Menopause

gynecology presentation, MENOPAUSE, definition, type , risk factor, non hormonal and hormonal threapy

1. PRESENTED BY :- SONALI HARSH RAJ MENOPAUSE

2. WHAT IS MENOPAUSE? Menopause occurs when a woman hasn’t menstruated in 12 consecutive months and can no longer become pregnant naturally. It usually begins between the ages of 45 and 55, but can develop before or after this age range . The average age of women experiencing their final menstrual period (FMP) is 51.5 years, Several environmental, genetic, and surgical influences may alter ovarian aging

3. Why does menopause occur? Menopause is a natural process that occurs as the ovaries age and produce less reproductive hormones . The body begins to undergo several changes in response to lower levels of : estrogen progesteron

4. There are three phases of transition Perimenopause Menopause postmenopause

5. Physiology of perimenopause

6. PREMATURE MENOPAUSE:- Natural/ induced menopause Surgical/medical factors Familial & genetic factors Cigarette smoking LATER AGE OF MENOPAUSE:- Later age of menarche, longer menstrual cycle length Oral contraceptive use

7. Symptoms Associated with Menopausal Transition Menstrual pattern :- Shorter cycles (typical) Longer cycles (possible) Irregular bleeding Vasomoto r :- Hot flushes, Night sweats, Sleep disturbances Psychological/cognitive :- Worsening PMS, Depression, Irritability, Mood swings, Poor concentration, Poor memory Sexual dysfunction :-Vaginal dryness, Decreased libido, Dyspareunia Somatic :- Headache, Dizziness, Palpitations, Breast pain/enlargement, Joint aches & back pain Others :- Urinary incontinence, Dry, itchy skin & Weight gain

8. The stages of reproductive aging.

9. PHYSIOLOGICAL CHANGES The lack of estrogen and progesterone causes many changes in women’s physiology that affect their health and well-being . The symptoms of menopause due to changes in the metabolism of the body . Increased cholesterol level in the blood Osteoporosis Change Urinary system Digestive system Changes in genital organs (Uterus, ovaries, vagina, breast) Changes in general appearance ( skin, weight, hair, voice) Changes in vasomotor system (hot flashes, night sweat)

10. Transvaginal sonographic images of a pre- and postmenopausal ovary. A. In general, premenopausal ovaries have greater volume and contain follicles, which are seen as multiple, small, anechoic smooth-walled cysts. B. In comparison, postmenopausal ovaries have smaller volume and are characteristically devoid of follicular structures

11. Psychological changes The psychological changes are mainly manifested by frequent headache, irritability, fatigue, depression and insomnia . Although these are often said to be due to changes in the hormonal levels, they are more likely to be related to the loss of sleep due to night sweat. Diminished interest in sex may be due to emotional upset or may be secondary to painful intercourse due to a dry vagina .

12. DIAGNOSIS Tests typically aren't needed to diagnose menopause. But under certain circumstances, you may recommend blood tests to check your level of: Follicle-stimulating hormone (FSH) and estrogen (estradiol), because your FSH levels increase and estradiol levels decrease as menopause occurs Thyroid-stimulating hormone (TSH), because an underactive thyroid (hypothyroidism) can cause symptoms similar to those of menopause

13. TREATMENTS:- NON- HORMONAL TREATMENT:- LIFESTYLE CHANGES ALTERNATIVE OR HERBAL THREAPY VITAMIN E ANTIDEPRESSANTS HORMONE REPLACEMENT THREAPY (HRT):- is indicated in menopausal women to overcome the short-term and long-term consequences of estrogen deficiency . HRT can be administered orally( in pill form),vaginally( as a cream),or transdermally ( in patch form) because it replaces female hormones produced by the ovaries, hormone replacement therapy minimize menopause symptoms. It can be used before, during and after menopause.

14. INDICATION FOR HRT 1.Relief of menopausal symptoms 2 . Prevention of osteoporosis 3 . To maintain the quality of life in menopausal years. special group of women to whom HRT should be prescribed. 4.Premature ovarian failure 5 .Surgical or radiation menopause TYPES OF HRT:- Estrogen and progesterone Estrogen only Progestin only RISK OF HRT:- ENDOMETRIAL CANCER BREAST CANCER LIPID METABOLISM DURATION:- recommend using HRT for up to  four to five years