Menopause pathophysiology
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 Gland that secrets of 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.
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