MENARCHE, MENSTRUATION AND MENOPAUSE: ESTROGEN THROUGH THE LIFECYCLE

1
MENARCHE, MENSTRUATION AND MENOPAUSE ESTROGEN
THROUGH THE LIFECYCLE
2
DEFINITIONS

• ESTROGEN
• MENARCHE
• MENSTRUATION
• MENOPAUSE
• PREMENOPAUSE
• PERIMENOPAUSE
• POSTMENOPAUSE

3
MENARCHE

• ONSET
• SIGNAL
• CENTRAL NERVOUS SYSTEM
• HYPOTHALAMUS
• PITUITARY
• OVARIES
• NEGATIVE FEEDBACK
• POSITIVE ESTROGEN
• FEEDBACK

4
MENSTRUATION

• INTERACTION OF HYPOTALAMUS, PITUITARY AND
  REPRODUCTIVE ORGANS
• CHANGES IN THE OVARY
• CHANGES IN THE LINING OF THE UTERUS

5
MENOPAUSE

• CLIMACTERIUM
• DECREASE IN THE NUMBER OF FOLLICLES
• DECREASE IN ESTROGEN AND AN ELEVATION OF FSH
• PROGRESSIVE LOSS OF ESTROGEN

6
3 TYPES OF ESTROGEN IN THE BODY

• 1. ESTRADIOL
• 2. ESTRONE
• 3. ESTRIOL

7
DIFFERENCE BETWEEN ESTROGENS

• 1. CONTRACEPTIVE ESTROGENS
• 2. ESTROGEN REPLACEMENT THERAPY (ERT)

8
PERIMENOPAUSAL SYMPTOMS TREATMENT WITH ESTROGEN

• HOT FLASHES/ FLUSHES
• VAGINAL DRYNESS/ VAGINITIS
• CHANGES IN THE URINARY TRACT
• CHANGES IN SEXUALITY
• AFFECTIVE, OR EMOTIONAL

9
PREVENTIVE USES OF ERT

• SKIN CHANGES
• RHEUMATOID ARTHRITIS
• MEMORY LOSS/ ALZHEIMERS DISEASE
• OSTEOPOROSIS
• CARDIOVASCULAR DISEASE

10
RISKS OF HORMONE REPLACEMENT THERAPY

• ENDOMETRIAL CANCER
• BREAST CANCER
• GALLBALDDER DISEASE

11
SIDE EFFECTS OF HORMONE REPLACEMENT

• ESTROGEN
• Breast Tenderness
• Headache
• Nausea
• Bloating
• Weight Gain
• Increased cervical mucous secretion
• Breakthrough bleeding

• PROGESTIN
• Acne
• Headache
• PMS like symptoms
• Gastrointestinal distress
• Breast tenderness
• Changes in libido
• Insomnia
• Itching
• Growth of excess hair

12
ESTROGEN PREPARATIONS

• ORAL ESTROGEN
• TRANSDERMAL ESTROGEN
• VAGINAL ESTROGENS
• OTHER ROUTES

13
WHEN TO START ERT

• CONTRADICTIONS

14
WHAT TO DO IF SIDE EFFECTS OCCUR

• CHANGE DOSAGE, TYPE GIVEN, OR ROUTE
• IF DEPRESSION,
• CHANGE THE PROGESTIN TYPE OR DOSE
• IF BREAKTHROUGH BLEEDING OCCURS
• PROGESTIN MAY BE INCREASED

15
ALTERNATIVE THERAPIES

• NUTRITION AND NUTRIONAL SUPPLEMENTATION
• EXERCISE
• RELAXATION
• HERBS
• HOMEOPATHY
• ACUPUNCTURE
• SELF HELP MEASURES

16
RESOURCES AND SERVICES
17
CASE STUDY

• THEORETICAL PERSPECTIVES OF THE CONCEPT