All About Menopause

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All About Menopause

menopause and menopause

definition. Menopause is the eventual cessation of menstruation, and menopause is the period when a woman transitions from fertile to senile. Menopause is also called a “life change” by laypeople. However, the two terms are often used synonymously, with menopause being the most commonly used term. These are physiological processes due to the cessation of ovarian follicular function.

Etiology. Menopause is caused by the depletion of eggs in the follicle and the ensuing lack of estrogen.

Physiological changes of menopause or menopause and postmenopausal age.

genitals. Progressive atrophy of the reproductive organs occurs as more and more fibrous tissue is deposited in them.

ovary. They become smaller (5g each), fibrous, wrinkled, and depleted of hair follicles. Ovarian vascular sclerosis. Cortico-stromal hyperplasia is a common finding in women aged 40-46 due to high LH levels. The ovarian stroma becomes the source of small amounts of androgens.

The fallopian tubes shrink and fertility decreases.

The uterus becomes smaller and fibrotic due to muscle atrophy. Thinning and shrinking of the lining of the uterus (aging). In some women, the lining of the uterus. Hyperplasia may occur after menopause due to continued estrogen stimulation. The cervix shrinks to the level of the vaginal vault. Cervical secretions become sparse and viscous, followed by 4is. The vaginal epithelium shrinks and loses its wrinkles. Vaginal smears showed atrophic changes. The vagina shrinks as the fornix becomes shallower. As the vaginal opening narrows, the vulva gradually shrinks: the pelvic tissue gradually relaxes.

secondary sexual characteristics. The breasts show a gradual shrinkage of the glandular tissue, resulting in sagging. These become saggy due to the deposit of surrounding fat. Pubic and armpit hair becomes thinner.

physical. Weight loss after age 65. Organ cell mass decreased. The skin wrinkles, becomes less elastic, and hair appears on the face. Subcutaneous fat deposits. Occurs on the buttocks and thighs. Postmenopausal height decreases after age 65. Osteoporosis of the spine may lead to kyphoscoliosis.

metabolism. Osteoporosis is the result of estrogen deficiency. Decreased bone trabeculae (collagen matrix) (osteoblasts) and calcium lead to estrogen-deficient osteoporosis. Premenopausal women are protected from ischemic heart disease due to high HDL and low LDL cholesterol. The latter increases after menopause, and thus the incidence of ischemic heart disease also increases. Premature menopause, either naturally or through oophorectomy, increases the risk of cardiovascular disease (heart attack and stroke) and osteoporosis.

Digestion. Hypochlorhydria develops. Reduced motor activity throughout the digestive tract, leading to dyspepsia and constipation in postmenopausal women. Atrophy of bladder and urethral epithelium.

sexual psychology. Mood disturbances are common. Sex drive may increase during menopause. After age 60, libido tends to wane with aging.

endocrine. Menopause with gonadal failure. Plasma estradiol levels decreased, estrone remained normal, but androstenedione was produced by the ovarian stroma. Extraglandular conversion of androstenedione to estrone occurs in adipose tissue. After menopause, the adrenal cortex becomes the source of estrone derived from androstenedione. Estrone becomes the dominant estrogen after menopause. Daily estrone production after menopause has been estimated at 15 100 mg/day (Mac Donald et al., 1973), with serum levels of 30 70 pg/ml. Progesterone ceases to be produced from the ovaries due to ovulation failure. Total urinary estrogen levels drop to approximately 6 Pg 24 hours after menopause. Androstenedione levels come mostly from the adrenal cortex, rarely. From the ovary came the half seen before menopause. Testosterone levels do not drop significantly because the ovaries produce more testosterone after menopause.

Pituitary gonadotropins. In the absence of negative feedback control by ovarian steroids, FHS and LH secretion is continuously increased. The LH ovulatory surge disappeared and mean basal menopausal gonadotropin levels ranged from 50 to 150 m IU/ml FSH and 50 to 100 m IU/ml LH. By 35 years after menopause, FSH levels are 15 times higher than premenopausal levels, while LH levels increase 3 times. Prolactin levels drop.

timing. The menopausal process may begin gradually 2-3 years before menopause, but may continue until 2-5 years after menopause. The age at which menopause occurs varies from 40 to 55 years, with an average age of about 47 years. Genetic makeup, race and climate affect age at menopause. Women in the tropics experience menopause earlier than women in colder climates. Some people think that early menstruation means late menopause, and late menstruation means early menopause. Early or delayed menopause was considered when menopause occurred before age 35 or after age 55, respectively. Early menopause may be due to ovarian failure, oophorectomy, or irradiation of the ovaries.

Delayed menopause is usually due to some pelvic pathology such as uterine fibroids or related to diseases such as diabetes.

