[The climacteric: aging of ovary and objective evaluation of the climacteric symptoms]

Since the geriatric population has been increasing in the recent years, the health care of the elderly, especially the climacteric group, has received special attention in the gynecological field. The primary endocrine feature during the climacteric is the decline in estradiol (E2) production due to the loss of ovarian function. Pathophysiological characteristics of aging ovaries remain obscure. To understand the mechanism of the aging process in the ovaries, the lipid peroxidative status which has been suggested as a deteriorator involved in aging, and antioxidative defense system were investigated during aging. The amount of lipid peroxide (LPO) as a free radical decreased steadily in human ovaries with aging. In contrast, antioxidative enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) showed a rapidly decreasing rate in these enzyme activities after 45 and 50 years of age, respectively. The in vitro production of E2 following the incubation with FSH was also measured in human ovaries with aging. The results indicate an excellent positive correlation between E2 production and the level of GSH-Px and reduced glutathione, but a negative correlation between E2 production and the amount of LPO. Our data suggest that the relatively high level of LPO to SOD and/or GSH-Px following 45 years of age may play an important role in the aging process of human ovaries. From the clinical aspect of the climacteric, scientific evaluation of the climacteric symptoms and responses to various therapies has not been sufficiently addressed because of the lack of a practical technique for objectively measuring the symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)