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What Is Menopause? An Overview of Physiological Changes

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Skin, Mucosa and Menopause

Abstract

Reproductive aging in women is a continuous process that begins prior to birth and extends through the menopausal transition. The theory that menopause is triggered primarily by ovarian aging is supported by the coincident occurrence of follicular depletion, elevated gonadotrophin levels, and subsequent menstrual irregularity with ultimate cessation of bleeding. The aim of this chapter is to present a systematic overview of physiological and endocrinological changes surrounding menopause, as well as to provide the most recent definition of stages of reproductive aging including menopause, menopause transition, and perimenopause.

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References

  1. United Nations. World population ageing: 1950–2050. New York: Population Division, Department of Economic and Social Affairs; 2001. Available at http://www.un.org/esa/population/publications/worldageing19502050/accessed. 22 Sept 2009.

  2. Kingkade WW, Torrey BB. The evolving demography of aging in the United States of America and the former USSR. World Health Stat Q. 1992;45:15–28.

    CAS  PubMed  Google Scholar 

  3. Olshansky SJ, Goldman DP, Zheng Y, Rowe JW. Aging in America in the Twenty-first Century: demographic forecasts from the MacArthur Foundation Research Network on an Aging Society. Milbank Q. 2009;87(4):842–62.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Research on the menopause. Report of a WHO Scientific Group. Geneva: World Health Organization; 1981 (WHO Technical Report Series, No 670).

    Google Scholar 

  5. World Health Organization Scientific Group. Research on the menopause in the 1990s. World Health Organ Tech Rep Ser. 1996;866:1–107.

    Google Scholar 

  6. Berek JS. Chapter 29. In: Novac’s gynecology. 13th ed. Baltimore: Lippincott Williams & Wilkins; 2002.

    Google Scholar 

  7. McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Maturitas. 1992;14:103–15.

    Article  CAS  PubMed  Google Scholar 

  8. McKinlay SM. The normal menopause transition. Maturitas. 1996;23:137–45.

    Article  CAS  PubMed  Google Scholar 

  9. Whelan EA, Sandler DP, McConnaughey DR, Weinberg CR. Menstrual and reproductive characteristics and age at natural menopause. Am J Epidemiol. 1990;131:625–8.

    CAS  PubMed  Google Scholar 

  10. Morabia A, Costanza MC. International variability in ages at menarche, first livebirth, and menopause. World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives. Am J Epidemiol. 1998;148:1195–205.

    Article  CAS  PubMed  Google Scholar 

  11. Brambrilla DJ, McKinlay SM. A prospective study of factors affecting age at menopause. J Clin Epidemiol. 1989;42:1031–9.

    Article  Google Scholar 

  12. de Bruin JP, Bovenhuis H, van Noord PA, Pearson PL, van Arendonk JA, te Velde ER, Kuurman WW, Dorland M. The role of genetic factors in age at natural menopause. Hum Reprod. 2001;16(9):2014–8.

    Article  PubMed  Google Scholar 

  13. Meschia M, Pansini F, Modena AB, de Aloysio D, Gambacciani M, Parazzini F, et al. Determinants of age at menopause in Italy: results from a large cross-sectional study. ICARUS Study Group Italian Climacteric Res Group Study. Maturitas. 2000;34:119–25.

    Article  CAS  PubMed  Google Scholar 

  14. Midgette AS, Baron JA. Cigarette smoking and the risk of natural menopause. Epidemiology. 1990;1:474–80.

    Article  CAS  PubMed  Google Scholar 

  15. Siddle N, Sarrel P, Whitehead M. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril. 1987;47:94–100.

    CAS  PubMed  Google Scholar 

  16. Hreshchyshyn MM, Hopkins A, Zylstra S, Anbar M. Effects of natural menopause, hysterectomy, and oophorectomy on lumbar spine and femoral neck bone densities. Obstet Gynecol. 1988;72:631–8.

    CAS  PubMed  Google Scholar 

  17. Matthews KA, Gibson CJ, El Khoudary SR, Thurston RC. Changes in cardiovascular risk factors by hysterectomy status with and without oophorectomy: study of Women’s Health Across the Nation. J Am Coll Cardiol. 2013;62(3):191–200.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Howard BV, Kuller L, Langer R, Manson JE, Allen C, Assaf A, Cochrane BB, Larson JC, Lasser N, Rainford M, Van Horn L, Stefanick ML, Trevisan M, Women’s Health Initiative. Risk of cardiovascular disease by hysterectomy status, with and without oophorectomy: the Women’s Health Initiative Observational Study. Circulation. 2005;111(12):1462–70.

    Article  PubMed  Google Scholar 

  19. Meng K, Tian W, Zhou M, Chen H, Deng Y. Impact of chemotherapy-induced amenorrhea in breast cancer patients: the evaluation of ovarian function by menstrual history and hormonal levels. World J Surg Oncol. 2013;11:101.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Coulam CB, Anderson SC, Annegan JF. Incidence of premature ovarian failure. Obstet Gynecol. 1986;67:604–6.

    CAS  PubMed  Google Scholar 

  21. Nelson LM. Clinical practice. Primary ovarian insufficiency. N Engl J Med. 2009;360:606–14.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Tibiletti MG, Testa G, Vegetti W, Alagna F, Taborelli M, Dalpra L, Bolis PF, Crosignani PG. The idiopathic forms of premature menopause and early menopause show the same genetic pattern. Hum Reprod. 1999;14:2731–4.