Clinical features of menopause and menopause

Menstrual symptoms. This occurs in the form of: (a) progressive menstrual bleeding followed by cessation of menses, (b) prolongation of menstrual intervals and eventual cessation, or (c) sudden cessation of menstruation. Before menopause, the menstrual cycle becomes anovulatory. Any heavy or irregular bleeding is not menopause as the general public generally believes, but is due to certain pelvic lesions.

other symptoms. Most women remain asymptomatic. They adapt well to the physiological changes of menopause. Some people may experience mild weight gain, joint pain, increased libido followed by a gradual decrease.

sign. Normal women will gradually appear the following symptoms during menopause and later.

1. General signs. Weight gain, fat deposits around the buttocks, buttocks, breasts. Examine the breasts.

2. Genital signs.

vulva. Progressive atrophy, thinning hair, and narrowing of the vaginal opening.

vaginal. This narrows with the ‘bump’ of the vaginal vault, thinning of the mucous membrane and folds of the 18ss.

cervix. Portio vaginalis atrophied and flushed by the vaginal vault.

Uterus. The body feels small and hard.

appendix. The ovaries become unpalpable.

diagnosis. This can be seen in clinical features aided by an atrophic vaginal smear and elevated serum FSH levels of 50 mIU/ml and above. Elevated plasma LH levels are less helpful. Urinary or serum estrogen levels show similar values ​​to those in the follicular phase, thus making the diagnosis less reliable.

Differential diagnosis. Pseudoovulation or pregnancy can mimic the cessation of menstruation caused by menopause.

treat. psychotherapy. Women going through menopause should be explained and reassured when seeking advice to stop menstruation. Improve your health with dietary modifications, adequate rest and exercise, and regular bowel movements. For sleep disorders, diazepam (Valium) 5 mg. or lorazepam 1 or 2 mg. Take orally at bedtime.

menopause or menopausal syndrome

Menopausal syndrome refers to a group of symptoms that some women experience during menopause. 80% of hot flashes (symptoms of vasomotor instability) lasting a year are characteristic of menopausal syndrome. It will reduce itself by 3 4 years. The cause of hot flashes is unknown, but estrogen withdrawal occurs in women with poor vascular control. The rise of hypothalamic endorphins has something to do with it. It is experienced by 25% of women with a psychological background, especially after oophorectomy or ovarian irradiation at a young age.

Blushing depends on the rate of estrogen loss and the formation of extragonadal estrogen. As the body adjusts to the natural drop in estrogen, the flushing gradually disappears.

symptom. These findings are as follows: Vasomotor and other symptoms usually follow or even precede cessation of menstruation.

1. Menstruation. As mentioned in menopause, menstruation stops. Some premenopausal women have emotional symptoms, loss of libido, vaginal dryness, hot flashes, and sweating during sexual intercourse, and some women complain of low and delayed menstruation.

2. Vasomotion. “Hot flushes” (warm sensations) due to dilated blood vessels in the skin are a common experience for these women, spreading over the body in women with the face and neck; this hot sensation may be accompanied by sweating. They may come once a day, but sometimes every hour; they come especially at night. These are all characteristic manifestations of menopausal syndrome.

3. Emotional. This manifests as headache, irritability, insomnia, dizziness, fatigue, depression, palpitations. There may be a “tingling” sensation in the soles of the feet and palms. Sleep disturbances may be due to hot flashes and sweating.

4. Sex. These are loss of libido and dyspareunia due to atrophic vaginitis and lack of vaginal lubrication during intercourse.

5. Musculoskeletal. These manifest as back pain, joint pain due to lax ligaments and muscles.

sign. These are the same as described under Menopause.

diagnosis. This has been described under menopause.

Differential diagnosis. Pseudocysts in pseudopregnancy may be mistaken by patients for menopausal syndrome. The former will cause amenorrhea, breast and abdomen enlargement caused by fat deposition during pregnancy; there is also the illusion of fetal movement caused by flatulence and indigestion. The patient should be assured that her symptoms are menopausal. In all of these cases, pregnancy may also occur and should be carefully ruled out by a thorough examination, immunological urine pregnancy test, and pelvic ultrasound.

premature menopause

definition. Menopause in patients younger than 35 is called premature menopause. reason. The insufficient stock of ovarian follicles will be depleted. Clinical features, symptoms, secondary amenorrhea over 6 months. In some hot flashes, emotional instability, disturbed sleep, loss of libido, (menopausal syndrome). dryness of the hair. sign. Atrophic vaginal epithelium, normal or small sized uterus. investigation. Serum FSH was raised above 50 mIU/ml; ovarian biopsy was not done to show absence of follicles. Therapeutic Assurance, Diazepam for poor sleep. Estrogen therapy for menopausal syndrome. Menstruation cannot take hormone therapy.

Andropause. About 10% of men experience menopausal symptoms later than women due to androgen deprivation. The remaining 90% will gradually adapt without symptoms.

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