Lecture 29 - menopause

Question 1

What is menopause

Answer 1

Ovaries running out of follicuels occurs between 50-52 years
Last menstrual bleed signified end of reproductive life

-age has not changed over the past few years

Question 2

Primary ovarian failure

Answer 2

Ovarian failure under the age of 40 years

affects 1% of women

Question 3

What happens when you get older?

Answer 3

Get less and less follicule but also get an increase in fsh to try and stimulate the last few follicules to develop (but ones earlier in life will be better)
-optimal fertility in 20s

Question 4

timing of menopause

Answer 4

• poorly nourished women have earlier menopause
• women who smoke aslo have earlier
• parity, marital status and age of menarche does not appear to influence timing of menopause
• mothers and daughters have a similar age at menopause

Question 5

Phases that occur with menopause

Answer 5

Pre menopause (40)

• regular menstrual cycles
• menopausal transition (6-8 years) 46 - Become more irregular, and less cycles
• Post menopause - then around 50-52 get last menstruation
• Ovarian senesce- after

Perimenopause - time around menopause up until features are not seen anymore

Question 6

Perimenopausal changes

Answer 6

• Hormone fluctuations start at the begging of menopause and continue through to ovarian senscence
• climateric - physical and emotional symptoms associated with perimenopause

Events - follicules reduce belo a critical thershold

• inhibin B levels decline 0 negative feedback on fsh drops - so this rices
• and acceleration of follicule loss, shroten follicualr phase, increase early follicular oestrogne

Question 7

Features of perimenopuase

Answer 7

irregular cycles
annovulation cycles common
fsh elevated
oestrogen levels high or low
unpredictable hormone patterns
conception is difficult 

-from time of erratic hormone fluctuations which starts at begining of menopause to ovarian senescene

Question 8

Post menopause oestrogen

Answer 8

• no longer get oestrogen beign produced much at all - very low levels

Oestradiol - decreases
Oestrone - decreases but not as much, and is main source

fatty tisues produce oestrone - and ovary secretes estrogiol however now we dont get the estrodiol secretion
-most symptoms are due to reduced amount of oestorgen produced

Question 9

Symptoms

Answer 9

hot flushes, night sweats

• vaginal driness
• reduce breast density
• osteoporosis

Question 10

Hormone treatment therapy

Answer 10

-most of the symptoms of menopause can be prevented or arrested by oestrogen treatment