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.
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