of climacteric symptoms and by listing these symptoms in an order of occur­ rence, one finds that nearly 90% of the effects of sexual hormones are of an extragenital nature and that, therefore, the use of the expression “sexual” to describe these hormones is too much of a restriction in terms of a functional analysis (fig 1). The term “extragenital target organs” was chosen to account for the fact that it was only in the past 20 to 30 years that the whole variety of target organs became known and gave rise to a more specific discussion and understanding. It was our colleague, Dr Markus Metka, from the Gynecological Department of the Vienna General Hospital, who was one of the first to address this issue and to deal with it comprehensively [1]. The working group which he organised for that purpose drew the attention of specialists from the various disciplines to the interac­ tions of sexual hormones and got them involved in further research. One of the main tasks of this working group was to objectively discuss and study the “target organs” which had previously hardly attracted any interest. The variety of climacteric symptoms and the effects of long-term oestrogen substitution on the body, as mentioned above, requires a view of sexual ster­ oids that reaches beyond the sexual sphere. It is from that perspective that