Definition. Menopause refers to closing cessation of menstruation although climacteric implies the period at which the lady progressively alterations through the reproductive lifestyle into considered one of senescence. Meno¬pause is also referred through the laity as ‘the improve of everyday living’. Nonetheless the two the conditions are often synonymously made use of, menopause currently being the popular term utilized. These are definitely physiological processes on account of cessa¬tion of ovarian follicular operate.
Aetiology. Menopause happens as result of exhaustion of eggs from ovarian follicles and Consequent oestrogen deprivation.
Physiological Alterations in Climacteric or Menopause and Post menopausal age.
Genital. Progressive atrophy of genital organs happens with An increasing number of deposition of fibrous tissue in them.
Ovary. They go modest (5 gm. Every), fibrotic with furrowed surface, Follicles get fatigued. Ovarian Vessels grow to be sclerosed. Cortical stromal hyperplasia is usually a Recurrent obtaining as a result of substantial LH amount in Gals aged forty¬46 yrs. Ovarian stroma turns into a supply of small amount of androgens.
Fallopian tubes shrink with diminished mortility.
Uterus turns into little and fibrotic as a result of atrophy of muscle mass. Endometrium results in being slender and atrophic (senile). In certain Women of all ages, endometrial. hyperplasia may well happen right after menopause because of consistent oestrone stimulation. Cervix atrophies and flushes Together with the vaginal vault. Cervical secretion gets scant, thick and later on 4isappears. The vaginal epithelium atrophies with lack of rugosity. Vaginal smear demonstrates atrophic adjustments. Vagina contracts with shallowness in the fornices. Vulva step by step atrophies with narrowing in the introitus : pelvic mobile tissue becomes little by little lax.
Secondary sex characteristics. Breasts exhibit gradual atrophy of the glandular tissue causing flabbynes. These turn into pendulous on account of deposition of Body fat all-around. Pubic and axillary hair results in being sparse.
Bodily. Overall body weight decreases after sixty five a menopavza long time. There exists lower in mobile mass of organs. Skin wrinkles, results in being considerably less elastic with hair showing up on deal with. Subcutaneous Fats deposition. happens within the hip and thighs. Height diminishes postraenopausally soon after 65 years. Kyphosis may perhaps acquire due to spinal osteoporosis.
Metabolic. Osteoporosis takes place because of oestrogen deprivation. Reduction in trabecular bone (collagen matrix) (Osteoblasts) and Calcium leads to oestrogen deprived Osteoporosis. Premenopausally female is safeguarded against ischaernic heart problems on account of higher HDL and very low LDL cholesterol. The latter rises postmenopause, Hence incidence of ischaernic cardiovascular disease also rises. Premature menopause normal or by oophorectomy suffers from greater danger of cardiovascular conditions (cardiac and cerebral stroke) and osteoporosis.
Digestive. Hypochlorhydria develops. Motor exercise of overall alimentary tract diminishes resulting in dyspepsia and constipation in postmenopausal Gals. Bladder and urethral epithelia atrophy.
Psychosexual. Emotional upsets are popular. At menopause sex urge may well raise. After 60 years, sex urge wanes being an getting older process.
Endocrinal. There exists gonadal failure at menopause. Plasma Oestradiol degree falls, oestrone stays standard, ovarian stroma however, makes andostenedione. Extraglandular conversion of androstenedione to oestrone occurs in fatty tissue. Postmenopausally, adrenal cortex turns into the supply of oestrone derived from androstenedione. Oestrone becomes the predominating oestrogen soon after menopause. Postmenopausal everyday oestrone formation has become estimated as 15 a hundred gg/day (Mac Donald et al, 1973) and serum level at thirty 70 pg/ml. Progesterone secretion ceases within the ovary as a consequence of failure of ovulation. Full urinary oestrogen degree falls to about 6 Pg1 24 several hours at the postmenopausal period. Androstenedione level largely from adrenal cortex, minor . from ovary involves one particular half that noticed before menopause. Testosterone level won’t appreciably tumble mainly because postmenopause ovary secretes far more testosterone.