Menopause or climacteric stage Write the organ changes
Permanent physiologic cesation of menstruation at the end of reproductive life due to loss of ovarian follicular activity is called menopause.It is the point of time when last and final menstruation occurs.
Climacteric is the phase of aging process during which a woman passes from the reproductive to the non reproductive stage. This phase covers 5-10 years on each side of menopause,premenopause and postmenopause .
Age of menopause:
45-55 years, average being 50 years
Organ changes:
Genitourinary system:
Ovaries shrink in size, become wrinkled and white. Thinning of cortex and abundance of stromal cells occurs.
Fallopian tubes show feature of atrophy.The muscles coat become thinner,the cilia disappears and the plicae become less prominent.
Breast : fat gets reabsorbed and the glands atrophy.The nipples decrease in size resulting in Breast becoming flat and pendulous.
Bladder and urethra: The epithelium becomes thin and is more prone to damage and infection.
Loss of muscle tone leads to pelvic relaxation, uterine descent and anatomic changes in the urethra and neck of the bladder.
Bone metabolism: Following menopause,there is loss of bone mass by about 3-5% per year due to deficiency of oestrogen leading to osteoporosis.
Cardiovascular system :
Deficiency of oestrogen increase the risk of cardiovascular disease because HDL cholesterol and and antioxidants property.
Signs of menopause :
General :
Increase in weight
Deposition of fat on the hip , buttocks around breast .
Progressive atrophy with scanty hair
Narrowing introitus
Thinning of mucous membrane
Loss of rugae
Cervix atrophies uterus body becomes hard and small and adenexae.
Symptoms:
The characteristics symptoms of menopause is ‘ hot flush’.It is characterized by sudden feeling of heat followed by profuse sweating with extraneous vasodilation.
Osteoporosis: osteoporosis occurs in postmenopausal woman due to oestrogen loss, deficiency of calcium and vitamin D or hereditary.
Cardiovascular and cerebrovascular effects:
Risks of ischaemic heart disease, coronary artery disease and stroke are increased due to atherosclerotic changes ,vasoconstriction and thrombus formation.
Management:
Counseling: Adequate explanation to every woman with symptoms.
Non hormonal treatment:
Nutritious diet — balanced with protein and calcium.
Encourage women to view menopause as natural change resulting in freedom from symptoms related to menses.
Discuss measure to improve general health.
Life style, health promotion and health screening are important to continue.
Sexual urges will continue and that they can retain their usual response to sex long after menopause.
Supplimentary calcium — total daily requirements of calcium is 1.5 grams.
To follow healthy life styles, health promotion and regular health screening.
Supplementation with vitamin D 400-800 IU/ day.
Cessation of smoking and alcohol.
Hormone replacement therapy (HRT) replacement of oestrogen and progesterone are prescribed for women with premature ovarian failure,gonadal dysgenesis and surgical or radiation menopause.