MENOPAUSEMENOPAUSEWHAT?WHAT?WHAT?WHAT?MenopauseisadeviationoftheancientGreekwordsmenos(month)andpauses(ending).Themenopauseissometimesknownasthemenopauseissometimesknownasthe'changeoflife'andismarkedbytheendingof'changeoflife'andismarkedbytheendingofmenstruation.menstruation.WHAT?WHAT?WHAT?WHAT?ItbedefinedwithcertaintyafterItbedefinedwithcertaintyaftertwelvemonths'spontaneoustwelvemonths'spontaneousamenorrhoea.amenorrhoea.Endofreproductivelife.Endofreproductivelife.Age(years)Pre-menopausePost-menopauseMENOPAUSE1YEARPeri-menopause“Climacteric”RELATEDTERMINOLOGYRELATEDTERMINOLOGYRELATEDTERMINOLOGYRELATEDTERMINOLOGYWHEN?WHEN?WHEN?WHEN?Menopausalage:45-55yearsMenopausalage:45-55years(mean:50.7years)(mean:50.7years)IfthemenopauseoccursinawomanIfthemenopauseoccursinawomanwhoisunder45yearsofage,itiswhoisunder45yearsofage,itisknownasprematuremenopause.knownasprematuremenopause.Latemenopause:>55yearsoldLatemenopause:>55yearsoldWHEN?WHEN?WHEN?WHEN?OtherfactorsthatcanaffecttheageOtherfactorsthatcanaffecttheageatwhichwomenhavetheirfinalatwhichwomenhavetheirfinalperiodincludeageatmenarche,periodincludeageatmenarche,parity,previousoralcontraceptiveparity,previousoralcontraceptivehistoryethnicityandfamilyhistory.historyethnicityandfamilyhistory.WHY?WHY?WHY?WHY?RELATIVEACTIVITYOFESTROGENRELATIVEACTIVITYOFESTROGENWHY?WHY?WHY?WHY?ThemenopauseistheendofeggThemenopauseistheendofeggproduction(ovulation).Thisoccursproduction(ovulation).Thisoccursasaresultoffallinglevelsoftheasaresultoffallinglevelsofthefemalesexhormoneoestrogen,femalesexhormoneoestrogen,whichregulatesawoman'speriods.whichregulatesawoman'speriods.WHY?WHY?WHY?WHY?ThemenopauseresultsfromafallinThemenopauseresultsfromafallinthelevelofthefemalehormonethelevelofthefemalehormoneoestrogenintheblood.oestrogenintheblood.WHY?WHY?WHY?WHY?Atahormonallevel-asovarianAtahormonallevel-asovarianfollicularactivitybeginstofail,follicularactivitybeginstofail,oestrogenandprogesteronelevelsfalloestrogenandprogesteronelevelsfallandthereducednegativefeedbacktoandthereducednegativefeedbacktothepituitarycausesariseinluteinisingthepituitarycausesariseinluteinisinghormone(LH)andfolliclestimulatinghormone(LH)andfolliclestimulatinghormone(FSH).hormone(FSH).HOW?HOW?HOW?HOW?OestrogenreductioneventuallyOestrogenreductioneventuallyresultsinmenstrualcycledisruptionresultsinmenstrualcycledisruptionandothermenopausalsymptoms.andothermenopausalsymptoms.HOW?HOW?HOW?HOW?OestrogenreductioneventuallyresultsinOestrogenreductioneventuallyresultsinmenstrualcycledisruptionandothermenstrualcycledisruptionandothermenopausalsymptoms.menopausalsymptoms.**FSHhigh(30–170mU/ml)*LHhigh(20–80mU/ml)*Estradiollow(<110pmol/L)VasomotorSymptomsVasomotorSymptomsSleepDisordersSleepDisordersMenstrualDisordersMenstrualDisordersMoodChangesMoodChangesVaginalAtrophyVaginalAtrophyDyspareuniaDyspareuniaSkinAtrophySkinAtrophyOsteoporosisOsteoporosisAtherosclerosisAtherosclerosisCoronaryHeartDiseaseCoronaryHeartDiseaseCerebrovascularDiseaseCerebrovascularDisease40yrs40yrs50yrs50yrsMenopauseMenopause60yrs60yrsSYMPTOMS!SYMPTOMS!SYMPTOMS!SYMPTOMS!ONSETOFSYMPTOMSINRELATIONTOAGEOFMENOPAUSESYMPTOMS!SYMPTOMS!SYMPTOMS!SYMPTOMS!Changesinyourperiod—timebetweenperiodsorflowmaybeChangesinyourperiod—timebetweenperiodsorflowmaybedifferent.different.Hotflashes(“hotflushes”...
