MENOPAUSE

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MENOPAUSE

• Definition
• Menopause is physiological cessation of
  menstruation due to exhaustion of primordial
  follicles in the ovary climatric ? initiate
  period of weaning ovarian function.
• The ovary age between 45-55 average 50

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MENOPAUSE

• Hormonal changes after menopause
• Pituitary Gn mainly FSH ? to loss of ve feed
  back mechanism with estrogel.
• Later on the FSH
• Estrogen . The main source of estrogen is
• Supra renal gland
• Good amount of circulating conversion of
  androstendion into estrone in the adopise tissues
• Androgen ? slightly
• Thyroid gland ? slight hypothyroidism
• Progesterone ? absent

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Menopausal symptoms

• 1. Vasomoter ? hot flushes and sweating (
  FSN)
• 2. Psychological ?
• irritability
• Depression
• Headache
• insommia
• 3. Rheumatic pain ?
• Due to osteoporosis ( estrogen)
• osteothritis

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Menopausal symptoms

• 4. Gastro interstinal erect ?
• dyspesia
• Constipation
• 5. Obesity ?
• Increase appetite
• Due to alteration in CHO metabolism
• 6. Sexual ?
• Lipido
• dyspareunia

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• General changes after menopause
• Breast ?
• Shrivelled
• Flat
• Bone ? as a result of increase estrogen
• Osteoporosis ? backpain
• Spinal compression 5 times 2.5.? height
• Celles fracture 10 ? mobility
• Hand 0.3/1000 20/100 15-20 die ? and
  fracture of vertebral body, humerous, upper femme
  distal forearm and ribs.
• Atherosclerosis
• Hypertension
• Coronary heart diseases

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• Vulva ?
• loss of fat from labia
• Narrow entroitsus
• Vagina ?
• the epithelium is thin and atrophic
• Loss of vaginal rugae
• Glycogen deposition
• Alkaline PH ? senile vaginitis
• Uterus ? small and lined with basal layer of
  endometirum only.
• Ovaries ? ovaries shrunken and atrophic
• Pelvic cellular tissue and ligament lax
• Menstruation ? may stop suddenly or gradual in
  amount or in pregnancy

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• Emotional changes after menopause
• Some women may develop depression
• Anxiety
• Nervousness
• Depresssion.

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Management of the climatric menopausal symptoms

• 1. General treatment
• Reassurance
• Avoid obesity
• Improve the general condition
• 2. Medical treatment
• Sedative may be indicated
• 3. Hormonal treatment
• Estrogen control hot flushes by inhibiting FSH
• Estrogen and progesterones progesterone used to
  prevent of endometrial hyperplasia ? so that
  result from estrogen alone.
• Androgen may be use to FSH But they have
  androvirilising effect

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• 4. Other consideration
• Women receiving Ga phosporous should have blood
  test for Ca phosporous yearly for the first 2
  years.
• Clomidine ? to reduce hot flushes but it is less
  effective.

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Menopausal symptoms

• Gastro interstinal erect ?
• dyspesia
• Constipation
• Obesity ?
• Increase appetite
• Due to alteration in CHO metabolism
• Sexual ?
• Lipido
• dyspareunia