Menopause physiology

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The menopause, from the Greek 'Menos' (month) and 'Pausis' (cessation) is defined as the last menstrual period. The diagnosis can only be made retrospectively after

Age of menopause

1S50

1900 1950

Date

2000

Fig. 47.1 Female life expectancy From Cope 1976.

a minimum of 1 year's amenorrhoea. Although the menopause occurs at an average age of 51, the physiological changes which result in the final menstrual period (FMP) can start 10 years prior to this. Hormonal changes continue long after the FMP. This episode of dynamic neuroendocrine change is characterized by 'the climacteric' from the Greek 'Klimax' ladder, that is, the climb to the menopause. It may be associated with distressing clinical problems such as reduced fertility, menstrual irregularity and vasomotor symptoms. The intermediate sequelae of these changes are typically seen in the skin and urogenital tract and in the long term, in skeletal and cardiovascular pathology.

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