• Menopause
    • signals end of menstrual cycles and reproductive function in females
    • progressive loss of ovarian follicle units (atresia) throughout reproductive life causes a decrease in ovarian production of estrogen and reduces negative feedback to anterior pituitary, leading to an increase in FSH and LH levels
    • typically preceded by several years of abnormal menstrual cycles
      • e.g., anovulatory cycles
    • diagnostic findings include ↓ estrogen, ↑↑ FSH, LH, GnRH
    • in post-menopausal women, source of estrogen includes ovary and adrenal cortex
      • via peripheral aromatization of androgens
        • adrenal cortex (major) and ovary (minor) are sources of androstenedione
          • androgens causes hirsutism
    • average age of menopause is 50 years
      • onset early in smokers
      • early menopause may indicate premature ovarian failure
  • Menopause symptoms 
    • symptoms are caused by loss of ovarian source of estrogen
      • hirsutism (male-pattern hair growth in women) via androgens
      • hot flashes (vascular instability)
      • atrophy of vagina (thinning of vaginal epithelium)
      • ↓ vaginal secretions
      • osteoporosis
      • coronary artery disease

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