MENOPAUSE Cause & Treatment


Climacteric is the period in old age when reproductive system undergoes changes due to the decreased secretion of sex hormones, estrogen and progesterone. It occurs at the age of 45 to 55. In females, climacteric is accompanied by menopause. Menopause is defined as the period when permanent cessation of menstruation takes place. Normally, it occurs at the age of 45 to 55 years. In some women, the menstruation stops suddenly. In others, the menstrual flow decreases gradually during every cycle and finally it stops. Sometimes irregular menstruation occurs with lengthening or shortening of the period with less or more flow. Early menopause may occur because of surgical removal of ovaries (ovariectomy) or uterus (hysterectomy) as a part of treatment for abnormal menstruation. Usually, females with short menstrual cycle attain menopause earlier than the females with longer cycle. Cigarette smoking causes earlier onset of menopause.




Due to advancement of age, the atrophy of ovaries occurs. It leads to the cessation of menstrual cycle

causing menopause. Throughout a woman’s sexual life, about 450 of the primordial follicles grow into graafian follicles and ovulate, while thousands of the follicles degenerate.

At the age of 45 years, only few primordial follicles remain in the ovary to be stimulated by FSH and LH.

Now, the production of estrogen by ovary decreases due to the decrease in the number of primordial

follicles. When estrogen secretion becomes almost zero, FSH and LH are continuously secreted. When all the primordial follicles are atrophied, estrogen secretion stops completely.


Postmenopausal syndrome is the group of symptoms that appear in women immediately after menopause. It is characterized by certain physical, physiological and psychological changes. The symptoms start appearing soon after the ovaries stop functioning.


Major cause for the symptoms is the lack of estrogen and progesterone. Symptoms may persist till the body gets acclimatized to the absence of estrogen and progesterone.


Symptoms do not appear in all women. Some women develop mild symptoms and some women develop

severe symptoms, which last for few months to few years.

Symptoms of postmenopausal syndrome:

1. Hot flashes characterized by extreme flushing of

the skin: Hot flashes start with discomfort in the abdomen and chill followed by the feeling of heat

spreading towards the head. Then the face becomes red followed by sweating and exhaustion.

2. Vasomotor instability: Wide fluctuation in blood pressure may be present. Blood pressure increases suddenly and it comes back to normal automatically.

3. Fatigue

4. Nervousness

5. Emotional outburst like crying and anger

6. Mental depression

7. Insomnia

8. Palpitation

9. Vertigo

10. Headache

11. Numbness or tingling sensation

12. Urinary disturbances such as increased frequency of micturition

13. Long-term effects of estrogen lack such as osteoporosis and atherosclerosis: Osteoporosis is the

bone disease resulting in reduction in bone mass. And the bones become susceptible for fracture.

Atherosclerosis is the condition characterized by deposition of cholesterol on the wall of the blood vessels.


Most of the women manage it very well. But, about 15% of the women need treatment. In many cases,

psychotherapy works very well. If it fails, hormone replacement therapy (HRT) is given. Daily administration of estrogen in small quantities will reverse the symptoms. The combination of estrogen and progesterone is considered to be more advantageous because progesterone prevents the estrogen-induced cancer and hyperplasia of myometrium. Dose of the hormones should be gradually reduced to prevent the reoccurrence of postmenopausal symptoms.

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