Menopause

Def: Menopause is a period in a woman where there is complete cessation of

menstruation. It is a turning point in a woman life because it marks the end of
child bearing.
Occurrence
 It occurs between the ages of 45 and 55 years. It may occur suddenly or
gradually taking over a period of 10 years. The onset may be influence
by nutritional or genetic factors.
 Menopause is caused by change in the concentration of sex hormones;
oestrogen and progesterone.
 The ovaries become less responsive to F.S.H and L.H.
 The ovulation and menstrual cycle become irregular and eventually
cease.
 Episodes of unpredictable behaviour.
 The woman experiences hot flushes, sweating, palpitations causing
discomfort and disturbance in sleep pattern
 The breast shrinks.
 Axillary and pubic hair become sparse, grey and may disappear
 Sex organs atrophy.
 Episodes of uncharacterised behaviour occur. They become irritated and
her mood changes.
 There is loss of bone mass that predispose to osteoporosis and fractures.
 There is slow increase in cholesterol level that predispose post-
menopausal woman to cardiovascular disorders.
 There is gradual thinning and shrinking of the skin.
 There is wrinkling of the skin due to loss of protein from the skin and
supporting tissues.
 The endometrium and myometrium atrophy and the uterine cavity
become stenosed.
 The vaginal mucosa becomes smooth, thin and the rugae disappears
resulting to loss of elasticity.
 There is painful coitus or dyspareunia due to the dryness.
 Dryness of the mucus membrane may result in itching and burning.
 The PH of the vagina increases (becomes alkaline) as the number of
Dodicin Bacilli decreases.
 The acidity of the vagina drops and there is a tendency to vaginal
infection.
 The breast shrinks and becomes pendulous.
 Sexual activity may increase as the need for contraception disappears.
  Diabetes melitus may increase at this age.
 Weight gain due to excessive calorie intake.
 There may be headaches, vague muscles pains and occasional emotional
instability.
Interventions
 Good nutrition to build up the skin and supporting tissues e.g. soya
beans, much protein products.
 The use of oestrogen can calm the hot flushes.
 Administration of calcium to strengthen the bone so as to prevent
fractures.
 Making of exercise so as to reduces weight but this should be done with
care to prevent fractions.
 Oestrogen therapy – high doss should be avoided as they can predispose
to malignancy in the reproductive tract.
 Use of intravaginal oestrogenic cream reduce vaginal atrophy.
 Sex should be done with care to avoid trauma to vagina (since it is dry).
 Care should be taken against infection since the protection of the vagina
(acidity) has dropped and this can give rise to vulvovaginitis.
 Ensure good hygiene of the genital tract.
 Good body cream can be used to keep the body soft and moist.

SEX HORMONS IN PREGNANCY

1. OESROGEN: It rises steadily and reaches a maximum and falls just when
labour begins
2. PROGESTERON: It is produced by the corpus Latium and later by the
placenta. It is maintained throughout pregnancy. In the first 3 months, it
is produced by the corpus luteum. After the 12th week, the placenta
takes over the production
3. RELAXIN: it is produced by the chorionic villi. It relaxes the pelvic
ligaments and allows the widening of the pelvic joints in labour
4. PROLACTIN: it is produced by the anterior lobe of the pituitary gland. It
stimulates the acini cells of the breast to produce milk