Menopause pathophysiology: Difference between revisions
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== Microscopic Pathology == | == Microscopic Pathology == | ||
On microscopic histopathological of menopause, Structures of the ovaries ( cortex and medulla) are change, the distinction between the cortex and medulla is less evident The cortex becomes thinner , it has fewer and aging follicles that is tendency towards the fragmentation of the corpora arenacea .Additionally, there are invaginations of the surface epithelium of the cortex, and epithelial inclusion cysts are present. The medulla develops stromal fibrosis and scars. The medulla also undergoes the hyalinization of vessel walls, with architectural changes of vessels. | On microscopic histopathological of menopause," Structures of the ovaries ( cortex and medulla) are change, the distinction between the cortex and medulla is less evident The cortex becomes thinner, it has fewer and aging follicles that is the tendency towards the fragmentation of the corpora arenacea. Additionally, there are invaginations of the surface epithelium of the cortex, and epithelial inclusion cysts are present. The medulla develops stromal fibrosis and scars. The medulla also undergoes the hyalinization of vessel walls, with architectural changes of vessels".<ref>https://www.ncbi.nlm.nih.gov/books/NBK507826/#!po=10.0000</ref> | ||
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==References== | ==References== | ||
Revision as of 17:52, 25 July 2020
Overview
Menopause is natural amenorrhea that is happened without any pathological causes, but premature menopause caused by several pathological diseases that induced premature ovarian insufficiency and early cessation of menses.
Pathophysiology
physiological menopause:
Menopause happens normally as women age, And the main cause of the menopause is the natural depletion of the primary follicles (oocytes) in the ovaries and And the decline of the response of ovaries to anterior pituitary gonads hormones that include Follicle Stimulating Hormone (FSH) and Luteinizing Hormone(LH). These hormones stimulate the ovaries to produce estrogen and progesterone hormones in a cyclic pattern under the control of the hypothalamus that produces the gonadotropin-releasing hormones which stimulate anterior pituitary gonads hormone secretion and inhibin-B that plays role in feedback mechanism. "During perimenopause (approaching menopause), estradiol levels and patterns of production remain relatively unchanged or may increase compared to young women, but the cycles become frequently shorter or irregular. The often observed increase in estrogen is presumed to be in response to elevated FSH levels that, in turn, is hypothesized to be caused by decreased feedback by inhibin".[1] "Characteristic changes in the hypothalamic-pituitary-ovarian (HPO) axis during the menopause transition result from decreased ovarian feedback of inhibin and estradiol and are manifested primarily as elevations in follicle-stimulating hormone (FSH). Although central mechanisms may contribute to reproductive aging, they are less well characterized. Adrenal changes concurrent with the menopause transition include elevations in serum cortisol and transient elevations in dehydroepiandrosterone sulfate, androstenediol, and other adrenal androgens"[2]. Post-menopause can be determined by a blood test that can reveal the very high levels of Follicle Stimulating Hormone (FSH) that are typical of post-menopausal women.
pathological menopause:
premature or early menopause induced by pathological disease in ovaries such as polycystic ovary syndrome, due to excessive secretion of androgen from ovaries lead to irregular nemeses or on the menstrual cycle. And autoimmune diseases, the body’s immune system attacks the ovaries and keeps them from making hormones. Premature ovarian failure is the loss of function of the ovaries lead to amenorrhea because of failure response ovaries for gonads hormone ( FSH, LH) and deficiency production of estrogen and progesterone. Ovarian tumor or endometriosis that is required surgical induction as Bilateral oophorectomy or salpingo-oophorectomy, periods will stop after this surgery, and hormone levels will drop quickly with strong menopausal symptoms. Bilateral oophorectomy sometimes was done in conjunction with Hysterectomy, removal of the uterus, hysterectomy, does not itself cause menopause, although pelvic surgery can sometimes precipitate somewhat earlier menopause, perhaps because of compromised blood supply to the ovaries, women who have undergone hysterectomy with ovary conservation go through menopause 3.7 years earlier than average. In addition to pathological disease in other glands such as thyroid disease and diabetes mellitus.[3]
Genetic
- Fragile X syndrome gene: Women born with missing chromosomes or problems with chromosomes can go through menopause early, such as Turner’s syndrome, women are born without all or part of one X chromosome, so their ovaries do not form normally at birth and their menstrual cycles, including the time around menopause, may not be normal.
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Microscopic Pathology
On microscopic histopathological of menopause," Structures of the ovaries ( cortex and medulla) are change, the distinction between the cortex and medulla is less evident The cortex becomes thinner, it has fewer and aging follicles that is the tendency towards the fragmentation of the corpora arenacea. Additionally, there are invaginations of the surface epithelium of the cortex, and epithelial inclusion cysts are present. The medulla develops stromal fibrosis and scars. The medulla also undergoes the hyalinization of vessel walls, with architectural changes of vessels".[4]
References