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Menopause happens normally as women age, And the main cause of the menopause is the natural depletion of the primary follicles (oocytes) in the [[ovaries]] and And the decline of the response of ovaries to anterior pituitary gonads hormones that include [[Follicle Stimulating Hormone]] (FSH) and [http://www.en.wikipedia.org/wiki/Luteinizing_hormone] (LH). These hormones stimulate the ovaries to produce [[estrogen]] and [[progestin]] hormones in a cyclic pattern under the control of the hypothalamus that secrets of the gonadotropin-releasing hormones which stimulate anterior pituitary gonads hormone secretion in addition to feedback mechanism by inhibin. '''"'''During perimenopause (approaching menopause), estradiol levels and patterns of production remain relatively unchanged or may increase compared to young women, but the cycles become frequently shorter or irregular. The often observed increase in estrogen is presumed to be in response to elevated FSH levels that, in turn, is hypothesized to be caused by decreased feedback by inhibin.'''"'''
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{{Menopause}}
{{CMG}} {{RA}}
 
==<big>Overview</big>==
[[Menopause]] is natural [[amenorrhea]] that is happened without any [[pathological]] causes, but [[premature menopause]]/[https://www.healthline.com/health/menopause/causes-early early menopause] is caused by  [[pathological]] [[diseases]] in [[ovaries]] and other [[organs]] such as [[premature ovarian failure]] ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762081/ Primary ovarian insufficiency, POI)],  [[Adrenal insufficiency]], type1 [[diabetes mellitus]], [[Autoimmune thyroid diseases|autoimmune thyroid disease]], [[Fanconi anemia|Fanconi’s anemia]],  and [[Congenital adrenal hyperplasia]]. [[Cardiovascular disease]] and [[Osteoporosis|osteoporosis]] are most important [[conditions]] associated with [[menopause]]. [[Women]] who had [[genetic disorders]] ( [[Fragile X syndrome]], [https://www.mayoclinic.org/diseases-conditions/turner-syndrome/symptoms-causes/syc-20360782#:~:text=Overview,to%20develop%20and%20heart%20defects. Turner’s syndrome])  more prone able to [https://www.healthline.com/health/menopause/causes-early early menopause]. The [[histopathological]] analysis include [[ovaries]]'s [[cortex]] becomes thinner and it has fewer [[Follicle|follicles]] and the [[medulla|medull]][[medulla|a]] develops  [[fibrosis]] and [[scars]]. Decrease of [[ciliated]] [[cells]] of  [[Fallopian tubes]] and [[Uterus]]. And [[atrophy]] of  [[Vagina|vaginal mucosal layer]] .
 
==<big>Pathophysiology</big>==
 
===Physiological menopause===
 
*[[Menopause]] happens normally as [[women]] [[age]] and the main cause of the [[menopause]] is the natural shortage of the primordial follicles ([[oocytes]]) that stored in the [[ovaries]] and the decrease of the response of [[ovaries]] to [https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93gonadal_axis#:~:text=The%20anterior%20portion%20of%20the,gonads%20produce%20estrogen%20and%20testosterone. anterior pituitary gonads hormones] that include [[Follicle Stimulating Hormone]] ([[FSH]]) and [[Luteinizing Hormone]]([[LH]]).
*These [[hormones]] stimulate the [[ovaries]] to produce [[estrogen]] and [[progesterone]] [[hormones]] in a cyclic method under the control of the [[hypothalamus]] that produces the [https://www.yourhormones.info/hormones/gonadotrophin-releasing-hormone/ gonadotropin-releasing hormones] which stimulate [https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93gonadal_axis#:~:text=The%20anterior%20portion%20of%20the,gonads%20produce%20estrogen%20and%20testosterone. anterior pituitary gonads hormone] secretion and [[Inhibin|inhibin-B]] that plays role in the [[feedback mechanism]].
*The [https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93gonadal_axis#:~:text=The%20anterior%20portion%20of%20the,gonads%20produce%20estrogen%20and%20testosterone. anterior pituitary gonads hormones] is decreased during the [[menopause]] transition result from decreased [[ovarian]] [[feedback]] of [[inhibin]]  and are manifested primarily as elevations in [[follicle-stimulating hormone]] ([[FSH]]).<ref name="pmid951489">{{cite journal| author=Mason AS| title=The menopause: the events of the menopause. | journal=R Soc Health J | year= 1976 | volume= 96 | issue= 2 | pages= 70-1 | pmid=951489 | doi=10.1177/146642407609600208 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=951489  }} </ref>
 
===Premature menopause===
[[Premature menopause]]/[https://www.healthline.com/health/menopause/causes-early early menopause] is caused by several [[pathological]] [[diseases]] include:
 
