The Biological Process of Menopause

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The word Menopause (Menespausie) was coined by the French physician Gardenne in the year 1816. The earlier explanation of menopause was the deficiency of ganglionic regulatory functions but afterwards the ovary was identified as an endocrine organ. Menopause represents a primary ovarian insufficiency and has an inception between 40 and 56 year, the mean age being 51 years. Natural Menopause coincides with the final menstrual period (FMP) and this condition is identified with the presence of 12 months of amenorrhea. In simpler words, menopause can be referred to as the stage where there is absence of menstruation for a period exceeding 10-12 months in the middle age of the women usually in 50’s.

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The permanent cessation of menstruation results from the loss of follicular activity of the ovaries. It is a stage when the menstrual cycle stops for longer than 12 months and there is a drop in the levels of Oestrogen and Progesterone, the two most important hormones in the female body. The onset of this physiological development not only marks the end of women’s reproductive function but also introduces them to a new phase of life.

The biological process of Menopause is a universal phenomenon but is experienced differently amongst women. There is a considerable variation among women regarding the age of attaining menopause and the manifestation of menopausal signs and symptoms. Globally, the estimates for the median age at menopause range from 45 to 55 years, with women from Western countries having a higher menopausal age compared to women from other parts of the world. A number of studies have shown that biological (e.g., genetic, nutritional, and reproductive history); sociocultural (e.g., educational, occupational, smoking habit and rural-urban residence); and lifestyle (e.g., smoking and use of tobacco and dietary habits) factors affect the age of menopause.

The Mean age at menopause of Indian women is 44.3 with 11.0 % of the women attending menopause before 40 years with an increase in the frequency by (0.5%) in subsequent years. Studies show that women who are indulged in smoking or use tobacco are likely to attain menopause 1-2 years earlier than those who are non-smokers. In another study Gold et al. (2001) reported that lower menopausal age is associated with low socioeconomic status, low educational and lower body mass index (BMI). Besides, early menarche and regular cycles are independently associated with lower age at natural menopause. Nagel et al. (2005) reported that age at natural menopause is influenced by lifestyle and dietary factors.

Besides, women who are less likely to be involved in any sexual activity, the process of atresia (Degeneration) accounts for all Oocytes disappearance from the ovary and not ovulation. It begins prenatally and continues throughout the lifespan.

Follicular decline results in lowered level of oestrogen that has been identified as the primary reason behind menopause. The decrease in the ovarian follicle and its effect on oestrogen level vary across women, leading to variation in the timing of menopause, development of menopausal traits and symptoms along with its intensity.

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