Climacteric and Menopause

Written by: Dr.Prof. Miguel Ángel Herráiz Martínez
Published: | Updated: 11/07/2018
Edited by: Top Doctors®

To talk about Menopause, the first thing is to define exactly what is. According to the strict definition, menopause is simply the cessation of menstruation that usually occurs around 50 years of age. In contrast, the climacteric is the period of time, about 10 years, in which all those symptoms that people commonly call menopause follow.

Before the menopause as such, a series of previous manifestations appear, the pre-menopause, which occurs in women between 45 and 50 years. Post-menopause, on the other hand, occurs between 50 and 55 years of age, that is, once menstruation has stopped.

The arrival of menopause is preceded by the progressive reduction of primordia (an oocyte set surrounded by a layer of estrogen-producing cells), as a result of which the hypothalamus reacts by increasing its stimulus to the pituitary gland to produce more gonadotropins, in particular FSH, to stimulate the ovaries that do not respond adequately by the progressive decrease of these primordia. This causes four or five years before the onset of menopause occur alterations in more or less striking cycles, such as shortening of the cycles or the opposite, appearance of large follicles (primordia developed) that cause high production of estrogen and as a consequence important hemorrhages, etc.

Once the last menstruation or menopause arrives there is an exaggerated response of the hypothalamus-pituitary gland that tries to make the ovaries work by exaggeratedly increasing the gonadotropins, so one way to know if a woman is already menopausal is to check that the gonadotropins-FSH and LH - they are elevated. When the ovaries do not respond, they stop producing the most important hormone in the fertile age of the woman, estrogen, the lack of which will produce all the symptoms.

Climacteric syndrome

There are certain signs that characterize the process of disappearance of the rule and that occur from pre-menopause. It is what is generally known as symptoms. There are alterations of four types:

- Neurovegetative alterations (hot flashes, sweats, palpitations, paresthesias, headaches)

- Psychic alterations (fatigue, irritability, aggression, depression, lack of concentration and memory loss)

- Organic or systemic alterations (the genitals atrophy, the size of the uterus decreases, the skin cracks, joint pains, cerebrovascular diseases and osteoporosis)

- Genitourinary disorders (bladder prolapses, prolapses of the uterus, loss of urine)

The first symptom to appear, even several years before, are hot flushes followed by skin problems and genitourinary symptoms. Once menopause arrives, it is when osteoporosis usually appears and, about five or six years later, cerebrovascular diseases can develop.


The treatment is only necessary in those women in whom the above-mentioned symptoms cause serious discomfort and health problems. In these cases, they must be supplied with what they lack, that is, estrogen.

On the other hand, those women who feel well and do not have serious symptoms can go through a series of basic recommendations:

- Do not gain a lot of weight

- No Smoking

- Do sport (walking at least)

- Nourish yourself a lot of dairy

- Vitamin D

- A balanced diet with special emphasis on fish, fruit and vegetables.

An exceptional case is women who suffer a menopause caused as a result of surgery, or treatment by chemotherapy or radiotherapy. Then, it is necessary to resort to a hormonal treatment.

Menopause and libido

Throughout this process it is very characteristic that women's libido decreases. This is due to the lack of estrogen. Occasionally, LH produces a secretion of testosterone through the connective tissue of the ovary and this allows some women not to lose their libido at all.

*Translated with Google translator. We apologize for any imperfection

By Dr.Prof. Miguel Ángel Herráiz Martínez
Obstetrics & Gynecology

*Translated with Google translator. We apologize for any imperfection

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