Changes in menopause research

Anatomical changes are also part of the changes that occur in women due to the aging process. It is these changes in both the anatomy and hormonal sequences in women that are characterized by age that this research paper aims to explore in detail. The research paper links the changes in the female reproductive hormones estrogen, FSH, LH and progesterone to the process of menopause. It details the various impact of a change in these hormonal levels on the various body systems with a specific focus on its effects on the endocrine system. Research paper format Unlike most other research articles, the research format follows a rather different organization that is organized in a sequence of flow of information from the introduction to the final concluding remarks.

Results The research articles succinctly showed the impact that menopause has on the various body systems and how such changes occur, are influenced by the varying hormonal levels in the human body and their implications to the physiological and physical health of a woman. The research also provided a distinct view of the different changes and occurrences of menopause during the premenopausal and the post-menopausal periods. The research was also able to provide a detailed linkage between the different body systems and how this interaction of systems impacted on the overall health of the menopausal woman. Conclusion A conclusion is drawn that provides a summative view of the information contained in the research paper. The conclusion brings home the message that the menopausal and premenopausal period in women is marked by the different changes that are interlinked and which affect the physiology and functionality of different body systems.

As respiratory issues increase with aging, menopausal changes increase the risk of respiratory diseases in women. iv) The musculoskeletal system The reduction in estrogen production results in increased osteoclast activity decreased bone mass and muscle mass. The decrease in estrogen further causes a reduction in the height of the intervertebral disc height. These changes affect movement and posture in some menopausal women. v) The integumentary system The decline in estradiol in menopause leads to a reduction in masking of the testosterone produced by the ovaries. ix) Th urinary system In menopause, there is a reduction in the urinary function of the renal system. Estrogen reduction reduces the ability of the urinary tract to control urination. This results in increased frequency increased urinary infections and dryness of the vagina.

x) The nervous system The hormonal changes in menopause have the effect on the central nervous system where the functions in mental health and development of neurological disorders occur due to changes in the nervous system. There is an increase in risk for development of nervous disorders such as Alzheimer's disease, senile dementia among others. The occurrence of menopause is preceded by a perimenopausal period which is the period during which there is a gradual reduction or erratic elevation of the reproductive hormones. The period is characterized by the occurrence of hot flushes, night sweats due to the changes in the estrogen hormone levels (Edwards & Li, 2012). Menopause marks the end of the perimenopausal symptoms and is characterized by the post-menopausal period usually marked by symptoms such as vaginal dryness due to decline in estrogen levels.

Menopause hence is an important developmental landmark in women’s reproductive health which is majorly mediated and affects the endocrine functions (Edwards & Li, 2012. Apart from the endocrine function, menopause has its impact on all other body systems such as the cardiovascular system, breathing system among others. The chief hormones involved in menopause are estradiol, progesterone, inhibin B, anti-Mullerian hormone (AMH) and FSH (Hall, 2015). The perimenopausal period is characterized by a decline in the number of oocytes in the ovary which leads to increase in FSH as it stimulates an increase of the oocytes in the ovary (Hall, 2015). The increase in FSH is usually regulated by a negative feedback by inhibin B and estrogen. The decline in the oocyte levels contributes partly to a reduction in estrogen production and a downregulation of the inhibin B (Jones & Boelaert, 2014).

The declining estrogen and inhibin B production hence reduces the negative feedback on the production of FSH leading to an increased production of FSH (Hall, 2015). Its production continues even after menopause. The hormonal changes in the transition period result in different symptoms and signs that are seen in perimenopausal periods. The erratic levels of estrogen often characterized by decreased levels of production result in the observed episodes of insomnia, bone loss, palpitations, vaginal dryness, night sweats and hot flashes. Estrogen which plays an important role in bone growth through the closure of the epiphysial growth plates closure induces osteoclastic activity and bone resorption is enhanced during its decline leading to bone mass loss. The decline in estrogen triggers the KNDy neurons in the hypothalamus to fire responding to lowered body temperature (Jones & Boelaert, 2014).

The increased production of testosterone in menopausal women can be further increased by insulin resistance if present. Insulin acts as a co-gonadotrophin stimulating further release of the androgens by the ovary. The increased androgen production in menopause may cause the observed symptoms of hyperandrogenic such as the appearance of facial hairs and reduced scalp hair. The declining function of the ovary in menopause is also characterized by a sustained reduction in estrogen production. Estradiol production in menopause falls to its lowest levels with most of the estrogen produced in the body being from the conversion of estrone (a peripheral derivative of androstenedione) in the peripheral body. The menopause period is characterized by significant reduction in estrogen and eventual unavailability of the hormone.

The declining estrogen availability due to reduced conversion of the androgens consequently contributes to the observable menopausal symptoms such as increased presence of conditions such as cardiovascular conditions, loss of bone mass and osteoporosis among others. Other symptoms of menopause also persist such as the decreased libido, dryness of the vagina and atrophy of the genitourinary tissues. The endocrine system is the most significant system in the development of menopause. There is an established relationship and interlinkages between different hormones and their contribution to the development of menopause which is preceded by a period of premenopausal changes. Estrogen helps in preventing increased blood pressure by preventing the conversion of Angiotensin 1 to Angiotensin 2 and decreasing the sensitivity of the angiotensin receptors (Souza, 2013).

