Physiology of Menopause kau生理更年期九.sa.pptVIP

Physiology of Menopause Dr Samaa Nazer Consultant - Assistant Professor King Abdulaziz University Menopause Menopause :- Perminent cessation of menstruation caused by failure of ovarian follicular development in the presence of adequate gonadotrophin stimulation. Climacteric :- The physiologic period in a womens life during which there is regression of ovarian function. Premature ovarian failure :- Cessation of menstruation due to depletion of ovarian follicles before the age of 40y. Menopause Menopause Age Median - 51.4, range of 48-55 yrs Median for perimenopause - 47.5 years, median length of 4 years Premature menopause -caused by genetic abnormalities on the long and short arm of X chromosome Earlier menopause: surgical causation (30%) family history of early menopause cigarette smoking, blindness abnormal chromosome karyotype precocious puberty left-handedness Later age : obesity higher socioeconomic class Menopause Society In most societies in the western world, about 13 % to 14% of the population are older than 50 years. Average age of menopause in USA is 50-51 year Physiologic menopause Iatrogenic menopause :- Surgical, radiation therapy ,chemotherapy, infection and tumer physiology of the perimenpausae Shorten of menstrual cycle length or anovulatory cycle and prolong cycle Shorten of the follicular phase ,↓no of follicles ↑ FSH ↓ inhibin hormone Estradiol level fluctuate but remain within the wide range Progesterone level fluctuate depending on the presence adequacy of ovulation Androgen level steadily ↓ during the transitional period Ovarian Dysfunction Women are born with about 1.5 million ova At menarche ↓400,000 ova Most women menstruate about 400 times between menarche menopause With menopause, the ovary is no longer capable of responding to pituitary gonadotropins →↓ production of estrogen progesterone Physiology of menopause Ovarian dysfunction Few remaining follicular units present but those are no longer cap