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Most other animals, including mammals, experience menopause, but only human females live a significant portion of their lives post-reproductively.
Most other animals, including mammals, experience menopause, but only human females live a significant portion of their lives post-reproductively.
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What are some factors that may influence the age at which a woman enters menopause? (Select all that apply)
What are some factors that may influence the age at which a woman enters menopause? (Select all that apply)
What is the name for the stage preceding actual menopause, marked by irregular menstrual cycles, hot flashes, mood changes, and other symptoms?
What is the name for the stage preceding actual menopause, marked by irregular menstrual cycles, hot flashes, mood changes, and other symptoms?
Perimenopause
Women who use the combination birth control pill (Chapter 13) are more likely to experience perimenopausal symptoms.
Women who use the combination birth control pill (Chapter 13) are more likely to experience perimenopausal symptoms.
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What is the name of the condition in which a woman enters menopause before age 40?
What is the name of the condition in which a woman enters menopause before age 40?
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Which of the following is the most common symptom experienced by postmenopausal women in the United States?
Which of the following is the most common symptom experienced by postmenopausal women in the United States?
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What is the name for the physiological changes that occur during menopause, including psychological and emotional changes, as well as hormonal and physical changes?
What is the name for the physiological changes that occur during menopause, including psychological and emotional changes, as well as hormonal and physical changes?
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What is the name of the major circulating estrogen in postmenopausal women?
What is the name of the major circulating estrogen in postmenopausal women?
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Obese women have higher levels of estrone compared to lean women.
Obese women have higher levels of estrone compared to lean women.
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What causes hot flashes?
What causes hot flashes?
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Women who experience hot flashes have a wider thermoneutral zone than women who do not experience hot flashes.
Women who experience hot flashes have a wider thermoneutral zone than women who do not experience hot flashes.
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What is the name of the small glycoprotein hormone that is released by Sertoli cells in the developing testis and causes degeneration of the Mullerian ducts in males?
What is the name of the small glycoprotein hormone that is released by Sertoli cells in the developing testis and causes degeneration of the Mullerian ducts in males?
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Anti-Müllerian hormone (AMH) levels remain detectable in the blood after menopause.
Anti-Müllerian hormone (AMH) levels remain detectable in the blood after menopause.
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What is the name of the glycoprotein that selectively suppresses the release of FSH from the anterior pituitary?
What is the name of the glycoprotein that selectively suppresses the release of FSH from the anterior pituitary?
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When the pituitary gland is released from the inhibition of inhibin-B, the secretion of FSH rises, which increases the rate of follicular maturation and shortens the follicular phase of the menstrual cycle.
When the pituitary gland is released from the inhibition of inhibin-B, the secretion of FSH rises, which increases the rate of follicular maturation and shortens the follicular phase of the menstrual cycle.
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Ovarian follicles are constantly being depleted, which means a woman has an unlimited number of ovulations after which her ovaries are exhausted.
Ovarian follicles are constantly being depleted, which means a woman has an unlimited number of ovulations after which her ovaries are exhausted.
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Studies have shown that a girl that enters menarche early will experience menopause earlier in life.
Studies have shown that a girl that enters menarche early will experience menopause earlier in life.
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What are some of the age-related changes that occur in oocytes as a woman ages? (Select all that apply)
What are some of the age-related changes that occur in oocytes as a woman ages? (Select all that apply)
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The depletion of ovarian follicles is the primary cause of menopause.
The depletion of ovarian follicles is the primary cause of menopause.
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The risk of miscarriage increases with increasing maternal age.
The risk of miscarriage increases with increasing maternal age.
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What is the range of age considered to be peak female fertility?
What is the range of age considered to be peak female fertility?
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A woman’s ability to become pregnant declines sharply after age 30, and by age 35, her chances of becoming pregnant are only a third of what they were in her twenties.
A woman’s ability to become pregnant declines sharply after age 30, and by age 35, her chances of becoming pregnant are only a third of what they were in her twenties.
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Women who have had several full-term pregnancies tend to experience menopause earlier in life.
Women who have had several full-term pregnancies tend to experience menopause earlier in life.
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What is the name of the hormone primarily produced by the granulosa and theca cells of developing small antral follicles, that acts to selectively inhibit the production and release of FSH from the pituitary gland?
