AGING AND THE REPRODUCTIVE SYSTEMS
For women there is a definite end to reproductive capability; this is called the menopause and usually occurs between the ages of 45 and 55. Estrogen secre-tion decreases; ovulation and menstrual cycles become irregular and finally cease. The decrease in estrogen has other effects as well. Loss of bone matrix may lead to osteoporosis and fractures; an increase in blood cholesterol makes women more likely to develop coronary artery disease; drying of the vaginal mucosa increases susceptibility to vaginal infections. Estrogen replacement therapy may delay some of these conse-quences of menopause, but there are risks involved, and women should be fully informed of them before starting such therapy. The likelihood of breast cancer also increases with age, and women over age 50 should consider having a mammogram to serve as a baseline, then one at least every other year.
For most men, testosterone secretion continues throughout life, as does sperm production, though both diminish with advancing age. Perhaps the most common reproductive problem for older men is pro-static hypertrophy, enlargement of the prostate gland. As the urethra is compressed by the growing prostate gland, urination becomes difficult, and residual urine in the bladder increases the chance of urinary tract infection. Prostate hypertrophy is usually benign, but cancer of the prostate is one of the more common can-cers in elderly men.
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