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
Symptoms
- 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
Diseases
- 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
Management
- calcium intake
- low impact, weight-bearing exercises
- prevent bone loss
- oestrogen replacement
- risk of endometrial hyperplasia, breast cancer & hypercoagulation