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Ovarian ageing and the menopausal transition
Gregory Zapantis1, Nanette Santoro
1Division of Reproductive Endocrinology, Department of Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461, USA.
Summary
The menopausal transition stems from fewer FSH-responsive follicles. Hormonal shifts and follicle dysregulation contribute to irregular cycles and symptoms during this reproductive phase.
Area of Science:
- Reproductive Endocrinology
- Gynecology
Background:
- The menopausal transition is characterized by a decrease in ovarian follicles.
- Factors like follicle dysregulation and hormonal imbalances contribute to the transition's progression.
Purpose of the Study:
- To elucidate the underlying causes and hormonal dynamics of the menopausal transition.
- To model the early stages of the menopausal transition and its hormonal implications.
Main Methods:
- Conceptual modeling of follicle pool dynamics and hormonal feedback loops.
- Analysis of hormonal changes (FSH, oestrogen, inhibins) during the menopausal transition.
Main Results:
- A dwindling supply of FSH-responsive follicles is the primary driver of the menopausal transition.
- Early transition shows shortened cycles and potential hyperoestrogenaemia due to loss of inhibin restraint.
- Later stages exhibit anovulatory cycles and impaired hypothalamic-pituitary function.
Conclusions:
- The decline in ovarian follicles initiates the menopausal transition.
- Hormonal fluctuations, including hyperoestrogenaemia, are key features of the early and late transition phases.
- Understanding these hormonal shifts aids in explaining menopausal symptoms.