The comprehensive and irreversible alterations in the hormonal milieu that occur following the cessation of menstrual cycles, primarily characterized by a significant decline in ovarian production of estrogen and progesterone. These shifts extend beyond the reproductive axis, influencing thyroid function, adrenal output, and metabolic hormone sensitivity, leading to widespread systemic changes. Clinical management focuses on mitigating the adverse health consequences associated with this new endocrine state.
Origin
This term is rooted in reproductive endocrinology, marking a definitive physiological stage in the female lifespan. The emphasis on “shifts” rather than a singular event highlights the complex, multi-systemic cascade of hormonal changes that unfold over time.
Mechanism
The primary mechanism is ovarian senescence, resulting in the loss of follicular activity and a dramatic drop in circulating estradiol and progesterone. This loss disrupts the hypothalamic-pituitary-ovarian (HPO) axis feedback loop, causing elevated pituitary gonadotropins (FSH and LH). The subsequent estrogen deficiency impacts bone density, cardiovascular health, and neurocognitive function, necessitating a holistic clinical approach to restore balance.
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