Physiology of the Menopause Transition

Question 1

Cause

Answer 1

Follicular depletion

Question 2

Normal length of follicular and luteal phase

Answer 2

14 days/14 days = 28 days

Question 3

Key hormonal changes

Answer 3

FSH increases stimulating rise in estradiol initiating LH surge and ovulation and then production of progesterone (peaks days 20-22)

Question 4

Effect of declining follicle numbers and size of cohoart

Answer 4

Results in decrease in inhibin B and AMH which releases
the restrain on follicular growth. So the allows for quicker growth of the dwindling pool causing accelerated follicle atresia

Question 5

Early MT (-2)

Answer 5

• ## increased irregularity of menstrual cycle by 7 or more days; an occasional skipped menstual period. Estradiol and FSH levels may vary. Follicular phase shortens as follicular growth accelerates making the luteal phase longer which can lead to premenstrual symptoms and more frequent periods. Sometimes there is ovulatory failures which contributes to irregular cycles

Question 6

Late Transition (-1)

Answer 6

• follicular depletion drops below a critical threshold and the compensatory mechanism that kept the cycle regular fails
• folliculogenesis is intermittent
• amenorrhea of longer than 60 days
  -estrogen deficiency symptoms become more prevalent due to decreased production
• progesterone is also decrease due to lack of ovulation
• eventually estradiol and progesterone produce ceases
• FSH levels are variable