*[[Pathological]] [[disease]] in ovaries include [[premature ovarian failure]] termed as [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762081/ primary ovarian insufficiency (POI)]. It is the loss of [[ovarian]] function lead to [[amenorrhea]] because of [[ovarian failure]] to respond for [https://courses.lumenlearning.com/boundless-biology/chapter/endocrine-glands/#:~:text=Endocrine%20system%3A%20gonads%20and%20their,prepare%20the%20body%20for%20childbirth. gonads hormone] ( [[FSH]], [[LH]]) and deficiency production of [[estrogen]] and [[Progesterone|progesterone hormone]].
*[[Pathological]] [[disease]] in other [[organs]] such as  [[Adrenal insufficiency]], type1 [[Diabetes mellitus]], [[Autoimmune thyroid diseases|Autoimmune thyroid disease]], [[Fanconi anemia|Fanconi’s anemia]], [[Congenital adrenal hyperplasia]] due to [[17α-hydroxylase|17''α''-hydroxylase]] deficiency.<ref name="pmid27377497">{{cite journal| author=Hernández-Angeles C, Castelo-Branco C| title=Early menopause: A hazard to a woman's health. | journal=Indian J Med Res | year= 2016 | volume= 143 | issue= 4 | pages= 420-7 | pmid=27377497 | doi=10.4103/0971-5916.184283 | pmc=4928547 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27377497  }} </ref><ref>{{cite journal| author=Okeke T, Anyaehie U, Ezenyeaku C| title=Premature menopause. | journal=Ann Med Health Sci Res | year= 2013 | volume= 3 | issue= 1 | pages= 90-5 | pmc=3634232 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23634337  }} </ref>
 
 
==<big>Genetic</big>==
There are [[genetic disorders]] involved in the [[Premature ovarian failure|premature menopause]]/[https://www.healthline.com/health/menopause/causes-early early menopause]  include:
 
*[[Fragile X syndrome]] is a [[genetic disorder]] characterized by reduction of [[ovarian]] function, women that have [[Fragile X syndrome|Fragile X Syndrome]] go through [https://www.healthline.com/health/menopause/causes-early early menopause] an average 5 years early than other [[women]].<ref name="pmid12398227">{{cite journal| author=Laml T, Preyer O, Umek W, Hengstschlager M, Hanzal H| title=Genetic disorders in premature ovarian failure. | journal=Hum Reprod Update | year= 2002 | volume= 8 | issue= 5 | pages= 483-91 | pmid=12398227 | doi=10.1093/humupd/8.5.483 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12398227  }} </ref>
*[https://www.mayoclinic.org/diseases-conditions/turner-syndrome/symptoms-causes/syc-20360782#:~:text=Overview,to%20develop%20and%20heart%20defects. Turner’s syndrome]: [[women]] born with missing [[X chromosome]] can go through [[menopause]] early, due to their [[ovaries]] do not form normally at [[birth]].<ref name="pmid12773939">{{cite journal| author=Santoro N| title=Mechanisms of premature ovarian failure. | journal=Ann Endocrinol (Paris) | year= 2003 | volume= 64 | issue= 2 | pages= 87-92 | pmid=12773939 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12773939  }} </ref>
 
==<big>Associated Conditions</big>==
The most important [[Conditions]] associated with [[Menopause]] include:
 
*[[Cardiovascular disease]]: during [[menopause]], [[estrogen]] deficiency causes [[vasoconstriction]] of the [[Blood vessel|vessel wall]]. [[menopause]] is linked to the increased risk of [[cardiovascular disease]].
 
*[[Osteoporosis]] is a [[disease]] of the [[bones]] that causes [[bones]] to become weak and break easily. During [[menopause]], [[estrogen]] deficiency increases [https://support.clearcorrect.com/hc/en-us/articles/203836908-Osteoclastic-and-Osteoblastic-Activity#:~:text=Osteoclastic%20activity%20refers%20to%20the,allowing%20the%20tooth%20to%20move. osteoclastic activity].<ref name="pmid24969415">{{cite journal| author=Lobo RA, Davis SR, De Villiers TJ, Gompel A, Henderson VW, Hodis HN | display-authors=etal| title=Prevention of diseases after menopause. | journal=Climacteric | year= 2014 | volume= 17 | issue= 5 | pages= 540-56 | pmid=24969415 | doi=10.3109/13697137.2014.933411 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24969415  }} </ref>
 
==<big>Microscopic Pathology</big>==
On microscopic [[histopathological]] analysis of [[menopause]] include:
 
*[[Ovaries]]: the [[ovaries]]’s structure are change, the difference between the [[cortex]] and [[medulla]] is less evident. The [[cortex]] becomes thinner, it has fewer [[Follicle|follicles]].  And there are invaginations of the surface [[epithelium]] of the [[cortex]].The [[medulla]] develops [[fibrosis]] and [[scars]],  also undergoes the [[Hyaline|hyalinization]] of [[Vessel wall|vessel walls]].
*[[Fallopian tubes]] and [[Uterus]]: both [[endometrial]] and [[Fallopian tube|tubal]] [[mucosa]] demonstrated a gradual decrease in the number of [[ciliated]] [[cells]] and the non ciliated [[cells]] of the [[uterus]].
 
