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MENOPAUSE

Definition: Menopause is physiological cessation of menstruation due to exhaustion of primordial follicles in the ovary climatric  initiate period of weaning ovarian function. [The ovary age between [45-55] average 50]. MENOPAUSE. Hormonal changes after menopause:

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MENOPAUSE

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  1. Definition: Menopause is physiological cessation of menstruation due to exhaustion of primordial follicles in the ovary climatric  initiate period of weaning ovarian function. [The ovary age between [45-55] average 50] MENOPAUSE

  2. Hormonal changes after menopause: • Pituitary Gn mainly FSH  to loss of –ve feed back mechanism with estrogel. • Later on the FSH • Estrogen . The main source of estrogen is: • Supra renal gland • Good amount of circulating conversion of androstendion into estrone in the adopise tissues • Androgen  slightly • Thyroid gland  slight hypothyroidism • Progesterone  absent MENOPAUSE

  3. 1.Vasomoter hot flushes and sweating ( FSN) 2. Psychological  • irritability • Depression • Headache • insommia 3. Rheumatic pain  • Due to osteoporosis ( estrogen) • osteothritis Menopausal symptoms:

  4. 4. Gastro interstinal erect  • dyspesia • Constipation 5. Obesity  • Increase appetite • Due to alteration in CHO metabolism 6. Sexual  • Lipido • dyspareunia Menopausal symptoms:

  5. General changes after menopause • Breast  • Shrivelled • Flat • Bone  as a result of increase estrogen • Osteoporosis  backpain • Spinal compression 5 times 2.5. height • Celles fracture 10;  mobility • Hand 0.3/1000 ; 20/100; 15-20% die  and fracture of vertebral body, humerous, upper femme distal forearm and ribs. • Atherosclerosis • Hypertension • Coronary heart diseases

  6. Vulva  • loss of fat from labia • Narrow entroitsus • Vagina  • the epithelium is thin and atrophic • Loss of vaginal rugae • Glycogen deposition • Alkaline PH  senile vaginitis • Uterus  small and lined with basal layer of endometirum only. • Ovaries  ovaries shrunken and atrophic • Pelvic cellular tissue and ligament – lax • Menstruation  may stop suddenly or gradual in amount or in pregnancy

  7. Emotional changes after menopause; • Some women may develop – depression • Anxiety • Nervousness • Depresssion.

  8. 1. General treatment: • Reassurance • Avoid obesity • Improve the general condition 2. Medical treatment: • Sedative may be indicated 3. Hormonal treatment • Estrogen – control hot flushes by inhibiting FSH • Estrogen and progesterones – progesterone used to prevent of endometrial hyperplasia  so that result from estrogen alone. • Androgen – may be use to FSH But they have androvirilising effect Management of the climatric – menopausal symptoms

  9. 4. Other consideration • Women receiving Ga & phosporous should have blood test for Ca & phosporous yearly for the first 2 years. • Clomidine  to reduce hot flushes but it is less effective.

  10. Gastro interstinal erect  • dyspesia • Constipation • Obesity  • Increase appetite • Due to alteration in CHO metabolism • Sexual  • Lipido • dyspareunia Menopausal symptoms:

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