Reproductive Endocrinology Diseases: Hormone Replacement and Therapy for Peri/Menopause

Abstract

There are many female causes for infertility but the incidence of infertility increases with advancing age. Colombat de L'Isere in a chapter on ‘Change of Life' in his “Treatise on the diseases and special hygiene of females” (1845) stated: Compelled to yield to the power of time, women now cease to exist for the species, and hence forward live only for themselves” (Colombat de L’Isere M., 1945). Fortunately, this pessimistic outlook on life after menopause has become outdated. Aiming to standardize terminology The World Health Organization (WHO) assembled in 1996 and the Council of Affiliated Menopause Societies (CAMS) in 1999 (WHO Scientific Group: Research on Menopause in the 1990s, Utian WH, 1999). Commonly accepted terms, including pre-menopause, peri-menopause, menopausal transition, and climacteric, were thought to be too vague to be useful. In July of 2001, the Stages of Reproductive Aging Workshop (STRAW) was held to address the absence of a relevant staging system for female reproductive aging, and to discuss the confusing current nomenclature for the pre-menopause (Soules MR, et al., 2001). The average age of menopause is 51 and less than 1% of women experience it before the age of 40. Some women undergo premature menopause at a very early age affecting their ability to have children. As more and more women delay child bearing, this life altering condition has become more prevalent. Population aging must be added to population growth as very important social problems. Women in our society get married and have children later in life. Therefore, evaluation of ovarian reserve is critical to understanding a patient’s reproductive potential. Ovulatory disorders are a common cause of infertility. Ovulation is controlled by complex interactions between numerous endocrine hormones including FSH, LH, estradiol, progesterone and others. Menopause is the cessation of the primary functions of the human ovaries, with associated changes in pituitary gonadotropin secretion occurring secondary to