The pathology of the menopause and climacteric

Summary

Although the reason for the uniform ovarian failure that occurs in all women, and hence the actual cause of the menopause, is still not clearly understood, many of the pathophysiological changes that occur at this time have now been elucidated. As the ovaries fail, the level of oestrogen in the blood falls and the level of the pituitary gonadotrophins F.S.H. and L.H. gradually rises. This is not a true negative feedback mechanism as might be expected. Nevertheless, the derangement thus produced and an altered hypothalamic sensitivity to the circulating hormones is sufficient to cause characteristic histological changes, and to herald the cessation of regular menstruation in 100 % of women and the onset of troublesome symptoms in as many as 80 %. For convenience these symptoms can be divided into two groups. The ‘acute’ symptoms of the early climacteric, and the results of long-term oestrogen deprivation occurring in what might be defined as the late climacteric.

Key Words::

• Menopause
• Climacteric
• sex hormones
• gonadotropins