    Article  CAS  PubMed  Google Scholar 

  23. Vegetti W, Marozzi A, Manfredini E, Testa G, Alagna F, Nicolosi A, et al. Premature ovarian failure. Mol Cell Endocrinol. 2000;161:53–7.

    Article  CAS  PubMed  Google Scholar 

  24. Okeke T, Anyaehie U, Ezenyeaku C. Premature menopause. Ann Med Health Sci Res. 2013;3(1):90–5.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Scott JR, Gibbs RS, Karlan BY, Haney AF, Danforth DN. Chapter 41. In: Danforth’s obstetrics and gynecology. 9th ed. Baltimore: Lippincott Williams & Wilkins; 2003.

    Google Scholar 

  26. Hansen KR, Knowlton NS, Thyer AC, Charleston JS, Soules MR, Klein NA. A new model of reproductive aging: the decline in ovarian non-growing follicle number from birth to menopause. Hum Reprod. 2008;23(3):699–708.

    Article  PubMed  Google Scholar 

  27. Forabosco A, Sforza C, DePol A, Vizzotto L, Marzona L, Ferrario VF. Morphometric study of the human neonatal ovary. Anat Rec. 1991;231:201–8.

    Article  CAS  PubMed  Google Scholar 

  28. Block E. A quantitative morphological investigation of the follicular system in newborn female infants. Acta Anat. 1953;17:201–6.

    Article  CAS  PubMed  Google Scholar 

  29. Block E. Quantitative morphological investigations of the follicular system in women: variations at different ages. Acta Anat. 1952;14 Suppl 16:108–23.

    Article  CAS  PubMed  Google Scholar 

  30. Gougeon A, Chainy GB. Morphometric studies of small follicles in ovaries of women at different ages. J Reprod Fertil. 1987;81:433–42.

    Article  CAS  PubMed  Google Scholar 

  31. Gougeon A, Ecochard R, Thalabard J. Age-related changes of the population of human ovarian follicles: increase in the disappearance rate of non-growing and early-growing follicles in aging women. Biol Reprod. 1994;50:653–63.

    Article  CAS  PubMed  Google Scholar 

  32. Richardson S, Senikas V, Nelson J. Follicular depletion during the menopausal transition: evidence for accelerated loss and ultimate exhaustion. J Clin Endocrinol Metab. 1987;65:1231–7.

    Article  CAS  PubMed  Google Scholar 

  33. Faddy M, Gosden R, Gougeon A, Richardson S, Nelson J. Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod. 1992;7:1342–6.

    CAS  PubMed  Google Scholar 

  34. Liu J, Wang W, Sun X, Liu L, Jin H, Li M, et al. DNA microarray reveals that high proportions of human blastocysts from women of advanced maternal age are aneuploid and mosaic. Biol Reprod. 2012;87(6):148.

    Article  PubMed  Google Scholar 

  35. McKinlay SM. The normal menopause transition: an overview. Maturitas. 1996;23(2):137–45.

    Article  CAS  PubMed  Google Scholar 

  36. Burger HG. The endocrinology of the menopause. Maturitas. 1996;23(2):129–36.

    Article  CAS  PubMed  Google Scholar 

  37. Burger HG, Dudley EC, Robertson DM, Dennerstein L. Hormonal changes in the menopause transition. Recent Prog Horm Res. 2002;57:257–75.

    Article  CAS  PubMed  Google Scholar 

  38. Adashi EY. The climacteric ovary as a functional gonadotropin-driven androgen-producing gland. Fertil Steril. 1994;62:20–7.

    CAS  PubMed  Google Scholar 

  39. Dennefors BL, Janson PO, Knutson F, Hamberger L. Steroid production and responsiveness to gonadotropin in isolated stromal tissue of human postmenopausal ovaries. Am J Obstet Gynecol. 1980;136:997–1002.

    CAS  PubMed  Google Scholar 

  40. Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, et al. Stages of Reproductive Aging Workshop (STRAW). J Womens Gend Based Med. 2001;10:843–8.

    Article  CAS  Google Scholar 

  41. Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, et al. Executive summary: Stages of Reproductive Aging Workshop (STRAW). Climacteric. 2001;4:267–72.

    Article  CAS  PubMed  Google Scholar 

  42. Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, et al. Stages of Reproductive Aging Workshop (STRAW). J Womens Health Gend Based Med. 2001;10:843–8.

    Article  CAS  PubMed  Google Scholar 

  43. Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, et al. Executive summary: Stages of Reproductive Aging Workshop (STRAW). Fertil Steril. 2001;76:874–8.

    Article  CAS  PubMed  Google Scholar 

  44. Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, et al. Executive summary: Stages of Reproductive Aging Workshop (STRAW) Park City, Utah, July, 2001. Menopause. 2001;8:402–7.

    Article  CAS  PubMed  Google Scholar 

  45. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44:291–303.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, Sherman S, Sluss PM, de Villiers TJ. STRAW + 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab. 2012;97(4):1159–68.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Correspondence to Aikaterini E. Deliveliotou MD, PhD .

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Deliveliotou, A.E. (2015). What Is Menopause? An Overview of Physiological Changes. In: Farage, M., Miller, K., Fugate Woods, N., Maibach, H. (eds) Skin, Mucosa and Menopause. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44080-3_1

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  • DOI: https://doi.org/10.1007/978-3-662-44080-3_1

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