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Gynaecological Problems Associated with Menopause

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Skin, Mucosa and Menopause

Abstract

The female reproductive system undergoes characteristic age-related changes in morphology and physiology over the course of a lifetime, while during menopause, aging changes result mainly from declining estrogen levels. Genital heath during menopause is directly related to aging changes of the female reproductive system beginning in the late reproductive stage, proceeding through the menopausal transition, and ending in late postmenopause. The aim of this chapter is to present a systematic overview of gynecological problems associated with menopause, including a wide spectrum of symptoms, diagnosis, and current treatment, despite the fact that prevention and early detection remain the cornerstones of health maintenance in this age group.

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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.

    Google Scholar 

  2. Farage MA, Maibach HI, Deliveliotou A, Creatsas G. Ch 3: Changes in the vulva and vagina throughout life. In: Farage MA, Maibach HI, editors. The vulva: anatomy, physiology and pathology. 1st ed. New York: Informa Health Care; 2006.

    Chapter  Google Scholar 

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

    Google Scholar 

  4. Storck S. A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

    Google Scholar 

  5. 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 

  6. 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 

  7. Erickson KL, Montagna W. New observations on the anatomical features of the female genitalia. J Am Med Womens Assoc. 1972;27:573.

    CAS  PubMed  Google Scholar 

  8. Lobo RA. Ch 14: Menopause and care of the mature woman: endocrinology, consequences of estrogen deficiency, effects of hormone replacement therapy, treatment regimens. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, editors. Comprehensive gynecology. 6th ed. Philadelphia: Elsevier Mosby; 2012.

    Google Scholar 

  9. Farage MA, Maibach HI. Lifetime changes in the vulva and vagina. Arch Gynecol Obstet. 2006;273(4):195–202. doi:10.1007/s00404-005-0079-x.

    Article  PubMed  Google Scholar 

  10. Jones IS. A histological assessment of normal vulval skin. Clin Exp Dermatol. 1983;8:513.

    Article  CAS  PubMed  Google Scholar 

  11. Fischer BK, Margesson LJ. Normal anatomy of the vulva. In: Genital Skin Disorders. Diagnosis and Treatment. St. Louis: Mosby Publishing; 1998. p. 99.

    Google Scholar 

  12. Nauth HF, Boger A. New aspects of vulvar cytology. Acta Cytol. 1982;26:1.

    CAS  PubMed  Google Scholar 

  13. McKinlay SM. Issues in design, measurement, and analysis for menopause research. Exp Gerontol. 1994;29:479–93.

    Article  CAS  PubMed  Google Scholar 

  14. Treloar AE. Menstrual cyclicity and the pre-menopause. Maturitas. 1981;3:249–64.

    Article  CAS  PubMed  Google Scholar 

  15. Buckler HM, Evans CA, Mamtora H, Burger HG, Anderson DC. Gonadotropin, steroid, and inhibin levels in women with incipient ovarian failure during anovulatory and ovulatory rebound cycles. J Clin Endocrinol Metab. 1991;72:116–24.

    Article  CAS  PubMed  Google Scholar 

  16. Hurd WW, Amesse LS, Randolph JF Jr. Ch. 29: Menopause. In: Berek JS, Novac’s Gynecology. 13th ed. Baltimore: Lippincott Williams & Wilkins; 2002.

    Google Scholar 

  17. 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 

  18. Gambrell Jr R. Clinical use of progestins in the menopausal patient: dosage and duration. J Reprod Med. 1982;27:531–8.

    PubMed  Google Scholar 

  19. Lidor A, Ismajovich B, Confino E, David MP. Histopathological findings in 226 women with post-menopausal uterine bleeding. Acta Obstet Gynecol Scand. 1986;65:41–3.

    Article  CAS  PubMed  Google Scholar 

  20. Goldstein SR, Zeltser I, Horan CK, Snyder JR, Schwartz LB. Ultrasonography-based triage for perimenopausal patients with abnormal uterine bleeding. Am J Obstet Gynecol. 1997;177:102–8.

    Article  CAS  PubMed  Google Scholar 

  21. Castelo-Branco C, Puerto B, Duran M, Gratacós E, Torné A, Fortuny A, Vanrell JA. Transvaginal sonography of the endometrium in postmenopausal women: monitoring the effect of hormone replacement therapy. Maturitas. 1994;19:59–65.

    Article  CAS  PubMed  Google Scholar 

  22. Cacciatore B, Ramsay T, Lehtovirta P, Ylöstalo P. Transvaginal sonography and hysteroscopy in postmenopausal bleeding. Acta Obstet Gynecol Scand. 1994;73:413–6.

    Article  CAS  PubMed  Google Scholar 

  23. Loffer FD. Hysteroscopy with selective endometrial sampling compared with D&C for abnormal uterine bleeding: the value of a negative hysteroscopic view. Obstet Gynecol. 1989;73:16–20.

