Menopause is a natural and irreversible part of aging in women, particularly affecting its reproductive function. By definition it is the last menstrual cycle confirmed after 12 months of absence of menstruation, in the absence of pathological reason. The period is associated with many symptoms that include, besides the change in the monthly menstrual cycles also vasomotor and urogenital symptoms such as vaginal dryness and dyspareunia (painful sexual intercourse), disturbed sleep, the occurrence of hot flushes, nervousness, mood swings and others. Described symptoms are observed more in item. Pomegranate. Perimenopausal period covering the period of transition from normal ovulatory function at menopause. It starts on average approximately 2 years prior to menopause and also includes 12 months after.
The average age at which naturally occurring menopause is 51 years. Menopause natural character or due to external influences (surgery or radiotherapy) 45 years ago is an early menopause. Premature menopause is one that develops before age 40. Menopause is the result of loss of ovarian sensitivity to gonadotropins operation of which is directly associated with follicular depletion. Gonadotropins are hormones synthesized by the pituitary gland – luteinizing hormone (LH) and follicle stimulating hormone (FSH). The ovaries are mainly composed of stroma and follicles. In the stroma is performed hormonosinteza ovarian estrogen, progesterone and androgens. A group of follicle ripens every month, one of which The islands eventually becomes a mature egg, helped by other maturing follicles.
The eggs in the ovaries undergo atresia throughout the life of the woman as a result of a decline in the quantity and quality of follicles. The change in length of the menstrual cycle in women entering menopause is primarily due to a reduction of the group of ripening monthly follicles, rather than follicular failure. By entering the perimenopausal period frequent anovulatory cycles (no ovulation) and months of irregular bleeding. The reasons for this are variable ovarian response to stimulation by gonadotropins, estrogen insensitivity and lack of peak secretion of luteinizing hormone mediated ovulation itself. Fluctuation in hormone secretion may not be the sole cause of irregular bleeding. That is why other reasons, such as uterine polyps, endometrial hyperplasia and tumor should be excluded. Over time, and “aging” of the follicles, they become more resistant to the effects of gonadotropins, hence their levels are increased. Mostly rising levels of follicle stimulating hormone, as the reason for this is the reduced synthesis of “aging” follicles hormone synthesized from them – inhibin B. Increasing levels of follicle stimulating hormone managed to increase estrogen levels, which lasts until about a year before menopause, when a sharp decline.
About 3 years after onset of menopause level of circulating estrogen is permanently low. The major circulating estrogen is estrone. In the absence of follicles on the majority of circulating estrogens are provided after aromatization to estrone of ovarian stroma synthesized and adrenal androstenedione. A postmenopausal progesterone is adrenal origin. Levels of DHEA DHEAS and also decreased, although it is mainly produced in the adrenal glands. Levels of total testosterone does not change after menopause. Ovarian reserve function to secrete significant amounts of testosterone after menopause. The conversion of androgens to estrogens in the ovarian stroma and in peripheral tissues determines the meaning of the postmenopausal ovary in the homeostasis of the woman. That is why prophylactic removal of the ovaries operations on another occasion is not recommended and should be avoided!