Mohammad Aizat bin Azam

0918851
Dr. Kartini
What is Menopause?
Greek : menos = month, pausos = ending
Occur due to loss of ovarian follicular activity leading
to a fall in estradiol level
Amenorrhea for 12 consecutive months
Perimenopausal: transition time
Postmenopausal: after menopause
Physiology
Loss of ovarian sensitivity to
gonadotropins
Reduced oocyte recruitment/
anovulation
Shorter follicular phase /
oligomenorrhea/ amenorhea
Stressor
Children
leaving
home
Death of
partner
Retirement Divorce
Physical
ageing
Menopause symptoms
Physical
Tiredness
Hot flushes
Night sweat
Insomnia
Vaginal dryness
Urinary frequency
Psychological
Mood swings
Anxiety
Loss of short term
memory
Lack of aconcentration
Loss of self confidence
Depression
Menopauses
related
psychiatric
illnesses
Depression
Panic disorder
Bipolar
disorder
Schizophrenia
Sleep
problems
Depression
US : 20% have depression at some point during
menopause.
Increases in perimenopausal, decreases in
postmenopausal (The Penn Ovarian Aging Study, a
cohort study)
Caused by fluctuating and sudden decreasing of
estrogen during perimenopausal.
Estrogen increases the effects of serotonin and
norepinephrine in CNS.
Symptoms are similar with depression occur at other
time of life

Sleep disturbances
40-50% have insomnia during the menopausal
transition
May or may not be connected to mood disorders
Caused by reduced estrogen, melatonin and GH by
aging
Increases LH rises core body temperature
difficult to sleep.
Commonly associated with anxiety, depressed
mood, fatigue, lost of interest etc.


Obsessive compulsive disorder (OCD):

New-onset, relapse of OCD, or a change in OCD
symptoms may occur during menopause.
Fluctuations in OCD have been correlated with the
menstrual cycle and with pregnancy, suggesting that
hormone levels may contribute to the disorder


Others
Panic disorder
New onset, or worsening of preexisting illness.
Associated with negative life events, functional impairment,
and medical comorbidity

Schizophrenia:
Worsening courses during menopausal transition.

Bipolar disorders
Exacerbation of symptoms in women with preexisting illness
Higher rates of depressive episodes


Alternative Management
Technique
Breathing techniques
Visualization
Hobbies - Relaxing
Bodywork Massages, Reflexology
Meditation The magic bullet
Aromatherapy
Rosemary and lavendar
Proved to reduce cortisol level and increase anti oxidant
activities
Islamic Input
Rasulullah bersabda maksudnya: "Jika bayi yang
gugur itu memiliki tanda-tanda hidup, hendaklah
disolatkan dan ia berhak mendapat warisan". (HR
Tirmizi, Nasai', Ibnu Majah dan Baihaqi)
"Orang yang berkenderaan hendaklah berada di
belakang jenazah, sedang yang berjalan kaki di
depannya, dekat kepadanya sebelah kanan atau
kirinya. Sedang anak yang keguguran juga disolatkan
dan didoakan keampunan dan rahmat bagi kedua
orang tuanya". (HR. Ahmad dan Abu Daud)
Think positive, menopause give extra time for the
muslimah to perform more ibadah
Previously they had menstrual period which did not
allowed them to perform ibadah
Thus the muslimah will have more opportunity to
perform ibadah
References
http://emedicine.medscape.com/article/295382-
overview#aw2aab6b3
http://emedicine.medscape.com/article/295382-
overview#aw2aab6b3