Read from Dr. Chen Yu Sui’s notes!

To be updated later.

  • FSH increase 1st
  • Decrease of all other hormones

Phases of changes during climacteric (transition)

  • Hypothalamic-pituitary hypersensitivity
    • Increase FSH
    • Premenopausal symptoms
  • Ovulation & corpus luteum failure
    • low progesterone
    • causes DUB, endometrial hyperplasia, CA
  • Ovarian follicular failure
    • low oestrogen
    • menopause


  • Hot flushes
    • due to oestrogen withdrawal
    • synchronised with pulsatile LH release
  • Depression
    • reduced plasma free tryptophan
      • involved in metabolism of serotonin
      • empty nest syndrome
  • Thinning of the skin & collagen content
    • easily bruised
    • slow heading
  • Loss of vaginal rugae
    • vascular epithelium reduced
      • sensitive towards oestrogen
    • severe atrophy/atrophic vaginitis
      • dyspareunia
    • diminised support of pelvic organs
      • prolapse
      • incontinence


  • Cardiovascular diseases
    • lack of oestrodiol
      • oestrodiol reduces cholesterol, LDL and increases HDL
      • antioxidant effect, prevent oxidation of LDL
  • Osteoporosis
    • calcitonin levels reduced
      • oestrogen deficiency
    • reduced intestinal conversion of Vit D – 1,25-dihydrovitamin D
      • oestrogen dependent
    • lack of growth factor-beta and insulin like growth factor
      • stimulates bone formation previously
    • urinary calcium excretion
      • oestrogen promote reabsorption


  • calcium intake
  • low impact, weight-bearing exercises
    • prevent bone loss
  • oestrogen replacement
    • risk of endometrial hyperplasia, breast cancer & hypercoagulation
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Terri is obsessed with making medical school as painless as possible. She studies and compiles medical school notes in a concise, easy-to-understand format. She also enjoys reading contributions by others. She is an investor in sustainability projects. Her ideal weekend is wine tasting and experimenting on bread-making. She has yet to master the art of Sourdough baking.


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