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    Menopausia Definició y características

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    Ysik Kbrera

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    Menopausia Definició y características

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    Ysik Kbrera
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    1 views1 page

    Menopausia Definició y características

    Uploaded by

    Ysik Kbrera

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    T h e M e n o p a u s a l Tr a n s i t i o n

    Janice L. Bacon, MD, FACOG

    KEYWORDS
     Menopause  Perimenopause  Hormones

    KEY POINTS
     Symptoms of menopause often begin 4 to 6 years before the cessation of menses and
    persist for years.
     Loss of ovarian hormones has widespread and often adverse effects on many organ
    systems.
     Therapy for menopausal symptoms must be individualized.

    Menopause occurs when the ovaries have complete (or near-complete) follicular
    exhaustion, resulting in very low serum levels of estradiol and markedly increased
    follicle-stimulating hormone (FSH) levels. Common symptoms of menopause
    (Box 1) often begin during the perimenopausal transition at a median of 47 years or
    4 to 6 years before menopause occurs. Because other medical disorders which occur
    frequently with aging exhibit some of the same symptoms as those of menopause,
    women may have difficulty distinguishing when they enter the menopausal transi-
    tion-.This is also true for women who have had irregular menses, an endometrial abla-
    tion or a hysterectomy. Symptoms continue for several years after menopause and
    some women continue to have vasomotor symptoms for even longer periods of
    time. Almost all women with an intact uterus experience menstrual irregularity in the
    menopausal transition years resulting from hormonal fluctuations before ovarian follic-
    ular depletion.
    The largest longitudinal study of women’s endocrine and clinical manifestations of
    menopausal transition comes from the Study of Women’s Health Across the Nation
    (SWAN).1 This research evaluated and followed more than 3000 women from diverse
    communities, aged 42 to 52 years, for 15 years. Scientific areas of study for SWAN
    included bone mineral density and body composition, cardiovascular measures and
    risk factors, and ovarian markers. Ovarian aging was assessed by serial assessment
    of FSH, luteinizing hormone, estradiol (E2), inhibin-B, and estrone (E1). Inhibins are
    peptides of the transforming growth factor family and are produced by granulosa cells
    of the ovarian follicle. Inhibin levels decline during menopause because of the negative

    Disclosure: No disclosure relevant to this topic.


    Women’s Health and Diagnostic Center, 2728 Sunset Boulevard, Lexington Medical Park 1,
    Suite 106, West Columbia, SC 29169, USA
    E-mail address: [email protected]

    Obstet Gynecol Clin N Am 44 (2017) 285–296


    http://dx.doi.org/10.1016/j.ogc.2017.02.008 obgyn.theclinics.com
    0889-8545/17/ª 2017 Elsevier Inc. All rights reserved.

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