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Menstrual irregularities and the perimenopause.

G Weiss1

  • 1Department of Obstetrics, Gynecology, and Women's Health, New Jersey Medical School, Newark, New Jersey 07103-2714, USA. weissge@umdnj.edu

Journal of the Society for Gynecologic Investigation
|February 27, 2001
PubMed
Summary
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Perimenopause involves hormonal shifts beyond ovarian changes, affecting the brain's control over reproductive hormones. Understanding these complex central nervous system mechanisms is key to managing perimenopausal symptoms effectively.

Area of Science:

  • Reproductive endocrinology
  • Neuroendocrinology
  • Women's health

Background:

  • Perimenopause is characterized by irregular cycles and hormonal fluctuations.
  • Elevated follicle-stimulating hormone and luteal insufficiency are common in perimenopausal women.
  • Estrogen secretion patterns change, and a deficient positive feedback mechanism for luteinizing hormone (LH) secretion occurs.

Purpose of the Study:

  • To investigate the hypothalamic-pituitary response to estrogen challenge in perimenopausal women.
  • To compare the LH surge response to estrogen in young versus perimenopausal women.
  • To explore the central nervous system mechanisms underlying perimenopausal changes.

Main Methods:

  • Administering estrogen boluses during the follicular phase to young and perimenopausal women.

Related Experiment Videos

  • Monitoring LH secretion to assess the positive feedback mechanism.
  • Comparing the incidence of LH surges between the two age groups.

    • Main Results:

    • Six out of eight young women exhibited LH surges in response to estrogen challenge.
    • Only one out of eight perimenopausal women showed an LH surge.
    • This suggests perimenopausal changes involve more than just ovarian function, implicating central nervous system mechanisms.

    Conclusions:

    • Perimenopausal hormonal dysregulation involves impaired central neuroendocrine control, not solely ovarian hypofunction.
    • Complex central nervous system changes contribute to the physiology of perimenopause.
    • Further understanding of these control mechanisms can lead to improved perimenopausal symptom management.