Tag Archives: perimenopause

Menopause

Menopause is a process of permanent cessation of menstruation at an end of reproductive life that is cause by loss of ovarian follicular activity. It is when the last and final menstruation occurs. Clinical diagnosis can be confirmed after following stoppage of menstruation (amenorrhea) for 12 consecutive months with no other pathology. This is the time a woman is declared to reach menopause only retrospectively. Premenopause refers to the period prior to menopause, postmenopause to the period after menopause and perimenopause to the period around menopause (40–55 years).

Climacteric is the period of time during which a woman passes from the reproductive to the nonreproductive stage. This phase covers 5–10 years on either side of menopause.

Perimenopause is the part of the climacteric when the menstrual cycle is likely to be irregular.

Postmenopause is the phase of life that comes after the menopause.

Age at which menopause occurs is genetically predetermined. The age of menopause is not related to age of menarche or age at last pregnancy. It is also not related to number of pregnancy, lactation, use of oral pill, socioeconomic condition, race, height or weight. Thinner women have early menopause. However, cigarette smoking and severe malnutrition may cause early menopause. Age of menopause ranges around 45–55 years, average about fifty years.

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Few years prior to menopause, along with depletion of the ovarian follicles, the follicles become resistant to pituitary gonadotropins. As a result, effective folliculogenesis is impaired with diminished estradiol production. There will be a significant reduce with the level of serum estradiol from 50–300 pg/mL before menopause to 10–20 pg/mL after menopause. This decreases the negative feedback effect on hypothalamopituitary axis resulting in increase in FSH. The increase in FSH is also due to diminished inhibin. Inhibin, a peptide, is secreted by the granulosa cells of the ovarian follicle. The increase of LH occurs subsequently.

Disturbed folliculogenesis during this period may result in anovulation, oligo-ovulation, premature corpus luteum or corpus luteal insufficiency. The sustained level of estrogens may even cause endometrial hyperplasia and clinical manifestation of menstrual abnormalities prior to menopause. The mean cycle length is significantly shorter. This is due to shortening of the follicular phase of the cycle.

Luteal phase length remaining constant. Ultimately, no more follicles are available and even some exist, they are resistant to gonadotropins Estradiol production drops down to the optimal level of 20 pg/mL → no endometrial growth → absence of menstruation.

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Following menopause, the predominant estrogen is estrone and to a lesser extent estradiol. Serum level of estrone (30–70 pg/mL) is higher than that of estradiol (10–20 pg/mL). The major source of estrone is peripheral conversion (aromatization) of androgens from adrenals (mainly) and ovaries. The aromatization occurs at the level of muscle and adipose tissue. The trace amount of estradiol is derived from peripheral conversion of estrone and androgens. Compared to estradiol, estrone is biologically less (about one-tenth) potent.

When the sources fail to provide the precursors of estrogen for around 5–10 years after menopause, there will be a significant reduce in estrogen and trophic hormones. Then it can be confirmed that the woman is in a state of true menopause.

Learn more about andropause – male menopause

If you are interested in sexual health and even if you are not, you have probably read something about female menopause. But articles about male menopause or andropause are very rare. Here are some of the things that you should know about andropause.

As you can see the word andropause sounds very similar to menopause and it comes from the Greek words Andros which means Man and Pausis which means End while menopause means end of the menstrual periods. It is worth mentioning that the term andropause is not widely accepted and there are still discussions if it should be used or not.

Whether the term is accepted or not, doesn’t change the fact that there are around 40% of men around 45 to 55 years old that have to deal with andropause. The first signs can be noticed when a man turns 30 years. It is a hormonal change that affects the sensitivity. During the process of aging, men produce less androgen. It is interesting that male and female menopauses have a lot in common and the main difference is that female menopause is a lot more researched. The reason might be the sense of loss of manhood that men feel during this period.

There are some clear symptoms that point to andropause and some of them include – loss or decrease of erection, lack of libido, fatigue, lethargy, depression, irritability, loss of bone mass, nervousness, muscle and joint aches, night sweats, frequent urination, osteoporosis, stress, cardiac arrhythmias, weight gain etc. Some men also feel more maternal, they become more sensitive and kinder.

Mend find very hard to deal with these things and their loss of manhood and that’s why they don’t want to talk about it. However, conversation is one of the most efficient methods for those who want to overcome the problems that andropause brings. You can talk with your friends, partner or doctor or talk with all of them. Just like in any other situation physical activity can be very helpful. And avoiding alcohol and tobacco can be useful too.

It often happens that both partners go through perimenopause simultaneously. This can be very stressful and in some cases devastating for the relationship. The changes in sexuality are very obvious – the erections are not that neither frequent nor predictable/powerful so the man can feel especially embarrassed especially if the woman becomes more imaginative or sexually active in the bed. The feeling of inability to satisfy the partner is constantly present. This situation can be resolved only through conversations. If they are having difficulties, a visit to a therapist is a must. After all they are experts and they have various methods that can help you. All these methods bring changes that can even strengthen the relationship.

Andropause should not be confused with midlife crisis which has its roots in sensibility and it is caused by emotions. Furthermore, midlife crisis usually occurs between 35 and 45 years while andropause usually occurs between 50 and 55 years.