Menopause (Klimakterium) is a transitional period in women’s lives, where:
- Ovary (ovaries) stop producing eggs
- Menstrual activity decreases and eventually stops
- The establishment of female hormone (estrogen and progesterone) decreases.
Actual menopause occurs at the end of the last menstrual cycle. But newly acquired certainty if a woman has not experienced the cycle for a minimum of 12 months. The average menopause occurs at age 50 years, but it can occur normally in women aged 40 years. Usually when approaching the menopause, the old and the amount of blood that came out in the menstrual cycle tends to vary, not as usual.
In some women, menstrual activity stops suddenly, but usually occur gradually (in terms of quantity and duration) and the distance between the 2 cycles become closer or more rarely. This disorder can last for 2-3 years before the cycle stopped.
CAUSE
Along with age, the ovaries become less responsive to stimulation by LH and FSH, produced by the pituitary gland. As a result the ovaries release less estrogen and progesterone and in the end the process of ovulation (release of egg cells) stopped.
Early menopause is menopause that occurs before the age of 40 years. Possible causes are genetic, autoimmune diseases and cigarettes.
Artificial menopause caused by medical interventions that cause reduction or cessation of the release of hormones by the ovaries. This intervention could be surgery to remove the ovaries or to reduce blood flow to the ovary as well as chemotherapy or pelvic radiation therapy to treat cancer.
Hysterectomy (removal of the uterus) cause the end of the menstrual cycle, but as long as there remains the ovary does not affect hormone levels and does not cause menopause.
SYMPTOMS
The symptoms of menopause caused by changes in estrogen and progesterone. Because ovarian function is reduced, the ovaries produce less estrogen / progesterone and the body reacted. Some women experience few symptoms only, while other women experience the symptoms of mild to severe in nature. This is normal.
Decreased estrogen levels cause the body to gradually adjust slowly to changes in hormones, but in some women this decline in estrogen levels occur suddenly and cause symptoms that great. This often happens when menopause caused by removal of the ovaries.
Symptoms that may be found in menopausal women are:
1. Hot flashes occur in response to increased blood flow in blood vessels face, neck, chest and back. The skin becomes red and warm with excessive sweating.
Hot flashes experienced by approximately 75% of menopausal women. Most experienced hot flashes for more than 1 year and 25-50% of women experience it until more than 5 years.
Hot flashes lasted for 30 seconds to 5 minutes.
2. The vagina becomes dry due to the wall thinning of the vaginal tissue so when intercourse can result in pain.
3. Psychological and emotional symptoms (fatigue, irritability, difficulty sleeping and anxiety) could be caused by reduced levels of estrogen.
Sweating at night causing sleep disturbance that fatigue got worse and more easily offended.
4. Dizziness, tingling and palpitations (heart pounding).
5. The loss of bladder control (beser).
6. Inflammation of the bladder or vagina.
7. Osteoporosis (bone loss).
High risk of osteoporosis found in women who:
- Thin
- Smoking
- Excessive alcohol consumption
- Taking corticosteroids
- Has a low calcium intake
- Rarely exercise.
Minor injuries can cause fractures (broken bones). Fractures most often occur in the spine, hips and wrists.
8. Heart disease and blood vessels.
Decrease in estrogen levels cause increased levels of LDL cholesterol (bad cholesterol) and decrease HDL cholesterol (good cholesterol). Estrogen is responsible for the formation of the epithelial layer of the uterine cavity. During the reproductive period, the formation of the uterus lining, followed by the release of the uterine wall at each menstrual cycle. Reduced levels of estrogen in menopause does not cause the formation of the epithelial layer in the cavity of the uterus. But androgenic hormone produced by the adrenal glands converted into estrogen, and sometimes this causes bleeding after menopause. This does not need to worry, but because of post-menopausal bleeding could be an indication of a disease (including cancer), then the doctors always check any bleeding that occurs after menopause.
Diagnosis
Diagnosis based on symptoms and physical examination results. In a Pap smear may note changes in the lining of the vagina due to changes in estrogen levels. Examination of blood and urine can be used to measure levels of estrogen, and progestero plasma oestrone and oestradiol.
