Menopause, Greek méno, rules and pause, stop, also called age climacteric, is stopping règles.Lors of menopause a woman no longer has enough follicles as they were either used for ovarian cycle is follicular cells have degenerated by the phenomenon of follicular atresia. It is divided into several stages:

* Perimenopause: period of irregularities menstrual cycles before menopause and the years following the apparent shutdown of the rules;
* Post-menopause (menopause confirmed)

Estrogen and progesterone hormones steroids are derivatives of cholesterol that have cellular receptors located on the surface of cells including pituitary, which reacted by retro controls to maintain the rate of ovarian hormones around a stable value. This is a period of depression which leads ovaries is insufficient to progesterone alone or accompanied by a lack of estrogen. In the latter case there is a amenorrhea (lack of rules) or lower them with hot flashes; against if there is still a secretion estrogenic, disorders are:

o sensation belly swollen and balloné, constipation
o unstable character, insomnia at night, helping pump the afternoon, depression, anxiety sudden change in mood and irritability for nothing.
o headache
o tensions breast impression of constantly swollen breasts

* Troubles menstrual cycle:
o cycle shorter or longer flow or very light over several days (pre) to a total lack thereof (menopause)
o decreased libido
o sweats during the night and morning.
o metrorrhagia (disposing off period rules supposed), méno-metrorrhagia.

It is defined as the absence of rules for over a year.

The lack of estrogen causes first:

* Vaginal dryness
* Minors psychological disorders (depression, fatigue, insomnia, decreased libido, etc.).
* Puffs of heat and night sweats
* Final amenorrhea (cessation of blood flow)

Later, the genitals (vagina, vulva, uterus) atrophy, and mammary glands, with accentuation of prolapse.

All these symptoms are only disadvantages. The risks are osteoporosis (loss of bone density: fracture risk largest repair and therefore more difficult and long, bone loss increases to menopause) and increasing cardiovascular disease.

It should be noted that weight gain is not due to menopause itself but the reduction in the basic metabolism which occurs at roughly the same period.

Over the past thirty years, there is a hormone replacement therapy for menopause. This treatment helps to compensate for inadequate secretions ovarian estrogen and progesterone responsible for unrest in the short and long term. It is effective on symptoms of menopause and prevent osteoporosis. Theoretically estrogen also have a protective role on the heart.

Used widely before, it is much less, including the USA since the publication of a study in 2002 highlighting the absence of benefit in terms of cardiovascular disease and an increased risk of certain cancers, occurrence of pulmonary embolism and stroke, surpassing the benefit of a lower rate of fracture of the femoral neck. This study has been widely debated and it is not clear whether it is applicable to any form of replacement therapy or only to those courses mostly in the USA. The study population is, moreover, particularly older (up to 80 years).

the increased risk of breast cancer associated with these treatments has been affirmed by a publication of the WHO and found a documenting through the reduction of the incidence of breast cancer in France and the USA roughly contemporary with the declining sales of hormone treatments after the publication of the WHI study in 2002.

Among younger women (fifties), the risk of cardiovascular disease appears to the contrary, equivalent or lower. Similarly, the coronary arteries (irrigating the heart) would be less calcified in the past, which is favourable index.

All these elements calls for a limited period of hormonal treatment, but the optimal duration remains to be determined.

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