UNIT 5.0

TOPIC – MENOPAUSE AND ANDROPAUSE

Instructional Materials

• White board and maker

• Projector/ Laptop

• Pictures 

Teaching methods

• Lecture 

• Discussion

• Brainstorming  

Type of Assessment

• MCQ

• Assignments

• Essay 

Learning Objectives; At the end of the lesson, learners will be able to:

• Describe the Menopause 

• Identify the Pre ad Post-menopausal syndromes

• Describe the Andropause

• Management of Menopausal Syndrome

5.0 Introductions

Menopause literally means the end of monthly cycle. It typically (not always) occurs in women in midlife, during their late 40’s or early 50’s and signals the end of fertile phase of a woman’s life. The transition from reproductive to non-reproductive is the result of a reduction in female hormonal production by the ovaries. The ovaries are the main source of female hormones, which control the development of female body characteristics such as the breast, body shape and body hair. The hormones regulate the menstrual cycle and pregnancy. Oestrogen also protects the bone.

5.1 Menopause

It is defined as the state of an absence of menstrual period for 12 months, the menopausal transition start with varying menstrual cycle length and ends with the final menstrual period.

This transition is normally gradual, over a period of years, and it is a natural consequence of aging. The accompanying signs and effects of menopause can significantly disrupt the daily activities and sense of well-being of a woman. Women who have some sort of functional disorders affecting the reproductive system e.g. endometriosis, polycystic ovary syndrome, cancer of the reproductive organs can go into menopause at a younger age than the normal time frame (the disorders speed up the menopausal process and create more health problems).

Menopause is an unavoidable change that every woman will experience, assuming she reaches middle age and beyond. It has a range of 42 - 58yrs with an average age of 51 years old.

5.2.1 Peri-menopause: It is the word used to describe the years leading up to the last period. It refers to the menopausal transitional period when the levels of reproductive hormones are already becoming lower and more erratic and the effects of hormones withdrawal may be present. It is different for each woman.

Symptoms includes: Irregular periods or hot flashes, night sweat, irritation.

5.2.2 Post Menopause: It is the term used to describe who have not experience a menstrual bleed for a minimum of 12months,assuming that they still have a uterus and are not pregnant or lactating.

5.3 Psychological Changes in Menopause

1. Depression and /or anxiety

2. Fatigue

3. Irritability

4. Memory loss and problem with concentration

5. Mood disturbance

6. Sleep disturbance, poor quality sleep or light sleep

5.4 Physiological Changes in Menopause

1. Urogenital atrophy – e.g. thinning of the membrane of the vulva, cervix and the outer urinary tract, shrinking and loss of elasticity of all the outer and inner genitals.

There is itching, dryness, irregular vaginal bleeding, watery discharge, urinary frequency, urinary incontinence, and urinary urgency, increased susceptibility to inflammation and infection e.g. vaginal candidiasis and urinary tract infection.

2. Skeletal – Back pain, joint pain, muscle pain, osteopenia and the risk of osteoporosis.

3. Skin and soft tissue – Breast atrophy, breast tenderness and swelling, decreased elasticity of the skin, formicating (itching, tingling, burning, pins and needles, or sensation of crawling under the skin), skin thinning and dryness.

4.  Sexual – Dyspareunia, vaginal dryness and atrophy, decreased libido, problems reaching orgasm.

5. Other physical changes – Hot flashes and night sweats, weight gain (more in the waist and abdominal region), wrinkles, worsening of Acne, hair growth on chin, upper lip, chest or abdomen.

5.6 Management

Perimenopause is a natural stage of life. It is not a disease or a disorder and therefore it does not automatically require any kind of treatment at all. However cases where the physical, mental and emotional effects of perimenopause are strong enough that they significantly disrupt the everyday life of the woman experiencing them, palliative medical therapy may sometimes be appropriate. 

            Other treatment includes hormonal replacements, soy foods (herbal remedies) – it cools hot flashes, and Antidepressants.

Condition that can affect the timing of Menopause

1. Removal of ovary (surgical menopause)

2. Hysterectomy

3. Cancer therapy and radiation therapy

4. Premature ovarian failure.

5. Auto immune disorder

6. Diabetes mellitus

7. X – gene syndrome

8. Race and ethnicity

9. High body mass index

10. Smoking

11. Under nutrition

5.7 ANDROPAUSE

It is the condition associated with decrease in the male hormone testosterone. It is a menopause- like condition in aging men. It is unlike menopause in that the decrease in testosterone and the development of symptoms is more gradual than what occurs in women.

Testosterone is the hormone responsible for deep voice, muscle mass and facial/body hair patterns found in males. As men get older, the level of testosterone in the body and production of sperm gradually becomes lower, and they experience physical and psychological symptoms as a result of these low levels. This is a part of the natural aging process and it is estimated that testosterone decreases about 10% every decades after men reach the age of 30 years.

5.7.1 Symptoms of Andropause

Physiological:

1. Low sex drive (libido).

2. Reduce potency (difficulty getting an erection or erection not as strong as usual).

3. Fatigue (lack of energy).

4. Loss of strength or muscle mass.

5. Increase body fat.

6. Hot flashes.

7. Joint aches and stiffness of hand.

8. Premature aging.

9. Changes in hair growth and skin quality.

Psychological:

1. Depression

2. Irritability and mood swings

3. Sleep disturbance

Complications: - Cardiovascular problems, and Osteoporosis.

Management of Andropause

Andropause, although a natural aging process can be prevented or treated through the following ways:

1. Testosterone replacement therapy – The hormone comes in variety of different preparations which includes skin patches, capsules, gels and injections. This treatment may provide relief from symptoms and help improve the quality of life in many cases.

2. Life style changes – Which means making adjustment to the existing way of life. It includes activities like increase exercises, stress reduction, and good nutrition. Other helpful issues include avoiding of tobacco smoking and alcohol consumption.

Test item – Explain the psychological and physiological changes that occurs during menopause and andropause

STUDENTS’ ACTIVITY

Topic: Abortion

Learning outcome: The student will be able to

• Discuss Menopause 

• Identify the Pre ad Post-menopausal syndromes

• Describe the Andropause

• Management of Menopausal Syndrome

Task; Brainstorm on the management of Andropause and Menopuse