Climax of the disease and menopause in women
Endocrinology / / August 12, 2017
Menopause (Menopause) - age involutional restructuring hypothalamic centers (and possibly other parts of the central nervous system), leading to disruption of cyclic and quantitative production of gonadotropins, to a violation of follicle maturation, cyclical and quantitative production of ovarian hormones, cessation of ovulation andreproductive capacity of women.
physiology of menopause in women
Over time the idea prevailed that the determining factor of menopause is the cessation of ovulatory and hormonal activity of the ovaries.Increased gonadotropin occurring after the cessation of the menstrual cycle, considered as a secondary process associated with disinhibition of hormonal activity of the pituitary cells that produce gonadotropins.It created an idea of the presence of several phases of menopause - giperfollikulinovoy, agormonalnoy and hypergonadotrophic.However, the number of accumulated data, which forced to reconsider the origins of menopause.Developing women in the aging process change
role of hypothalamic centers in regulating ovulation in animals has been shown by several researchers.It was established separate hypothalamic regulation of the production of FSH and LH.In experiments Dey, Hillarp and others have shown that damage to the hypothalamus region of the suprachiasmatic estrus results in permanent, to the cessation of ovulation and absence of corpora lutea, an increase in uterine endometrial hyperplasia.Damage in eminentia mediana caused the development of atrophic changes in the ovaries and other genital organs.Subsequent experiments, it was found that in the region there are nadsuprahiazmaticheskoy centers providing cyclic release of LH and centers eminentia mediana, which extend axons cells suprachiasmatic centers provide continuous release of LH required for follicular development and estrogen production.
It was also shown that estrogens have effect on the production of gonadotropins is carried out through the hypothalamic centers.It was further found that the primary aging process in animals, leading to disruption of the estrous cycle, do not occur in the ovary.Transplant ovaries from old rats with impaired cycle young ovariectomized rats provided the latter normal astral cycle.In experiments it was found that transplanting the ovaries of young rats, old rats who had different age cycle disorders, did not remove these violations.These data suggest that age-related disorders in old rats cycle could be reduced to a primary aging ovaries.
Most hypothalamus role in the development and course of normal sexual cycle has been shown Harris and Jacobson.Transplanting mature females with pituitary gland in the remote area under eminentia mediana pituitary gland or the pituitary gland of males sexually immature female rats, they have provided in adult females normal astral cycle and the possibility of pregnancy.These experimental data also favor understanding of the decisive significance of age-related disorders of hypothalamic centers that regulate the production of gonadotropins, in the genesis of disturbances of follicular maturation, ovulation cessation.
Studies have shown that women in the "climacteric" age period when stored cyclic spotting regardless of age saved cyclical selection of gonadotropins, estrogens and pregnandiol in quantitative terms and timing of the recovery, the identity corresponding to the allocation in the reproductive age.This indicated that while stored cyclic spotting in the vast majority of women have ovulatory cycle and there is no functional parameters of ovarian aging.These cyclic bleeding is menses.Only a small proportion of women occur with anovulatory cycles and cycles altered the level of allocation of hormones and their metabolites.Urinary excretion of gonadotropins, estrogens and pregnandiol changes dramatically when a women's menopause age-related disorders of the cycle.From the first days of menstruation delay occurs persistently increased release of gonadotropins and estrogen excretion and pregnandiol is set at a low level, no cyclical ups of their allocation.With the resumption of menses immediately restored cyclical and quantitative recovery of all of these hormones and their metabolites at the level of reproductive age.Early appearance of gonadotropins rise at a time when there is even in the normal menstrual cycle, the low level of allocation of estrogen, indicating that the rise in gonadotropin release can not be considered as a result of the initial reduction of estrogen production, and it confirmed the idea of the primary age-related changes of the hypothalamic regulation of cyclic and quantitativegonadotropin products.When menopause - age irreversible cessation of menstruation - there came a permanent high excretion of gonadotropins in the urine and low estrogen excretion.Considering the rise of gonadotropins in the period of menopause and postmenopausal period as the process of primary and largely unrelated to the hypoestrogenemy, you must consider it possible that a developing hypoestrogenemy can release the brake gonadotropic pituitary function and cause an additional increase in gonadotropins.
High selection of gonadotropins in postmenopausal women found many authors.According to some data, the maximum release of gonadotropins accounted for 5 years after the cessation of menstruation, in drugim- 15-20 years after menopause, after which there is a slight decrease in their.However, according to some researchers a high level of gonadotropin release is maintained even in old.
Isolation of estrogen after menopause to persistent low level, although in the first two years there may be a short climbs them.It is necessary to take into account that women in the postmenopausal estrogen main products under physiological conditions is ensured by the adrenal cortex.
Persistent vibrations release of gonadotropins and estrogens with their short-term ups and downs could lead many authors to an erroneous perception of the presence of series of successive phases of menopause (giperfollikulinovoy, agormonalnoy, hypergonadotrophic).The fallacy of this view can be shown in long-term follow-release estrogen and gonadotropins from the early days of menstrual disorders.Another possible explanation is that the group surveyed fell face with pathologically occurring menopause and the presence of proliferative changes in the endometrium that result from hormonal relationship with a tendency to uterine bleeding.
idea of increased allocation of 17-ketoste roidov in postmenopausal period was based on a small number of cases, the statistically was not processed and was not confirmed in other studies.
- hormone producing tumors of the ovaries
- Ovarian tumors of the elements of the male gonads - arrhenoblastoma.Tek-cell tumors of the ovary Tecom
- menstrual cycle Hormonal
- menstrual irregularities
- granulosa tumor.Follikuloma
- Violation monthly rate.Amenorrhea
- Violation of the menstrual cycle with monthly rhythm disorder.Opsomenoreya
- Violation of the menstrual cycle with monthly rhythm disorder.Polimenoreya
- principles of hormone therapy violations
- menstrual Principles of hormonal treatment of dysfunctional uterine bleeding
- Prevention of recurrence of dysfunctional uterine bleeding
- Tumors Leydigovyh cells hilyusa ovarian
with respect to the function of other endocrine glands in physiological menopause is no conclusive data.
There is no reliable evidence that women with physiological menopause characterized by metabolic change, change in blood pressure and other indicators, as well as an increased tendency to the development of pathological conditions, such as diabetes, hypertension and others.The erroneous idea of changing the number of indicators in menopause often develops in the absence of a sufficient differentiation between individuals with the physiological and pathological course of menopause.
About menopause can be judged by the appearance of menstrual disorders (gipomenoreya, oligomenorrhea, menorrhagia, metrorrhagias, anovulatory cycles).Menopause - age permanent cessation of menstruation - is a clinically available measure of stopping ovulation.
period after menopause is called postmenopausal.Premia pauzalny period - the period of the cessation of ovulation and prior to menopause - is identical to the concept of menopause.The age irreversible cessation of ovulation and menopause correspond to the end of menopause.
cessation of ovulation and the consequent termination of the reproductive capacity of women is the main content of the biological menopause.
period cycle disorders can be of varying length and can reach several years.For some women, menopause occurs suddenly, without prior cycle disorders.According to the data, women with a sudden onset of menopause usually occurs more severe climacteric neurosis than the phasing out of the cycle.This is probably due to a pathological condition of hypothalamic centers and possible value here is also a steeper decrease of hormonal activity of the ovaries with secondary effect of rapid onset hypoestrogenemy the hypothalamus.