THE CLIMACTERIC present by imran majeed.ppt

Climacteric refers to a period of significant physiological and psychological change in an individual's life, particularly in women, marking the transition to menopause. It is often used interchangeably with "menopause," but climacteric encompasses a broader range of symptoms and changes that occur during this transition.

The climacteric period typically spans several years, including:

1. Perimenopause: The transition period leading up to menopause, characterized by hormonal fluctuations and symptoms like hot flashes, mood changes, and irregular periods.
2. Menopause: The point when a woman has not had a menstrual period for 12 consecutive months, marking the end of her reproductive period.
3. Postmenopause: The period after menopause, during which symptoms may persist or subside.

Climacteric changes can include physical, emotional, and psychological symptoms, such as:

- Hot flashes
- Night sweats
- Mood changes
- Sleep disturbances
- Vaginal dryness
- Weight gain
- Fatigue
- Memory problems

It's important to note that not all women experience all of these symptoms, and their severity can vary widely.

1. The Climacteric

2. Introduction A period of decrease of reproductive capacity in men and women, culminating, in women, in the menopause. The menopause occurs between the ages of 45 and 55 years, with a mean of 50 years. A single menstruation, then two or three consecutive ones, may be missed. The flow may become progressively less with successive cycles. Indicative of pathology

3. Terms Used in Relation to Climacteric

4. Physical Symptoms Hot Flushes and Night Sweats Upper chest, neck and face Palpitations Night soaked in perspiration Low or falling levels of oestrogens in the blood Rises in the levels of FSH and LH

5. Vaginal Soreness – Atrophic Vaginitis Vaginal lining becomes: Thin Dry Less elastic Vagina becomes more prone to: Infection Vulnerable to soreness Irritation burning Discharge Physical Symptoms

6. Urinary Disorders Urinary incontinence (stress and/or urge)or prolapse, or both Atrophy, inflammation and infection of the vagina may have secondary effects on the urethra and bladder Urogenital symptoms which presents postmenopausal is known as urethral syndrome Physical Symptoms

7. Dry Skin A reduction in epidermal cell turnover rate Up to 50% reduction by the age of 70 years Decreased ability of the skin to withstand and repair damage Decrease in oestrogen levels is partly responsible for: Dryness Thinning Reduced elasticity of skin Physical Symptoms

8. Psychological & Emotional Symptoms Cholinergic neurons within the brain contain oestrogen receptors A declining oestrogen level likely to contribute: Impaired cognitive performance Increased incidence of dementias

9. Sexuality in Climacteric Declining levels of oestrogen and testosterone, associated with decreased: Sensitivity Response Postmenopausal atrophic urogenital effects interfere mechanically with: Sexual comfort Disease

10. Postmenopausal Problems Postmenopausal women are at increased risk of cardiovascular disease (CVD) Oestrogen depletion accelerates: Osteoporosis Subsequent fractures

11. Cardiovascular Disease The biggest killer of postmenopausal women in Western society The incidence of CVD increases as oestrogen levels diminish Postmenopausal oestrogen replacement confers protection against CVD, greatly reducing the risk Postmenopausal Problems

12. Osteoporosis Low bone mass and microarchitectural deterioration of bone tissue A consequent increase in bone fragility and susceptibility to fracture Peak bone mass (PBM) is achieved late in the third or fourth decade The greatest rate of bone loss, or reduction in bone mineral density First 3 years following menopause Three main factors for development of osteoporosis: Irreversible damage to the micro-architecture of bone Decreased bone mass An increased tendency to fall Postmenopausal Problems

13. Oestrogen receptors are present in osteoclasts Oestrogen and androgen receptors have been found in osteoblasts Postmenopausal Problems

14. Postmenopausal Problems

15. Diagnosis of Osteoporosis Bone densitometry DEXA (Dual Energy X-ray Absorptiometry ) scanner Treatment Aim Alleviate the patient’s symptoms Reduce the risk of fractures Exercise Weight-bearing exercise Low repetitions with resistance (loading) Balance and flexibility training Postmenopausal Problems

16. Pharmacological Management Hormone replacement therapy Non-HRT drug therapies Bisphosphonates Selective oestrogen receptor modulators (SERMS) Postmenopausal Problems