*[[Vagina]]: the [[mucosa]] layer begins to [[atrophy]] due to decreased [[estrogen]] that causes this layer to become drier and thinner.<ref name="pmid25410301">{{cite journal| author=Zerbinati N, Serati M, Origoni M, Candiani M, Iannitti T, Salvatore S | display-authors=etal| title=Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment. | journal=Lasers Med Sci | year= 2015 | volume= 30 | issue= 1 | pages= 429-36 | pmid=25410301 | doi=10.1007/s10103-014-1677-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25410301  }} </ref><ref name="pmid11907929">{{cite journal| author=Makabe S, Motta PM, Naguro T, Vizza E, Perrone G, Zichella L| title=Microanatomy of the female reproductive organs in postmenopause by scanning electron microscopy. | journal=Climacteric | year= 1998 | volume= 1 | issue= 1 | pages= 63-71 | pmid=11907929 | doi=10.3109/13697139809080683 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11907929  }} </ref>
 
 
 
 


post-menopause can be determined by a blood test that can reveal the very high levels of [[Follicle Stimulating Hormone]] (FSH) that are typical of post-menopausal women.


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{{Menopause}}


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==References==
==References==
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[[Category:Primary care]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Gynecology]]
[[Category:Gynecology]]

Latest revision as of 04:21, 22 February 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Rahmah Al-Edresi, M.D.[2]

Overview

Menopause is natural amenorrhea that is happened without any pathological causes, but premature menopause/early menopause is caused by pathological diseases in ovaries and other organs such as premature ovarian failure (Primary ovarian insufficiency, POI), Adrenal insufficiency, type1 diabetes mellitus, autoimmune thyroid disease, Fanconi’s anemia, and Congenital adrenal hyperplasia. Cardiovascular disease and osteoporosis are most important conditions associated with menopause. Women who had genetic disorders ( Fragile X syndrome, Turner’s syndrome) more prone able to early menopause. The histopathological analysis include ovaries's cortex becomes thinner and it has fewer follicles and the medulla develops fibrosis and scars. Decrease of ciliated cells of Fallopian tubes and Uterus. And atrophy of vaginal mucosal layer .

Pathophysiology

Physiological menopause

Premature menopause

Premature menopause/early menopause is caused by several pathological diseases include:


Genetic

There are genetic disorders involved in the premature menopause/early menopause include:

Associated Conditions

The most important Conditions associated with Menopause include:

Microscopic Pathology

On microscopic histopathological analysis of menopause include:





References

  1. Mason AS (1976). "The menopause: the events of the menopause". R Soc Health J. 96 (2): 70–1. doi:10.1177/146642407609600208. PMID 951489.
  2. Hernández-Angeles C, Castelo-Branco C (2016). "Early menopause: A hazard to a woman's health". Indian J Med Res. 143 (4): 420–7. doi:10.4103/0971-5916.184283. PMC 4928547. PMID 27377497.
  3. Okeke T, Anyaehie U, Ezenyeaku C (2013). "Premature menopause". Ann Med Health Sci Res. 3 (1): 90–5. PMC 3634232.
  4. Laml T, Preyer O, Umek W, Hengstschlager M, Hanzal H (2002). "Genetic disorders in premature ovarian failure". Hum Reprod Update. 8 (5): 483–91. doi:10.1093/humupd/8.5.483. PMID 12398227.
  5. Santoro N (2003). "Mechanisms of premature ovarian failure". Ann Endocrinol (Paris). 64 (2): 87–92. PMID 12773939.
  6. Lobo RA, Davis SR, De Villiers TJ, Gompel A, Henderson VW, Hodis HN; et al. (2014). "Prevention of diseases after menopause". Climacteric. 17 (5): 540–56. doi:10.3109/13697137.2014.933411. PMID 24969415.
  7. Zerbinati N, Serati M, Origoni M, Candiani M, Iannitti T, Salvatore S; et al. (2015). "Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment". Lasers Med Sci. 30 (1): 429–36. doi:10.1007/s10103-014-1677-2. PMID 25410301.
  8. Makabe S, Motta PM, Naguro T, Vizza E, Perrone G, Zichella L (1998). "Microanatomy of the female reproductive organs in postmenopause by scanning electron microscopy". Climacteric. 1 (1): 63–71. doi:10.3109/13697139809080683. PMID 11907929.


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