During the premenopausal years the cyclical events gradually decrease until postmenopausal amenorrhea is established. The primary process takes place in the ovaries as a gradual decline and final cessation of the generative and endocrine functions, although a certain non-cyclical endocrine activity of the ovaries is maintained until advanced age. Alexander found that the absence of ovarian steroids does not influence the hypothalamic secretion of gonadotropin releasing hormone (GnRH): the mean level of GnRH does not change with advanCing age. The lack of response of postmenopausal ovaries to endogenous gonadotropin stimulation is a result of primary age-related changes in the ovaries, not in the hypothalamus. As a result ofthe decrease in estrogens, the feed-back of ovarian estrogens on the hypothalamus diminishes, resulting in high FSH levels. A high serum FSH level is the only constant laboratory finding in the postmenopausal years. Apart from hormonal changes other effects of the aging do occur. No study so far has pointed out that in the climacteric years there is an acceleration of aging.

attutudes, climacteric, hormone replacement therapy, well-being
H.J. Dokter (Heert) , A.C. Drogendijk
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

Groeneveld, F.P.M.J. (1994, June 29). The climacteric: blood, sweat and tears? : population based studies of well-being, attitudes and hormone replacement therapy among 1947 women aged 45-60 years. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/23794