MenopausePresented by:-

Sanjana MuryaBsc. Nsg IIIrd yr

Roll No. 74

Menopause :- Permanent cessation of menstruation caused by

failure of ovarian follicular development in the presence of adequate gonadotrophin stimulation.

Derived from the Greek words “men” (month) and “pausis” (cessation)

Climacteric :- The physiologic period in a women's life during which

there is regression of ovarian function.

Premature ovarian failure :- Cessation of menstruation due to depletion of ovarian

follicles before the age of 40y.

Menopause

Menopause Age

Typically between 42 and 56 years of age

Median - 51.4, range of 48-55 yrsMedian for perimenopause - 47.5 years, median length of 4 years

Physiologic menopause

Iatrogenic menopause :- Surgical, radiation therapy ,chemotherapy,

infection and tumor

Types of Menopause

The Reproductive Cycle

Degeneration of granulosa & thica cells

OVARIAN DYSFUNCTION

Failure to react to endogenous gonadotrophine

↓ Estrogen

↑ FSH & LH

What Happens During The Menopausal Transition?

Postmenopausal yearsPremenopausal years

* Monthly cycle begins to change.* Number of stored eggs in the ovaries decreases.* Hormone levels fluctuate

Androgens :- ↑ androgen level due to stromal cell

stimulation by endogenous gonadotrophins ↓ Androstenedion (adrenal) ↑ Testosterone level

Estrogen : In preimenpausal women ,the main Estrogen

is E2 In post menopause is E1(from the peripheral

conversion of Androstenadione)

Changes in hormones metabolism associated with menopause

Multiple Sites of Estrogen Action

Brain Helps maintain body temperature mood, cognition, sexual health Ovaries Stimulates maturation and start of woman’s menstrual cycle Vagina Stimulates maturation and helps maintain lubricated and thick vaginal lining

Heart and liver Regulates production of cholesterol / decreases plaque in coronary arteries Bones Helps to preserve bone density Breast Stimulates development at puberty and prepares glands for future milk production Uterus Stimulates maturation and helps to prepare the uterus to nourish a developing fetus

Hot flushes / night sweats Irregular periods Change in cholesterol / blood vessels Mental function Sexuality Sleep disturbances Joint discomfort

Vaginal / vulvar / bladder changes Loss of bone / osteoporosis Mood changes

Menopausal Symptoms

No two women experience menopause in the same way

Lifestyle changes Alternative & complementary therapies Traditional hormonal therapy Non-hormonal prescription therapies Avoid triggers (hot drinks, alcohol) Breathing techniques Ceiling/bedside fan Cool evening shower or bath Dress in layers - dry wicking clothing Turn down thermostat

How Are Women Trying To Manage Hot Flashes?

How Can We Maximize Our Health

As We Get Older?

Menopause And Aging:

94% of risks are things you can change:

1. Obesity 2. High blood pressure 3. Smoking 4. Stress 5. Diet (fruits and vegetables) 6. Alcohol 7. Blood lipid levels

Preventing Heart Disease

Balanced diet Reduce total fat

intake / cholesterol intake

Control weight Calcium 1000 – 1500

mg / day Vitamin D at least

400-800 IU / day Limit alcohol intake Limit caffeine intake

Nutrition Recommendations

Osteoporosis1 in 4 women over 50 has osteoporosis

Estrogen helps maintain bone strength

Crucial time: 2 to 4 years around the last menstrual period

Essential for good bone health Average Canadian diet –

only 500 mg per day Recommended intakes

(from diet and supplements):◦ Peri-menopause - 1000 mg/d◦ Post-menopause - 1500 mg/d ◦ Should be taken in divided doses

Calcium therapy alone is not enough to prevent fracture

Calcium

Important to maintain bone health

Most recommend intake of 1000 IU/day

Deficiency due to limited sun exposure / use of sunscreen

Food sources not adequate May be more important

than calcium

Vitamin D

Risk to your health:◦ Diabetes◦ Hypertension◦ Cancer◦ Stroke

Will happen if you don’t maintain an active lifestyle

Average weight gain 5-10 lbs

Weight Gain During Menopause

•Estrogens and progestogens prescribed to treat symptoms of menopause (e.g., hot flashes, vaginal dryness) not to treat or to achieve a specific blood hormone level

•Also effective for prevention of osteoporosis and urogenital atrophy.

•Detailed scientific studies have evaluated efficacy and safety (including endometrial safety)

Traditional Hormone Therapy

•Monitor BP, glucose, lipid profile, thyroid function •Regular Pap smear •Regular breast exam (personal & provincial

mammogram screening program) •Bowel cancer screening •Flu shot •Safe sex •Selective bone density testing •Fracture risk assessment •Cautionary recommendations concerning accidents

such as falls or slips

Preventive Care for Menopausal Women

Above ALL…..

Be The Heroine Of Your Life…Classy & Fabulous….!!

As UsuaL….There Is A Great Women Behind Every

Interesting Idiot…..!!

THANK YOU