The climacteric is the adaptation period that every woman goes through once her natural reproductive capacity has been exhausted, generating at the same time that symptoms related to her hormonal decline occur.

What is the reproductive age?

It is the stage between puberty and menopause (understood, the last menstruation), in which the woman is able to generate the necessary conditions to produce ovulation and conceive a new life through the process of fertilization.

When does the reproductive age start?

The beginning of this reproductive stage, known culturally as the appearance of the first menstruation, (in medical terms, menarche or menarche), is a reflection of the development and maturity of the hypothalamic – pituitary – gonad (ovaries) axis, which allows to generate the characters secondary sexual activity in women, as well as the preparation for her to be able to reproduce. It will depend on genetic and environmental factors, the age of onset being broadly between 11 to 15 years.

Menopause and climacteric

The woman is born with a finite number of ovules that will mature and are eliminated throughout each menstrual cycle, until finally, the ovarian reserve is finished, generating with it reproductive disability and the cessation of menstruation that, as we already mentioned, is known as menopause.

It must be remembered, and many of our readers know this, that this process described above does not appear abruptly; At least, not in a physiological or natural way, so the woman has to first go through a gradual period of adaptation, which begins months before the last menstruation, until the physiological and psychosomatic adjustments after menopause, which They occur in an average of two to three years, this stage being generally known as the climacteric .

Climacteric symptoms

To better understand the symptoms related to this stage, we must understand the reason for their origin, which is none other than the progressive and continuous decrease in estrogen levels.

The ovaries are not only capable of allowing ovulation with each menstrual cycle, but also synthesize some hormones necessary for the reproductive activity of women, including estrogens and progesterone, resulting in a state of hypoestrogenemia with the cessation of ovarian function. (low levels of estrogens) that conditions the classic symptoms of climacteric.

The symptoms will depend on the moment in which we analyze the consequences of this hormonal decrease , and can be classified according to the moment of appearance in the short, medium and long term.

Among the first symptoms in frequency, which occur in the short term, are the so-called hot flashes or hot flashes that constitute one of the main and most common symptoms in peri-menopausal women, which consists of a sensation of increased temperature that rises from the chest to the face with redness of the skin with cutaneous vasodilation and even, increased heart rate and sweating (more common at night).

The irregular menstrual cycles (in the run- up to the cessation of menstruation), as well as changes in sudden mood (depression, anxiety, joy, sadness) and even decreased libido or sexual appetite are other symptoms in very common short and medium term that happen during the climacteric.

The other symptoms that are established in the medium to long term after menopause, is vaginal dryness, with the appearance of pain when having sexual intercourse and urinary incontinence, which carries with it an increased risk of urinary infections.

In the long term, the increase in androgen levels with the decrease in estrogens for periods of more than 2 years generates consequences related to the loss of bone mass, a process known as osteopenia and osteoporosis, as well as an increase in cardiovascular risk (formation of thrombi , heart attacks and strokes) to even equal the risk with the male gender.

What is the common age of onset of the climacteric?

The period in which the climacteric and menopause occur varies from woman to woman, either due to factors related to their race or ethnicity, the region (there are countries with averages of more advanced ages of menopause with respect to others, related to their degree of cultural and economic development), genetic-family (related to the age of menarche and menopause of the mother and close relatives in the first degree of consanguinity), as well as environmental, customs, eating habits, use of contraceptives, number of children, etc.

Finally, it has been shown that maintaining healthy lifestyle habits and exercising, as well as having a balanced diet and avoiding the consumption of illicit substances, prolongs the reproductive life period compared to patients with bad lifestyles, and this is the case, as is the The appearance of climacteric symptoms could generally range from 40 to 55 years of age.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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