-IBIS-1.5.0-
tx
reproductive system
menopause
diagnoses
definition and etiology
definition:
The time in a women's life after her menses has stopped. The time before the total cessation of menses when periods are irregular is termed the "climacteric". Menopause is also termed "the Change of Life".
etiology:
Menopause may be natural (between 40 and 52 years old), premature (under 40) or induced (by surgical removal or irradiation of the ovaries; or radium implantation in the uterus). During the climacteric there is gradually decreasing ovarian function and often physical, endocrinal, and mental/emotional diseases/imbalances arise at this time. The average age of menopause is 50-51 years old.
signs and symptoms
signs and symptoms:
Symptoms and degrees of symptoms vary greatly. The woman may be asymptomatic except for menses cessation or she may suffer severe symptoms for several years.
Vasomotor instability: hot flashes with sweating.
Atrophy of the urogenital epithelium and skin.
Osteoporosis.
Hyperlipidemia.
Nervousness and irritability.
Depression and insomnia.
Urinary frequency and burning.
lab findings:
Increased FSH.
Decreased urinary estrogens and urinary 17-KS.
Serum estrone greater than estradiol.
course and prognosis
Menopause is not fatal or dangerous, although it can be extremely uncomfortable and socially embarrassing (hot flashes in particular). Conventional treatment is usually estrogen replacement therapy. Unopposed estrogen therapy is now linked with cancer of the uterus, ovaries, and breasts, so most up-to-date physicians now give progesterone in opposition. This may cause a return of the woman's periods. Most of the medical problems that women are warned will develop with the onset of menopause (osteoporosis, heart disease) can be fully prevented by diet and lifestyle adherences to healthy living. The woman should be reassured that menopause is not a disease that needs to be treated, but a normal and healthy time of change in her body.
differential diagnosis
pregnancy
amenorrhea
other causes of presenting symptoms
footnotes