What is the name of the hormone primarily produced by the granulosa and theca cells of developing small antral follicles, that acts to selectively inhibit the production and release of FSH from the pituitary gland?
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In general, a rise in FSH levels is an indicator of ovarian aging in women.
In general, a rise in FSH levels is an indicator of ovarian aging in women.
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What hormone is present in the developing testis and causes degeneration of the Müllerian ducts in males?
What hormone is present in the developing testis and causes degeneration of the Müllerian ducts in males?
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Levels of Anti-Müllerian Hormone (AMH) typically remain stable during the menstrual cycle, which makes it a good biomarker for the number of healthy early tertiary follicles.
Levels of Anti-Müllerian Hormone (AMH) typically remain stable during the menstrual cycle, which makes it a good biomarker for the number of healthy early tertiary follicles.
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Estrogen levels fluctuate during the female cycle, so it should not be measured during the follicular phase.
Estrogen levels fluctuate during the female cycle, so it should not be measured during the follicular phase.
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Because of the significant health benefits discovered from the use of hormone replacement therapy, especially for heart disease and cardiovascular health, it is now widely recommended to women of all ages.
Because of the significant health benefits discovered from the use of hormone replacement therapy, especially for heart disease and cardiovascular health, it is now widely recommended to women of all ages.
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HRT is often used to decrease the risk of osteoporosis and hip fractures, but it should be used in conjunction with other treatments, such as weight-bearing exercise and non-hormonal treatments for osteoporosis.
HRT is often used to decrease the risk of osteoporosis and hip fractures, but it should be used in conjunction with other treatments, such as weight-bearing exercise and non-hormonal treatments for osteoporosis.
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What is the name of the condition that can develop when a woman’s bones become weak and prone to fracture?
What is the name of the condition that can develop when a woman’s bones become weak and prone to fracture?
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The risk of developing osteoporosis is higher in women who are obese.
The risk of developing osteoporosis is higher in women who are obese.
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Andropause is often referred to as a slow, gradual process and may begin in a man’s forties.
Andropause is often referred to as a slow, gradual process and may begin in a man’s forties.
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Men who experience andropause have increased blood testosterone levels compared to older men who abstain from sex.
Men who experience andropause have increased blood testosterone levels compared to older men who abstain from sex.
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Androgen production declines entirely during andropause.
Androgen production declines entirely during andropause.
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Older men are more likely to experience a decrease in semen volume.
Older men are more likely to experience a decrease in semen volume.
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Androgen replacement therapy (ART) can help to reverse symptoms of andropause, and has no adverse side effects.
Androgen replacement therapy (ART) can help to reverse symptoms of andropause, and has no adverse side effects.
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The increased risk of neurological disorders and miscarriage in offspring is related to a woman’s age, but not to a man’s age.
The increased risk of neurological disorders and miscarriage in offspring is related to a woman’s age, but not to a man’s age.
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What is the name of the theory that suggests the evolution of menopause evolved as an adaptive trait in humans, where older women would help with caretaking of their grandchildren, benefiting their own evolutionary fitness?
What is the name of the theory that suggests the evolution of menopause evolved as an adaptive trait in humans, where older women would help with caretaking of their grandchildren, benefiting their own evolutionary fitness?
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The grandmother hypothesis for the evolution of menopause in humans is based on an understanding of the roles of older women in ancient hunter-gatherer societies.
The grandmother hypothesis for the evolution of menopause in humans is based on an understanding of the roles of older women in ancient hunter-gatherer societies.
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The grandmother hypothesis only explains the evolution of menopause in women, not in men.
The grandmother hypothesis only explains the evolution of menopause in women, not in men.
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The grandfathers' role in ancient societies contributed to their evolutionary fitness by helping with hunting and foraging, while grandmothers were primarily focused on raising children.
The grandfathers' role in ancient societies contributed to their evolutionary fitness by helping with hunting and foraging, while grandmothers were primarily focused on raising children.
