Abstract
Physiological menopause is defined as the cessation of menses that occurs due to the depletion of primordial follicles and the resistance of follicular structures to the action of gonadotropins. The term is applied when a year without menses has been completed, so it is a date that is established retrospectively. In this sense, postmenopause is the correct expression to refer to the situation of women who have passed this point in time. In a multicenter study conducted in Latin America, it was found that the median age at menopause was 48.6 years, ranging from 43.8 years in Asunción (Paraguay) to 53 years in Cartagena (Colombia).
From the endocrinological point of view, menopause is characterized by hypogonadism-hypergonadotropic. However, physiological menopause is not the only cause of this hormonal state; other causes of primary ovarian failure, which can occur even at very early ages, are also characterized by hypogonadotropic-hypergonadotropic hypogonadism. Such is the case of gonadal dysgenesis, autoimmune lesions of the ovary, effects of pelvic radiotherapy or chemotherapy with alkylating agents, bilateral oophorectomy for benign or malignant indications, repeated cystectomies, premutation in the FMR1 gene for fragile X, untreated galactosemia, and idiopathic early menopause, among others.
References
Castelo-Branco C, Blümel JE, Chedraui P, Calle A, Bocanera R, Depiano E, et al. Age at menopause in Latin America. Menopause. 2006;13(4):706-12. https://doi.org/10.1097/01.gme.0000227338.73738.2d
Chon SJ, Umair Z, Yoon M-S. Premature Ovarian Insufficiency: Past, Present, and Future. Front Cell Dev Biol 2021;9:672890. https://doi.org/10.3389/fcell.2021.672890
Maas A, Rosano G, Cifkova R, Chieffo A, van Dijken D, Hamoda H. Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists. Eur. Heart J. 2021;10(42): 967–984 https://doi.org/10.1093/eurheartj/ehaa1044
Edwards H, Duchesne A, Au AS, Einstein G. The many menopauses: searching the cognitive research literature for menopause types. Menopause. 2019;26(1):45-65. https://doi.org/10.1097/GME.0000000000001171
Menopause: diagnosis and management. [Internet]. NICE Guideline. National Institute for Health and Care Excellence; 2015 [updated 2019 Dec 5; cited 2023 Feb 14]. Available from: https://www.nice.org.uk/guidance/ng23
Kagan R, Kellogg-Spadt S, Parish SJ. Practical Treatment Considerations in the Management of Genitourinary Syndrome of Menopause. Drugs Aging. 2019(10):897-908. https://doi.org/10.1007/s40266-019-00700-w
Nilsson S, Mäkelä S, Treuter E, Tujague M, Thomsen J, Andersson G, et al. Mechanisms of estrogen action. Physiol. Rev. 2001;81(4):1535-1565. https://doi.org/10.1152/physrev.2001.81.4.1535
Valadares ALR, Kulak Junior J, Paiva LHS, Nasser EJ, da Silva CR, Nahas EAP, et al. Genitourinary syndrome of menopause. Rev Bras Ginecol Obstet. 2022;44(3):319-324. https://doi.org/10.1055/s-0042-1748463
Porterfield L, Wur N, Delgado ZS, Syed F, Song A, Weller SC. Vaginal vitamin E for treatment of genitourinary syndrome of menopause: A systematic review of randomized controlled trials. J Menopausal Med. 2022;28(1):9-16. https://doi.org/10.6118/jmm.21028

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