These will not improve symptoms such as joint pain or vaginal dryness which affects over 55% of women. Exercise may help with sleeping problems. While Many of the concerns about the use of MHT raised by older studies are no longer considered barriers to MHT in healthy women. High-quality evidence for the effectiveness of alternative medicine has not been found. There is tentative evidence for phytoestrogens. Signs and symptoms
During early menopause transition, the menstrual cycles remain regular but the interval between cycles begins to lengthen. Hormone levels begin to fluctuate. Ovulation may not occur with each cycle.The term menopause refers to a point in time that follows one year after the last menstruation. During the menopausal transition and after menopause, women can experience a wide range of symptoms. However, for women who enter the menopause transition without having regular menstrual cycles due to prior surgery, other medical conditions or ongoing hormonal contraception the menopause cannot be identified by bleeding patterns and is defined as the permanent loss of ovarian function. Vagina and uterus
During the transition to menopause, menstrual patterns can show shorter cycling (by 2–7 days); longer cycles remain possible. There may be irregular bleeding (lighter, heavier, spotting). Dysfunctional uterine bleeding is often experienced by women approaching menopause due to the hormonal changes that accompany the menopause transition. Spotting or bleeding may simply be related to vaginal atrophy, a benign sore (polyp or lesion), or may be a functional endometrial response.
Tenosynovial giant cell tumor (TGCT) is a group of rare, typically non-malignant tumors of the joints. TGCT tumors often develop from the lining of joints (also known as synovial tissue). : 100 : 245 Common symptoms of TGCT include swelling, pain, stiffness and reduced mobility in the affected joint or limb. : 102  This group of tumors can be divided into different subsets according to their site, growth pattern, and prognosis. : 361  Localized TGCT is sometimes referred to as giant cell tumor of the tendon sheath;: 100  diffuse TGCT is also called pigmented villonodular synovitis (PVNS). : 102

Classification
Classification for TGCT encompasses two subtypes that can be divided according to site – within a joint (intra-articular) or outside of the joint (extra-articular) – and growth pattern (localized or diffuse) of the tumor(s). : 100 : 361  Localized and diffuse subsets of TGCT differ in their prognosis, clinical presentation, and biological behavior, but share a similar manner of disease development. : 100

Localized TGCT
Localized TGCT is sometimes referred to as localized pigmented villonodular synovitis (L-PVNS), giant cell tumor of the tendon sheath (GCT-TS), nodular tenosynovitis, localized nodular tenosynovitis, and L-TGCT. : 1 : 100 The localized form of TGCT is more common. : 100 : 245  Localized TGCT tumors are typically 0.5 cm-4 cm),: 101  develop over years,: 100  are benign and non-destructive to the surrounding tissue, and may reoccur in the affected area. : 101  The most common symptom is painless swelling. : 101  Localized TGCT most often occurs in fingers, but can also occur in other joints. Diffuse TGCT
Diffuse TGCT is sometimes referred to as pigmented villonodular synovitis (PVNS), conventional PVNS, and D-TGCT.