Menopause pathophysiology: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
(25 intermediate revisions by the same user not shown)
Line 4: Line 4:


==<big>Overview</big>==
==<big>Overview</big>==
[[Menopause]] is natural [[amenorrhea]] that is happened without any [[pathological]] causes, but [[premature menopause]]/early [[menopause]] is induced 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]], [[Congenital adrenal hyperplasia]], and [https://www.mayoclinic.org/diseases-conditions/turner-syndrome/symptoms-causes/syc-20360782#:~:text=Overview,to%20develop%20and%20heart%20defects. Turner’s syndrome]. [[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 pronable to early [[menopause]]. On microscopic [[histopathological]] analysis of, the [[cortex]] becomes thinner and it has fewer [[Follicle|follicles]], the [[medulla|medull]][[medulla|a]] develops  [[fibrosis]] and [[scars]]. The [[mucosa]] layer of the [[vagina]] begins to [[atrophy]].
[[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>==
==<big>Pathophysiology</big>==


====<big>Physiological menopause</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).


*[[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]].
*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>


*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]]).
===Premature menopause===
[[Premature menopause]]/[https://www.healthline.com/health/menopause/causes-early early menopause] is caused by several [[pathological]] [[diseases]] include:


====<big>Pathological menopause</big>====
*[[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]].
[[Premature menopause]]/early [[menopause]] is induced by several [[pathological]] [[diseases]] include:  
*[[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>


*[[Pathological]] [[disease]] in ovaries include [[premature ovarian failure]] termed as [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762081/ Primary ovarian insufficiency (POI)].(POI) 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]] 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="pmid19196677">{{cite journal| author=Nelson LM| title=Clinical practice. Primary ovarian insufficiency. | journal=N Engl J Med | year= 2009 | volume= 360 | issue= 6 | pages= 606-14 | pmid=19196677 | doi=10.1056/NEJMcp0808697 | pmc=2762081 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19196677  }} </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:


==<big>Genetic</big>==
*[[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>
[[Genes]] involved in the [[pathological]] [[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 early [[menopause]] an average 5 years early than other [[women]].
*[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>
*[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>


Line 38: Line 37:
On microscopic [[histopathological]] analysis of [[menopause]] include:
On microscopic [[histopathological]] analysis of [[menopause]] include:


*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]].
*[[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]].
*The [[medulla]] develops [[fibrosis]] and [[scars]], The [[medulla]] also undergoes the [[Hyaline|hyalinization]] of [[Vessel wall|vessel walls]].
*[[Fallopian tube|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>
*[[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>




Line 66: Line 63:
[[Category:Menstruation]]
[[Category:Menstruation]]
[[Category:Needs content]]
[[Category:Needs content]]
<references />

Latest revision as of 04:21, 22 February 2021

Menopause Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differential Diagnosis

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Ultrasonography

Other Imaging Findings

Treatment

Medical Therapy

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Menopause pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Menopause pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Menopause pathophysiology

CDC on Menopause pathophysiology

Menopause pathophysiology in the news

Blogs on Menopause pathophysiology

Directions to Hospitals Treating Menopause

Risk calculators and risk factors for Menopause pathophysiology

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.


Template:WikiDoc Sources