Lecture 28 - Menopause Flashcards
4 reasons for menopause?
long life span of humans, senescence (deterioration and protection of aging body), group selection (protection from birth defects), Good Mother/Grandmother theory (pause from reproduction for caring purposes)
Premature ovarian failure?
<40yr, 1% of all women, epidemiology due to delaying childbirth
Follicle loss progression?
7 million in utero, 1 million birth, 400k puberty, 1k menopause
Factors affecting timing of menopause?
poor nourishment, smoking, maternal influence
Andropause?
men between 40 and 55 decline testosterone -> moodswings, fatigue, energy and libido loss
Phases?
Pre-menopause with two paths: menopausal transition into post-menopause (last menstruation) OR peri-menopause (overlay into post-menopause and past last menstruation) into ovarian senescence
Anovulatory cycles?
more likely with age and long cycle length
Climacteric?
physical and emotional symptoms associated with perimenopause
Events during perimenopause?
follicle levels below critical threshold, inhibin B decline w lowered -ved feeback leading to greater FSH levels, accelerating follicle loss from heightened recruitment and shortened follicular phase
Features of perimenopause?
irregular cycles, oestrogen levels high early then low late, ovulation possible, contraception difficult
Postmenopausal estrogen production?
from stromal cells of adipose tissue, less than 10th, oestradiol depletes, oestrone remains but is weaker
Perimenopausal symptoms?
vaginal dryness, uterial reduction, reduced breast density, bone metabolism, bloop lipid changes, behavioural changes
HRT?
no uniform agreement on safety, appropriate for mod-severe symptoms, use for lowest and shortest time, side effects cancer and Alzheimer’s