    CAS  PubMed  Google Scholar 

  24. Goldrath MH, Sherman AI. Office hysteroscopy and suction curettage: can we eliminate the hospital diagnostic dilatation and curettage? Am J Obstet Gynecol. 1985;152:220–9.

    Article  CAS  PubMed  Google Scholar 

  25. North American Menopause Society. Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010;17(2):242–55.

    Article  Google Scholar 

  26. Schüler S, Ponnath M, Engel J, Ortmann O. Ovarian epithelial tumors and reproductive factors: a systematic review. Arch Gynecol Obstet. 2013;287(6):1187–204.

    Article  PubMed  Google Scholar 

  27. Holtz D. Ovarian cysts and masses in menopause in menopause and you library women’s health Source..,http://www.mainlinehealth.org/phy/Page.asp?out=html&familyName=Holtz&acceptPSpec=1&maxAge=100&mlhc=0&radius=5&PageID=PHY001207

  28. Guzel AI, Kuyumcuoglu U, Erdemoglu M. Adnexal masses in postmenopausal and reproductive age women. J Exp Ther Oncol. 2011;9(2):167–9.

    PubMed  Google Scholar 

  29. Koh SC, Huak CY, Lutan D, Marpuang J, Ketut S, Budiana NG, et al. Combined panel of serum human tissue kallikreins and CA-125 for the detection of epithelial ovarian cancer. J Gynecol Oncol. 2012;23(3):175–81.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Notelovitz M. Gynecologic problems of menopausal women: part 1. Changes in genital tissue. Geriatrics. 1978;33:24–30.

    CAS  PubMed  Google Scholar 

  31. Keil K. Urogenital atrophy: diagnosis, sequelae, and management. Curr Womens Health Rep. 2002;2:305–11.

    PubMed  Google Scholar 

  32. Kamarashev JA, Vassileva SG. Dermatologic diseases of the vulva. Clin Dermatol. 1997;15:53.

    Article  CAS  PubMed  Google Scholar 

  33. Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N Engl J Med. 1993;329:753–6.

    Article  CAS  PubMed  Google Scholar 

  34. Willhite LA, O’Connell MB. Urogenital atrophy: prevention and treatment. Pharmacotherapy. 2001;21:464–80.

    Article  CAS  PubMed  Google Scholar 

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

    Google Scholar 

  36. Hulley S, Furberg C, Barrett-Connor E, Cauley J, Grady D, Haskell W, HERS Research Group, et al. Noncardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/progestin Replacement Study follow-up (HERS II). JAMA. 2002;288(1):58–66.

    Article  CAS  PubMed  Google Scholar 

  37. Sherburn M, Guthrie JR, Dudley EC, O’Connell HE, Dennerstein L. Is incontinence associated with menopause? Obstet Gynecol. 2001;98:628–33.

    Article  CAS  PubMed  Google Scholar 

  38. Brown JS, Sawaya G, Thorn DH, Grady D. Hysterectomy and urinary incontinence: a systematic review. Lancet. 2000;356:535–9.

    Article  CAS  PubMed  Google Scholar 

  39. Bhatia NN, Bergman A, Karram MM. Effects of estrogen on urethral function in women with urinary incontinence. Am J Obstet Gynecol. 1989;160:176–81.

    Article  CAS  PubMed  Google Scholar 

  40. Schick V1, Herbenick D, Reece M, Sanders SA, Dodge B, Middlestadt SE, et al. Sexual behaviors, condom use, and sexual health of Americans over 50: implications for sexual health promotion for older adults. J Sex Med. 2010;Suppl 5:315–29.

    Article  Google Scholar 

  41. DeLamater J1, Karraker A. Sexual functioning in older adults. Curr Psychiatry Rep. 2009;11(1):6–11.

    Article  PubMed  Google Scholar 

  42. Traupmann J. Does sexuality fade over time? A look at the question and the answer. J Geriatr Psychiatry. 1984;17:149–59.

    CAS  PubMed  Google Scholar 

  43. DeLamater J1, Moorman SM. Sexual behavior in later life. J Aging Health. 2007;19(6):921–45.

    Article  PubMed  Google Scholar 

  44. Burger HG, Dudley EC, Cui J, Dennerstein L, Hopper JL. A prospective longitudinal study of serum testosterone, dehydroepiandrosterone sulfate, and sex hormone-binding globulin levels through the menopause transition. J Clin Endocrinol Metab. 2000;85:2832–8.

    CAS  PubMed  Google Scholar 

  45. Greenblatt RB, Karpas A. Hormone therapy for sexual dysfunction. The only “true aphrodisiac”. Postgrad Med. 1983;74:78–80.

    CAS  PubMed  Google Scholar 

  46. Bachmann GA. Correlates of sexual desire in postmenopausal women. Maturitas. 1985;7:211–6.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Aikaterini E. Deliveliotou MD, PhD .

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Deliveliotou, A.E. (2015). Gynaecological Problems Associated with Menopause. 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_16

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  • DOI: https://doi.org/10.1007/978-3-662-44080-3_16

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