ANHB2216 Study Guide - Final Guide: Senescence, Anxiety, Libido
3 Jun 2018
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Reproductive Ageing
Female Reproductive Ageing:
• Menopause → loss of ovarian follicular activity resulting in permanent
cessation of menstruation
• Perimenopause → time prior to and just after menopause →
characterized by physiological features marking decline of ovarian
activity
• Menopause transition → time before final menstrual period →
characterized by variability in menstrual cycle
• Timing of menopause
o Generally very constant → 47-53 years
o Cant be delayed but can be advanced
o Premature menopause → menopause before 40
o Advanced by
▪ Smoking
▪ Chemotherapy/radiation
▪ Ovarianectomy/hysterectomy
o Not affected by
▪ Age of menarche
▪ Number of pregnancies
▪ Contraception
▪ Infertility treatment
• Endocrinology of menopause
o Decrease in amount of follicles → decrease in inhibin B → first
endocrine sign
o Increase in FSH levels
o Decline in sensitivity of hypothalamus/anterior pituitary to
estradiol → no LH surge → no ovulation
o Increase in anovulatory cycles with occasional ovulatory cycles →
irregular cycles
o Decrease in estradiol levels → last endocrine change
o Postmenopausal sources of estrogens
▪ Estrone → biologically weak androgens
▪ Sources
• Adipose tissue
• Adrenal gland
• Ovarian stromal cells
▪ Peripheral tissues → aromatase → convert androgen to
estrone
▪ Estrone does not protect against consequences of estrogen
deficiency
• Menopausal symptoms
o Physical
▪ Abnormal bleeding/amenorrhoea
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