Menopause

The menopause , of the Greek méno, rules and pause, stop, also called climateric age , is the stop of the rules. At the time of the menopause the woman does not have follicules sufficient any more because those either were used for the cycle ovarien or the follicular cells degenerated by the phenomenon of follicular atresy. One divides it into several stages:

  • périménopause: period of irregularities of the menstrual cycles preceding the menopause and the year which follows the apparent stop of the rules;
  • post-menopause (confirmed menopause)

Périménopause

The estrogens and the progesterone are hormones steroids derived from cholesterol which in particular have cellular receivers, located at the surface of the hypophyseal Cellules, and which reacts by rétrocontrôles to maintain the rate of hormones ovariennes around a stable value. It is one period of depression of the ovary S which involves either an insufficiency out of progesterone alone or accompanied by an insufficiency in estrogens. In this last case there exists an amenorrhoea (absence of rules) or reduction as of those with puffs of heat; so on the other hand there is still a oestrogenic Sécrétion, the disorders are:

    • feeling of inflated and swollen belly, unstable constipation
    • character, Insomnia in middle of the night, blow of pump the afternoon, depression, Anxiety change of sudden mood and irritability for one nothing.
    • headaches
    • tensions mammaires impression of centres constantly inflated

  • Turbid of the menstrual cycle:

    • shorter or longer cycle or flow very very light over several days (préménopause) until an complete absence of this one (menopause)
    • reduction in the libido
    • sweats noctures and morning.
    • Métrorragie (flow except period of the supposed rules), Méno-métrorragie

Post-menopause

It is defined as the absence of rules since more than one year.

The insufficiency in estrogens involves initially:

  • vaginal dryness
  • disorder psychological minors (depression, Asthenia, insomnia, reduction in the libido, etc)
  • puffed out night heats and sweats
  • final Amenorrhoea (final adoption of blood flow)

Later, the genitals (Vagina, Vulva, Uterus) are atrophied, as well as the glands mammaires, with stressing of the prolapsus.

All these symptoms are only disadvantages. The risks are the Ostéoporose (reduction in the osseous density: risk of fracture more important and thus more difficult and longer repair; the osseous loss is accentuated with the menopause) and the increase in the cardiovascular diseases.

It should be noted that the catch of weight is not due to the menopause itself but to the significant drops of the basal metabolism which intervenes about at the same period

Treatment

Since about thirty years, there exists a substitute hormonal treatment of the menopause. This treatment makes it possible to compensate for the insufficiency of secretions ovariennes estrogens and progesterone persons in charge of disorders to short and long-term. It is effective on the symptoms of the menopause and the prevention of the Ostéoporose. Theoretically the estrogens also have a protective role on the heart.

Used largely before, it is it definitely less, in particular in the United States since the publication of a study in 2002 proposing the absence of benefit in term of cardiovascular diseases and an increase in the risk of some Cancer S, of which has occurred of pulmonary Embolie and cerebral vascular accidents, exceeding the benefit of a less rate of fracture of the collar of the femur. This study was the object a wide-ranging debate and it is not clear if it is applicable to any form of substitute treatment or only to that which generally has course in the United States. The studied population is, in addition, particularly old (up to 80 years).

Among younger women (around fifty), the cardiovascular disease risk seems, on the contrary, equivalent or weaker. In the same way, the coronary arteries (irrigating the heart) would be calcified in these last, which is favorable index.

The whole of these elements pleads for one limited time of the hormonal treatment but the optimal duration still remains to be determined.

See too

Related articles

  • Gynécologie

  • Menstruation
  • Dysménorrhée
  • Andropause
  • the Hypothèse of the grandmother tries to explain the appearance of the menopause during the human evolution.
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