Aging changes in the female reproductive system

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Menopause

As a woman ages, a number of changes take place in the female reproductive system. For women, the cessation of menses (menopause) is an obvious sign of aging. But, it is by no means the only change. A transition period, called the climacteric, lasts for many years before and after a woman's last menstrual period.

See also: Menopause

For a woman, aging changes involve hormone levels, physical changes in the woman's entire reproductive tract, and psychological changes. Changes occur in the intricate relationship between the ovarian hormones and those produced by the pituitary gland (in the brain).

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AGING CHANGES

Menopause is a normal part of a woman's aging process. The ovaries stop releasing eggs (ova), and menstrual periods stop. Most women experience menopause around age 50, although it occurs before age 40 in about 8% of women. Prior to menopause, menstrual cycles often become irregular.

The ovaries become less responsive to stimulation by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). To try to compensate for the decreased response, the body produces more of these ovary-stimulating hormones for a time. The level of these hormones will eventually decrease.

The hormones produced by the ovaries include the different forms of estrogen (including estradiol), progesterone, and androgens (including testosterone). These hormones also decrease around menopause. The ovaries continue to produce small amounts of testosterone and some estrogen. The hormones produced by the pituitary gland are also decreased.

Because hormone levels fall, changes occur in the entire reproductive system. The vaginal walls become less elastic, thinner, and less rigid. The vagina becomes shorter. Secretions become scant and watery. The external genital tissue decreases and thins (atrophy of the labia).

In both men and women, reproductive system changes are closely related to changes in the urinary system.

EFFECT OF CHANGES

Prior to menopause, fertility varies depending on hormone levels. Menopause is said to have occurred when there has been one year without a menstrual period. With menopause, reproductive capacity is lost (the woman can no longer become pregnant).