Menopause



Menopause







TERMS




QUICK LOOK AT THE CHAPTER AHEAD

Menopause is defined as the cessation of menses for 12 consecutive months. The age at which menopause occurs is predetermined genetically. There are several possible stages of menopause: perimenopause, menopause, induced menopause, premature menopause, and postmenopause. Currently, diagnosing menopause is based solely on the patient’s symptomatology. Traditionally, measuring a serum estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were enough to determine whether a woman was in menopause.

Consequences of menopause include increased risk of cardiovascular disease, hypertension, hyperlipidemia, and osteoporosis or osteopenia.

Treatment options for menopause include hormone therapy (HT), which continues to be controversial, and complementary or alternative therapies. Life-style changes are also recommended to help reduce menopausal symptoms.


Menopause is defined as the cessation of menses for 12 consecutive months. It is also referred to as the climacteric phase of a woman’s life. The average age of menopause in the United States is 51 years of age. Women today can expect more than one-third of their lives to be ahead of them when they reach menopause and have a mean life expectancy of 84 years. The age at which menopause occurs is predetermined genetically as is the onset of menarche in young women. A woman can expect menopause at about the same age that her mother or older sisters experienced it. Cigarette smoking can increase the onset of menopause by about 2 years. Table 19-1 describes the different stages of menopause.



imageMenopause is defined as the cessation of menses for 12 consecutive months. It is also referred to as the climacteric phase of a woman’s life. The average age of menopause in the United States is 51 years of age. Women today can expect more than one-third of their lives to be ahead of them when they reach menopause and have a mean life expectancy of 84 years.








Table 19-1 Stages of Menopause





































Stage

Characteristics


Perimenopause

Two to 8 years before the last menstrual period when changes occur plus 1 year after menopause


Begins in mid-40s with subtle changes in menstrual cycle characteristics


Occurs when incidence of pelvic disorders are statistically high


Cessation of menses could be due to endometrial polyps, cancer, or precancerous condition


Menopause

No menses for 12 consecutive months or when ovaries are surgically removed or damaged


Induced menopause

Immediate menopause caused by medical intervention such as


Surgery


Chemotherapy


Radiation


Certain drugs, such as immunosuppressive therapy


Premature menopause (also known as physiological menopause)

Naturally occurring menopause before the age of 40


Only found in one in four women


Caused by autoimmune disorders, endocrine disorders, childhood illnesses (i.e., mumps, viral infections), reproductive tract tumors, or malnourishment


Postmenopause

All the years beyond menopause


Greatest risk for developing complications due to lack of estrogen




PATHOPHYSIOLOGY

Ovaries are responsible for the production of estrogen and progesterone as well as small amounts of androgens, including testosterone, which are responsible for a woman’s libido. The other function of the ovaries is to produce eggs. At birth, the ovaries contain approximately a half million follicles, which decrease with age. When puberty occurs, the follicles mature to become eggs. As the number of follicles or eggs decrease, estrogen levels begin to decrease. Approximately 90% of all circulating estrogen is produced by the ovaries; however, androgens produced by the adrenal glands convert the adipose cells into estrogen.



imageAt birth, the ovaries contain approximately a half million follicles, which decrease with age.

The pituitary gland produces follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH causes stimulation of the follicles to develop, whereas LH causes the release of the egg from the ovary. The biofeedback between the ovaries, the hypothalamus, and the pituitary gland must be well regulated for menstruation to occur. As the ovary produces less estrogen and progesterone, FSH and LH levels rise and irregular menses occur. Ultimately, the production of ovarian follicles ceases, leading to decreased estrogen and progesterone levels while FSH and LH levels remain high. This causes menstruation to stop.

Only gold members can continue reading. Log In or Register to continue

Related posts:

  1. Embryology and Fetology
  2. TORCH
  3. Cardiac Structural Defects
  4. Dermatitis and Psoriasis

Stay updated, free articles. Join our Telegram channel
Tags:
Oct 17, 2016 | Posted by in NURSING | Comments Off on Menopause

Full access? Get Clinical Tree
Get Clinical Tree app for offline access