Menopause & Climacteric.
[1]. 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.
[2]. 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.
[3]. 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.
[4]. Usually, females with short menstrual cycle attain menopause earlier than the females with longer cycle. Cigarette smoking causes earlier onset of menopause.
Causes of Menopause .
[1]. 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.
[2]. 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.
[3]. When all the primordial follicles are atrophied, estrogen secretion stops completely.
Changes During Menopause-Postmenopausal syndrome.
[1]. Postmenopausal syndrome is the group of symptoms that appear in women immediately after menopause. It is characterized by certain physical, physiological and psychological changes.
[2]. The symptoms start appearing soon after the ovaries stop functioning.
Causes of Postmenopausal Syndrome.
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 of Postmenopausal Syndrome.
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.
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.
Treatment-Hormone replacement therapy.
[1]. 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.
[2]. 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.
[3]. Dose of the hormones should be gradually reduced to prevent the reoccurrence of postmenopausal symptoms.
Infertility introduction.
[1]. Infertility is the inability to produce the offspring. In females, it is the inability to conceive a child by natural process or inability to carry pregnancy till the completion of term.
[2]. Infertility occurs due to various factors such as immature reproductive system, defective reproductive system, endocrine disorders, etc.
Causes of Infertility in Males.
1. Decreased Sperm Count – Oligozoospermia.
[1]. Normal sperm count in a male is about 100 to 150millions/mL of semen. Infertility occurs when the sperm count decreases below 20 millions/mL of semen. Sperm count decreases because of disruption of seminiferous tubules or acute infection in testis.
[2]. In some males, there is possibility of sterility (permanent inability to produce offspring) because of absence of spermatogenesis as
in the case of cryptorchidism or underdeveloped testis.
2. Abnormal Sperms.
[1]. Sometimes, the sperm count may be normal, but the structure of the sperm may be abnormal. The sperms may be without tail and nonmotile or with two heads or with abnormal head.
[2]. When a large number of abnormal sperms are produced infertility occurs.
3. Obstruction of Reproductive Ducts.
Obstruction of reproductive ducts like vas deferens leads to infertility.
4. Other Disorders relates to infertility in Males.
a. Cryptorchidism.
b. Trauma.
c. Mumps.
d. Long term use of drugs.
e. Alcoholism.
f. Genetic disorders.
g. Hypothalamic disorders.
h. Disorders of pituitary, thyroid and pancreas.
Causes of Infertility in Females.
1. Abnormalities of Ovary.
[1]. Sometimes, a thick capsule develops around the ovaries and prevents ovulation.
[2]. In some women, ovaries develop cysts (membranous sac containing fluid) or become fibrotic (hardened tissues resulting from lymphedema). In these conditions, maturation and release of ovum does not occur.
2. Abnormalities of Uterus.
[1]. A type of endometrial tissue similar to uterine endometrium grows in the pelvic cavity surrounding .the uterus, fallopian tubes and ovaries. It is called endometriosis. And, pregnancy does not occur in this condition.
[2]. In some cases, there is low grade infection or inflammation or abnormal hormonal stimulation in the cervix. It leads to the abnormal secretion of thick mucus in cervix, which prevents entry of sperm and fertilization of ovum.
3. Absence of Ovulation.
[1]. Ovulation does not occur in some females, because of hyposecretion of gonadotropic hormones.
[2]. Quantities of these hormones are not sufficient enough to cause maturation of ovum or release of ovum. The cycle without ovulation is known as anovulatory cycle.
4. Other Disorders relates to Infertility in Females.
a. Diabetes mellitus.
b. Renal diseases.
c. Liver diseases.
d. Hypothalamic disorders.
e. Disorders of pituitary gland, thyroid and adrenal glands.
Thank you for Visiting us.
