Page 169 - 86 human physiology part-2

Chapter 19

leads to the post-menopausal symptoms of hot flashes, insomnia, osteoporosis, atherosclerosis, vaginal
atrophy and depression.

Cigarette smoking has been found to decrease the age at menopause by as much as one year
however, premature menopause (before the age of 40) is generally idiopathic.

Symptoms

The clinical features of menopause are caused by the estrogen deficiency.

• vasomotor instability
• hot flashes, hot flushes
• sleep disturbances
• Urogenital atrophy
• dyspareunia
• itching
• dryness
• bleeding
• urinary frequency
• urinary urgency
• urinary incontinence
• skeletal

Breast Atrophy

• skin thinning
• decreased elasticity
• Psychological

Mood Disturbance

• irritability
• fatigue
• decreased libido
• memory loss
• depression

Treatments: Medical treatments for menopausal symptoms have been developed. Most notably,
Hormone Replacement Therapy (HRT), has been used to reduce the weakening of bones (known as
osteoporosis). However, some women have resisted the implication that menopause is a disorder,
seeing it as a natural stage of life. There has also been scientific controversy over whether the benefits
of HRT outweigh the risks. For many years, women were advised to take hormone therapy after
menopause to reduce their risk of heart disease and various aspects of aging. However, a large,
randomized, controlled trial (the Women's Health Initiative) found that women undergoing HRT had an
increased risk of Alzheimer's disease, breast cancer, heart disease and stroke.

384 | Human Physiology