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Study Notes
Reproductive Aging
- Reproductive capacity in women peaks in their twenties, declines over several years, ending at menopause
- Over a million US women enter menopause annually
- Increased human life expectancy leads to a larger portion of women's lives being post-reproductively
- Male fertility diminishes with age, but continues throughout adult life
- Reproductive aging involves changes in endocrine systems in both sexes and the pros/cons of hormone replacement therapy in older adults
Menopause
- Most women surviving to 50 expect 20-40+ years of further health
- Ovarian function dramatically declines
- Follicles deteriorate, egg supply is lost, and fertility ends
- Ovarian hormones' levels drop, impacting steroid-responsive tissues, like the uterus, vagina, breasts.
- This loss of ovarian steroids causes menstruation to cease.
- A typical last menstrual period occurs around age 51, with a 45-55 range
- Smoking is associated with earlier menopause
- Number of ovulatory cycles experienced influences menopause onset
- Women with many pregnancies may have a later menopause compared to those with few or no pregnancies
- Oral contraceptives may delay menopause
Timing of Menopause
- Menopause signifies the permanent end of menstrual cycles and ovarian activity
- Diagnosed retrospectively after a full year of no menstrual cycles
- Age at menopause varies widely, approximately 45-55 years old
- The specific factors influencing the age of menopause onset are still largely unknown.
- Varying number of oocytes at birth, or varying rates of follicular atresia, may contribute to the age difference in women entering menopause
- There are various possible contributing factors, including lifestyle elements.
Perimenopause
- Perimenopause is the stage before true menopause
- Average duration: four years
- Characterized by irregular menstrual cycles ranging from more frequent to less frequent/missed periods
- Other symptoms may include: hot flashes, sleep disturbances, mood changes, vaginal dryness
Premature Menopause
- Premature menopause (premature ovarian failure) occurs before 40
- Can have genetic origins, surgical removal of ovaries, chemotherapy, or autoimmune disorders
- Symptoms are identical to those of natural menopause
Symptoms of Menopause
- Hot flashes or flushes are common (over 75% of women experience this)
- These are sudden feelings of heat, often in the chest and face potentially spreading to the body, sometimes accompanied by sweating.
- Duration: last for more than a year, and in some women, persist for more than five years after menopause occurs.
- Other physical symptoms include: slight shrinkage of genitals, breasts, and uterus; thinner, drier vaginal lining, and urinary tract infections and incontinence
- Psychological/ emotional/behavioral symptoms are common: fatigue, irritability, insomnia, and other symptoms associated with hormone changes.
Endocrine Changes During Menopause
- Decline in small glycoprotein hormone release (inhibin-B) from ovaries
- Anti-müllerian hormone (AMH) also declines
- FSH levels increase due to reduced feedback regulation
- LH levels also increase due to reduced feedback regulation
- Estradiol and other estrogen levels fall dramatically.
Decline in Fertility
- Fertility rates decrease beginning in the late 20s
- Reduced number and quality of eggs
- Increased rate of chromosomal abnormalities in oocytes.
- Increase in miscarriage rates
- These facts contribute to a drop in the probability of conception
Egg Aging
- Chances of infertility increase with age
- Infertility rates increase from 20-24 to 35-39 (by 19.7 times or so)
- Main cause of infertility below age 40 is the increasing loss of pre-embryos and early implanted embryos, not the failure to ovulate or implant.
- Early embryonic loss is a significant problem in later reproductive years
- The risk of chromosomal abnormalities in embryos increases with maternal age.
Treatments for Menopausal Symptoms
- Hormone replacement therapy (HRT) is effective for alleviating hot flashes, night sweats, sleep problems and related symptoms
- HRT may also decrease the risk of osteoporosis
- HRT has potential risks, increasing the risk of certain cancers (breast, endometrial, ovarian)
- Heart disease risk is increased by HRT, but the risks and benefits vary for different women
- HRT should be individualized.
Andropause
- Andropause is a gradual decline in androgen production in men, often beginning in their forties, and continuing until age 70+
- Characterized by declines in testosterone levels, affecting sexual function, mood, and cognitive function
- Male libido, sexual function, and physical characteristics (e.g., voice pitch, facial hair) may change
- Other possible symptoms: fatigue, depression, decreased muscle mass and strength, osteoporosis.
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Description
This quiz focuses on the reproductive aging process in both women and men, with an emphasis on the changes women experience during menopause. It explores the effects of aging on fertility, hormonal changes, and the implications for health and well-being in post-reproductive life. Additionally, health factors influencing menopausal onset are discussed.