Estrogen also acts as a stimulator of nitric oxide synthesis which stimulates vasodilation hence reducing hypertension. In menopause, the decline in estrogen levels is characterized by a similar decline in the ability of the body system to control hypertension. There is an increased prevalence of hypertension among menopausal women. Hypertension is one of the cardiovascular illnesses associated with menopause and can lead to a series of cardiovascular complications for women in their menopause periods (Souza, 2013). Hormonal replacement, which is a possible event in menopausal women is also a significant contributor to increased cardiovascular disease in menopause. Menopause and the respiratory system The changes in menopause result in an increased steroid production by the ovary in menopausal women. There is a close relationship between the changes in menopause with increased production of the androgens and the bronchial tree.

As respiratory issues increase with aging, menopausal changes increase the risk of respiratory diseases in women. Pulmonary function in women is affected by both aging and hormonal changes (Macsali, Svanes, Bjørge, Omenaas & Real, 2012). Because estrogen and progesterone help improve muscle strength and foster bone growth and repair, during menopause this is decreased leading to lower lung function i. e. low FEV1, FVC, PEFR and FEF 25-75 (Karia, Kedar & Munje, 2017). Estrogen decreases airway hyperactivity and thus reduces the incidence of allergic asthma in women. This is mediated through reduction of endothelin-1 by estrogen a strong vasoconstrictor and broncho-constrictor with proinflammatory properties. However, in perimenopausal period, bone loss has been associated with high concentrations of FSH. FSH, a pituitary hormone, binds to FSHR receptor on bone tissue and impairs signaling of proteins associated with cell proliferation.

Instead, FSH activates osteoclasts that aid in bone reabsorption. The ultimate effect is a loss of bone mass (Calleja-Agius & Brincat, 2014). Estrogen plays a critical role in tendon metabolism and in the production of different growth factors. Estrogen deficiency prolongs wound healing by negatively affecting inflammation and re-granulation of damaged skin tissue. In older women, treatment with exogenous estrogen has helped improve wound healing (Wilkinson & Hardman, 2017). Approximately 20-60% of women suffer from hair loss during menopause. Hair loss during this period is associated with a decline in estrogen and a rise in blood androgen concentration. Dihydrotestosterone (DHT) is a derivative of testosterone and is implicated in hair loss among women. During menopause, women have more androgens than estrogen. Androgens have been shown to suppress both B-cell and T-cell immune responses.

Furthermore, menopausal women exhibit an inflammatory state that lacks protective immune factors. This is evident with chronic high levels of pro-inflammatory cytokines seen and include MCP1, TNFα, and IL-6. Because of weakened immunity, their ability to respond quickly to pathogens and stimuli is reduced (Ghosh, Rodriguez-Garcia & Wira, 2014). The deposition of fat in the body with reduction of the estrogen changes from fat deposition in the buttocks and the thighs and hips and fat is deposited in the midsection leading to the occurrence of central obesity. Increased abdominal fat deposition presents risks for metabolic issues such as insulin resistance and the development of diabetes in menopause (Boukhris, Tomasello, Marzà, Bregante, luchinotta & Galassi, 2014). Menopause and the Reproductive system Women in menopausal age often present with symptoms such as vaginal dryness, burning, irritation, decreased lubrication with sexual activity, and dyspareunia with resultant sexual dysfunction (Faubion, Sood & Kapoor, 2017).

These symptoms vary in severity, in extreme cases may lead to painful sexual intercourse. Many women will have low libido and may avoid sexual intimacy with their partners. Genitourinary syndrome of menopause affects the labia majora/minora, clitoris, vestibule/introitus, vagina, urethra, and bladder. The urinary symptoms in menopausal women may include increased frequency of micturition, dysuria, and increased risk for urinary tract infections. Stress or mixed incontinence and overactive bladder are other urinary symptom seen among menopausal women visiting the gynecology clinic (Faubion, Sood & Kapoor, 2017). The physiological changes that occur in menopause on the urinary tract are similar to those that affect the genital anatomy. In the urinary tract, there is thinning of the transitional epithelium lining the urethra and the trigone of the bladder.

It has been hypothesized that decline in estrogen leads to a corresponding decline in serotonin levels (Santoro, Epperson & Mathews, 2015). This causes serotonin receptor upregulation, which inadvertently causes increased secretion of serotonin. Serotonin will interact with the hypothalamic receptors and cause a rise in body temperature set point hence the hot flashes (Santoro, Epperson & Mathews, 2015). Conclusion Menopause is an integral physiological point in the aging female through which the body changes impact on the patient’s physical and physiological outcomes. The different effect of menopause on the different body systems is key to understanding the intricate and the interconnectedness of menopause and the body physiology. http://dx. doi. org/10. 5114/pm. 46468 Boukhris, M. 1155/2014/413920 Calleja-Agius, J. , & Brincat, M. Menopause-Related Changes in the Musculoskeletal System, Cartilages and Joints.

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