Review the OMOP standardized vocabularies in release v5.0 29-AUG-26 for an OB/GYN planning research on perimenopause and menopause. This is a vocabulary and clinical-semantics review. There is no patient data set. Do not request patient records, estimate cohort size, assign a feasibility score, or treat lack of clinical data as a failure to complete this task.

Use the installed vocabulary tables as the identifier authority: CONCEPT, CONCEPT_SYNONYM, CONCEPT_RELATIONSHIP, CONCEPT_ANCESTOR, VOCABULARY, and DRUG_STRENGTH where available. Query them read-only. If only exported results are provided, describe the findings as verified against those exports and identify what cannot be independently re-resolved. Never invent an ID, a mapping, or a domain.

1. IDENTIFY THE VOCABULARY RELEASE
Confirm that the available tables or extracts correspond to v5.0 29-AUG-26. If they do not, state the actual vocabulary release and do not attribute its results to this reference release. Report vocabulary-release metadata and source-vocabulary coverage, including missing or limited ICD10PCS or licensed CPT4 content. Distinguish the OMOP CDM version from the vocabulary release. Use the vocabulary release as the reference date; omit download, upload, extraction, and review dates.

2. SEARCH BY CLINICAL TOPIC, NAME, AND SYNONYM
Cover perimenopause and the menopausal transition; established menopause/postmenopause; natural, surgical, treatment-induced, premature, and early menopause; POI and generic ovarian failure; menstrual history, final menstrual period, irregular cycles and amenorrhea; vasomotor, sleep, mood, cognitive, sexual, genitourinary, and bleeding symptoms; hormone tests; patient-reported instruments; hysterectomy, ovarian removal, endometrial/ovarian ablation and suppression; systemic/local therapy, contraception, nonhormonal treatment and indication-ambiguous products; competing explanations and family history.

Do not restrict discovery to one OMOP domain or one search word. Distinguish an instrument, an assessment, an individual item, a total score, a response, and an encounter. Search for MENQOL, Menopause Rating Scale, Kupperman, Greene, FACIT and PhenX terminology and synonyms, but do not assume absence if the initial name search is negative.

3. RETURN A CLINICIAN-READABLE REFERENCE MATRIX
For each relevant concept, report clinical topic, concept_id, exact concept_name, vocabulary_id, concept_code, domain_id, concept_class_id, standard_concept, invalid_reason, validity dates, expected primary table or result field, required answer/value/unit/date, specificity, and the open clinical question. Preserve nonstandard and historical concepts in a separate source/historical inventory. Distinguish valid standard concepts from clinically sufficient evidence.

Explicitly inspect these IDs and use their domain_id in the specified release:
198715 Premature menopause; 4071683 Menopausal symptom; 4113666 Menopausal flushing; 4128329 Menopause present; 4172857 Menopause finding; 4307543 Difficulty managing menopause; 4059477 Menopause; 4113665 Female climacteric state; 45757505 Perimenopausal state; 4295261 Postmenopausal state; 4128330 Menopause absent; 4331463 Premenopausal state; 4028935 Premature ovarian insufficiency; 193739 Ovarian failure; 4279913 Primary ovarian failure.

For hot flashes, also inspect 318566 Flushing, 4181178 Night sweats, 4231628 Hot flash caused by medication, 37170543 Hot flash caused by aromatase inhibitor, 37174285 Hot flash caused by tamoxifen, 46270134 Non-menopausal hot flash, 42868847 FACIT hot-flash item, 40772136 PHQ hot-flashes-or-chills item, and the historical/source IDs 40557760, 40562318, 40618826, and HPO 37432081. Verify their exact labels, validity, and standard status in the specified release.

4. AUDIT SOURCE-TO-TARGET MEANING
Use active Maps to and Maps to value relationships, preserving source and target metadata and relationship validity. Show one-to-many mappings and paired attribute/value mappings. Review whether a mapping adds or loses menopausal attribution, cause, laterality, organ specificity, age meaning, or encounter-versus-performed status. Do not confuse Concept replaced by with Maps to.

Inspect generic Hot flash/Hot flashes sources mapping to Menopausal flushing; ICD10CM N95.2; ICD9CM 627.2 and V07.4; ICD9Proc 65.53, 65.63, 68.71 and 65.01; acquired-absence and prophylactic-removal codes. For V07.4, inspect both the primary target and therapy value. A value concept's domain alone does not dictate the primary event table.

5. REVIEW HIERARCHIES AND ANSWERS
Inspect descendants before recommending expansion. Explicitly check whether broad menopause/menstrual parents include negative status, perimenopause, family history, or unrelated menstrual conditions. Keep a generic parent distinct from an affirmative state. Do not treat test selection, care encounters, gravidity, medication use, or a question's presence as definitive stage evidence.

List reviewed question-answer pairs. Preserve positive, negative, uncertain and missing values separately, with numeric/date responses and units where applicable. Never interpret a generic Yes independently of its question. A combined hysterectomy-or-tubal-ligation question cannot distinguish the two procedures. A recorded LMP date is not automatically a confirmed final menstrual period.

6. REVIEW TREATMENT CATEGORIES
Use ingredients, strength, route, formulation, combination products and product-specific indication information. Distinguish systemic therapy, local vaginal therapy, hormonal contraception, progestogen alone, nonhormonal treatment, and unknown indication. Vaginal route alone does not establish local therapy. NuvaRing/Annovera contraceptive combinations must not be classified as local menopausal hormone therapy; distinguish Femring from Estring. A product can be valid in a vocabulary even if historical or unavailable in a particular country. Do not interpret approval, effectiveness, or clinical use from vocabulary validity alone.

7. SUMMARIZE OPEN QUESTIONS FOR THE OB/GYN
Separate: (a) verified vocabulary behavior, (b) clinical interpretation requiring her judgment, (c) candidate mapping/domain issues for OHDSI review, (d) concept-grouping decisions requiring review, and (e) aspects that would require a future clinical data source. Focus on stage, onset versus recording date, natural versus induced causes, age definitions, symptom specificity and burden, surgery, treatment indication, patient-reported outcomes, and competing explanations.

OUTPUT
Write a standalone clinical reference anchored to the identified vocabulary release.
Return a plain-language clinical overview, a domain/reference matrix, a source-mapping issue table, a prioritized clinical discussion agenda, and exact versioned evidence tables. Include sources for clinical definitions and any guideline differences. Provide optional candidate concept modules as DRAFTS; do not claim clinical validation or generate patient counts. Cite the installed vocabulary snapshot for concept facts and primary sources for clinical guidance. State 'not identified in the searched snapshot' when completeness is uncertain.