The Peri- and Postmenopausal Period

Abstract

Pathogenesis. The progressive decline of ovarian estrogen production during the climacteric and especially after menopause creates a “menopausal syndrome” in many women. It is also brought on by castration. The syndrome not only affects the hypothalamic-pituitary-ovarian axis, but also leads to functional derangements of other autonomic centers in the diencephalon. Symptoms include irritability, headaches, forgetfulness, insomnia, and depression; but the most characteristic complaint is the hot flush, which occurs in over 80% of women. It takes the form of disturbing paroxysmal hyperemia of the face, neck, chest, and hands, accompanied by a sensation of heat and sweating. The pathogenic details are unclear but may involve regulation disturbances in the region of the cervical sympathicus. Circulatory symptoms include palpitation of the heart, vertigo, and tinnitus aurium (Table 9).