Menopause

Synonyms

• Climacteric
• Climacterium
• Climacter
• Climax

Definition

Menopause describes the natural transition of a woman from full sexual maturity, the reproductive age, to hormonal rest of the ovaries (ovaries), which determines the onset of old age (senium). The decrease in the hormonal activity of the ovaries is noticeable during the last menstrual period, which is called the menopause. This usually occurs at the age of 52 and is determined retrospectively after a bloodless year.

The period before the menopause with mostly still irregular bleeding is called premenopause, the period after the menopause is called postmenopause. Due to the increasing decrease in hormone production by the ovaries, symptoms can occur throughout the entire menopause period. On average, the menopause lasts 10 years and takes place between the woman’s 45th and 55th year of life.

The menopause has its origin in organ changes in the ovaries, which are manifested in a decrease in the number of eggs and the hardening of vessels (sclerotherapy) that contribute to the nutrition of the ovaries. From the birth of a girl, the number of eggs within the ovaries decreases. At the time of puberty, only one eighth of the initial two million eggs are left.

This number of eggs continues to decrease as the woman grows older, so that at around 52 years of age, there are no eggs left and menopause (menopause) occurs. For this reason, the weight of the ovaries gradually decreases with the 4th decade of a woman’s life. Bleeding that occurs after menopause should therefore always be examined by a doctor to determine its cause, which is often found in the hormonal fluctuations that still persist.

At the beginning of the menopause (climacteric) there is a reduced hormone production in the second half of the female menstrual cycle, medically the luteal phase. This hormonal change, which affects the sex hormone progesterone, gradually reduces a woman’s ability to conceive and thus to become pregnant. As a result, ovulation is increasingly frequent, which is known as anovulation.

However, menstruation continues to occur, caused by the rejection of the upper layer of the uterus (stratum functionale). Especially in the pre-menopausal period, there are often intermittent bleeding and irregular cycles due to the gradual loss of ovarian function. Due to the altered progesterone production in the second half of the female cycle, the muscle layer of the uterus (endometrium) is not built up and transformed as usual.

As a result, the uterus may become enlarged in places by increasing the number of cells (hyperplasia). In the further course of the menopause and with increasing functional weakness of the ovaries, hormone production also decreases in the first half of the cycle. This affects another female sex hormone.

It is called estrogen and also decreases in quantity during the menopause. It should be emphasized, however, that the production of estrogens does not stop completely. A precursor of the estrogens can still be produced, especially in the marginal area of the ovaries, and then converted in some fat cells with the help of appropriate substances.

Hormones are also produced in parts of the brain, which stimulate the ovaries to produce the female sex hormones. They are called FSH (follicle stimulating hormone) and LH (luteinizing hormone). With the onset of menopause, FSH and LH are not inhibited by the free sex hormones as is usually the case, but their quantity increases. This increase in FSH and LH can be easily measured in a woman’s blood and is a clear sign of the menopause. After the menopause, the hormone increase decreases slightly again around the age of 65, but always remains higher than before the menopause.