Menopause

Abstract

Menopause is an inevitable component of ageing and encompasses the loss of ovarian reproductive function, either occurring spontaneously or secondary to other conditions. It is not yet possible to accurately predict the onset of menopause, especially early menopause, to give women improved control of their fertility. The decline in ovarian oestrogen production at menopause can cause physical symptoms that may be debilitating, including hot flushes and night sweats, urogenital atrophy, sexual dysfunction, mood changes, bone loss, and metabolic changes that predispose to cardiovascular disease and diabetes. The individual experience of the menopause transition varies widely. Important influential factors include the age at which menopause occurs, personal health and wellbeing, and each woman's environment and culture. Management options range from lifestyle assessment and intervention through to hormonal and non-hormonal pharmacotherapy, each of which has specific benefits and risks. Decisions about therapy for perimenopausal and postmenopausal women depend on symptomatology, health status, immediate and long-term health risks, personal life expectations, and the availability and cost of therapies. More effective and safe therapies for the management of menopausal symptoms need to be developed, particularly for women who have absolute contraindications to hormone therapy. For an illustrated summary of this Primer, visit: http://go.nature.com/BjvJVX.

MECHANISMS IN ENDOCRINOLOGY: Aging and anti-aging: a Combo-Endocrinology overview

“…Estrogen decline affects both directly and indirectly the vasculature, leading to the development of atherosclerosis (106). Beyond menopause, increasing age is associated with physical inactivity, mood instability and sarcopenia, resulting to weight accumulation and obesity, further exacerbating the atherosclerotic process (106).…”

“…Beyond menopause, increasing age is associated with physical inactivity, mood instability and sarcopenia, resulting to weight accumulation and obesity, further exacerbating the atherosclerotic process (106). The formation of atherosclerotic plaques increases the risk of ischemic heart disease (IHD) and stroke (106). Recent research indicates that vasomotor symptoms may represent an independent risk factor of cardiovascular disease (107).…”

Addressing the Role of Obesity in Endometrial Cancer Risk, Prevention, and Treatment

“…21 After menopause, peripheral tissues, especially adipose tissue, become the main site of estrogen synthesis. 22 Adipocytes, preadipocytes, and mesenchymal stem cells within fat tissue are the predominant source of aromatase, the enzyme responsible for the conversion of androgens to estrogen. 23,24 Aromatase levels and activity increase as a function of age and adiposity 25,26 and, therefore, contribute to estrogen-induced endometrial proliferation in the postmenopausal woman.…”

Reproductive Aging: Perimenopause and Psychopathological Symptoms

“…A hot flush is a sudden episode of vasodilation in the face and neck, which lasts from a few seconds to several minutes and is accompanied by profuse sweating and an increase in heart rate [1,23]. The frequency of hot flushes may range from a few per day to one every few minutes.…”