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AGE-RELATED CHANGES IN THE REPRODUCTIVE SYSTEM
Menopause is the time that ovulation and menstrua-tion cease. It may be defined as the phase in the aging process of women that marks the transition from the reproductive stage of life to the nonreproductive stage. As a woman gets older, the ovaries become unrespon-sive to the gonadotropins (pituitary hormones) and, gradually, the sexual cycles disappear. The decline in function results in lower levels of estrogen and proges-terone secretion. The reproductive organs slowly atro-phy, together with the ligaments and supporting tissue as the hormonal stimulus decreases. Reduction of glandular secretion in the reproductive organs leads to excessive regional dryness. There is atrophy of the ure-thra, vaginal wall, and vaginal glands, with loss of lu-brication. The glands in the breast also atrophy. How-ever, menopause does not indicate the end of sexuality.
Menopause, also known as climacteric, usually occurs between the ages of 45 and 55 years (average, 52 years). In 8% of women, menopause occurs before the age of 40. A few years prior to menopause, the ovarian and uterine cycles become irregular. The ces-sation of menstruation is just one component in this transition period, which extends many years before and after the last cycle. It involves endocrine, physi-cal, and psychological changes in the woman.
Menopause is often accompanied by psychic symp-toms. As well, sudden sensations of warmth spreading from the trunk to the face (hot flushes) tend to appear. It is accompanied by increased perspiration, pulse rate, and vasodilatation. Although the cause is unknown, they tend to accompany sudden surges of LH secretion.
The risk of osteoporosis is higher after menopause. One reason is attributed to lower estrogen levels and many women, especially those at risk for developing osteoporosis, are routinely given low dose estrogen therapy after menopause. The risk of developing ath-erosclerosis is also high after menopause.
Other symptoms of menopause include headache, hair loss, muscular pains, insomnia, depression, weight gain, and mood swings.
Most women experience mild symptoms, although others experience unpleasant sensations. Many women undergo hormone replacement therapy (see Hormone Replacement Therapy) to alleviate osteoporosis and other symptoms.
In men, while the function of the testis diminishes slowly with age, there is no “male menopause” similar to that in women. Between the ages of 50 and 60, the level of testosterone decreases while FSH and LH levels increase. Sperm production may continue for a long time, but there is a gradual reduction in sexual activity.
In many elderly men, the prostate enlarges to two to four times its original size. This is known as be-nign prostatic hyperplasia. If the enlargement ob-structs the urethra, the men experience obstructive symptoms, such as frequency of urination, hesita-tion, decreased force of the urine stream, and sensa-tion of incomplete emptying.
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