However, you can not talk about menopause itself until it has been a year of amenorrhea. Before the onset of menopause occurs a period of irregular periods and less frequent pre-menopause or perimenopause.
Although there can be wide variations (between 45 and 60 years), their occurrence is around 52 years, life expectancy was reached in the late nineteenth century. At the end of this century, menopause was a key milestone in the existence of women.
There is no scientific basis can do anticipate its appearance: it is usually familial and hereditary character. "Like mother, like daughter." Either way, it seems to depend on the emergence of the first rule, the number of pregnancies, or taking the pill.
Physiology
It would be interesting to remember that menopause is not a disease. It is a physiological process common to all women which marks a stage in their lives.
May be associated with a number of unpleasant symptoms that can be exacerbated by psychological or sociological reasons. Although physiological changes are the same in all women, should be emphasized that the discomfort can vary widely from case to case, so it has a strong individual and unsystematic.
What happens from a hormonal standpoint?
The normal menstrual cycle is divided into two phases:
• Follicular phase.
• luteal phase.
During the first phase, there is secretion of FSH (follicle stimulating hormone) that promotes the development of the follicle for further processing into egg is released around day 14 of the cycle, coinciding with the increase of LH (luteinizing hormone). This is the time of ovulation and the start of the second phase of the menstrual cycle.
Estrogens are elevated during the follicular phase under the stimulation of FSH and down somewhat during the luteal phase, during which increases the concentration of progesterone.
From the standpoint of hormone perimenopause is characterized by a decrease in progesterone production. The cycles are increasingly irregular. With respect to the rule, it is increasingly late (espanomenorrea), weaker (hypomenorrhea) or heavy (irregular bleeding or continuous). Each rule is preceded by premenstrual syndrome.
Menopause marks the end of the secretion of estrogen leading to specific disorders of the same.
Clinical signs
1. Stage of development or perimenopause
Recall that the term "premenopause" is no longer in use, using instead the perimenopausal. Therefore, in this volume always talk about perimenopause.
In general, perimenopause lasts 2 to 3 years, and sometimes up to 8. As we have seen, always accompanied by cycle irregularities and rule, and premenstrual syndromes. These
hormone imbalance symptoms may be accompanied by weight gain.
2. Menopause
Menopause is characterized by the disappearance, sometimes brutal, of the rule. Most often occurs gradually, over several years.
Disorders associated with hormonal deficiency:
• The classic hot flashes affect 1 in 2 women. Its symptoms, sudden sensation of heat for a few minutes and profuse sweating followed by a sensation of cold are unpleasant, but are spaced over time.
• Dry mucous membranes: they are most visible genital level. The lack of lubrication can hinder sexual intercourse. Given this lack of lubrication, the result is an evolution towards vaginal atrophy.
• autonomic disorders:
Palpitations, headache, tiredness, irritability, nervousness, insomnia.
• Osteoporosis is a manifestation of postmenopausal bone demineralization due to the lack of estrogen that act by regulating the osteoclastic action of PTH (parathyroid hormone). It is asymptomatic until the occurrence of fractures.
• Atherosclerosis: hormonal cycles protect women's cardiovascular risk. After menopause, coronary and vascular risk tends to increase and deepen with age. At this time, women lose their natural protection from acquiring the same mortality risk as men.
Additional biochemical analysis
Menopause is essentially a clinical diagnosis. However, you can know the specific hormonal status through the following assessments:
• Estradiol
• FSH and LH
• PRL (prolactin)
It should be noted that hormonal status varies greatly depending on the scope of the menopausal process: at first, there is an increase of FSH and LH as a result of decreased estradiol and other sex hormones. In the period of menopause confirmed, the vaginal smear have characteristics typical (round cells with a large nucleus parabasal).
