Biology of menopause: the causes and consequences of ovarian ageing
All the diverse aspects of ovarian ageing in our own species and in animal models have been brought together for the first time in this concise volume. The physiological and biochemical processes responsible for the deterioration of ovarian function, the consequential loss of fertility and somatic effects of postmenopause are fully explained for biologists interested in reproduction and gerontology and for clinicians concerned with fertility in middle age and hormone replacement therapy. PREFACE: There should be good reasons for adding to the current flood of scientific literature, especially since the task of writing a monograph is a long and lonely one. This book was written for research workers, clinicians and students who have a special interest in the biology of the ageing reproductive system, of which the human menopause is a central issue. It deals with the causes of ovarian failure in mid-life, the associated physiological and behavioural changes and the preceding decline in fecundity and fertility. Despite widespread interest in this subject, no one until now has attempted to tackle the subject as a whole. A number of books have been written for the non-scientific reader who is concerned about "menopausal problems", but the professional scientist and clinician are faced with a widely dispersed literature. I felt that there was still time for an author with sufficient temerity to bring together the many aspects of reproductive system ageing and show the extent to which these are interrelated. This book is primarily concerned with human biology, but in some sections where direct evidence is lacking there are detailed accounts of animal research, and often this is interesting in its own right. By way of introduction to some of the chapters, I have outlined historical concepts leading to our present knowledge of the physiology and biochemistry of reproduction. This is intended to help readers who are not well acquainted with the subject to appreciate the less tractable problems of ageing. However, to maintain balance and economy, it has been necessary to be highly selective. Originally, I planned to shun all practical issues in reproductive medicine, but, as the book evolved, the provinces of the biologist and clinician seemed less distinct, and some mention of contraception and hormone replacement therapy became desirable. Nevertheless, these topics have been tackled primarily from the scientific standpoint, and I leave questions of clinical management of subfertility and postmenopause to others having appropriate experience and expertise. Discussion of the psychological changes of middle age, apart from those of a sexual nature or connected with ovarian ageing, are beyond the scope of this book, and as the title plainly indicates my subject is strictly the female of the species. Males are not exempt from ageing of their sexual functions, but a term other than "menopause" is needed for their less discrete changes. A good deal more research needs to be done before as detailed a story can be written about them.
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Distribution of Menopause
OestrogenQueen of the Realm of Reproduction
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activity age of menopause androgens androstenedione aneuploidy animals anovulatory aromatase atresia Baird Biol biological blood bone loss calcium changes chromosome circulating climacteric Clin contraception corpora lutea cyclic disease embryos Endocrinol evidence exogenous oestrogens factors feedback fertility fetal fetuses follicular phase follicular store frequency function germ cells gland gonadal gonadotrophins Gosden granulosa cells growth Gynecol hormone hot flushes human ovaries hypothalamus increased Krohn LHRH luteal luteinizing luteinizing hormone maternal age menarche menopausal age menopause menstrual cycle Metab metabolism mice normal number of follicles Obstet oestradiol oestrogen oestrogen levels oestrone oocytes osteoporosis ovarian cycles ovarian failure ovarian follicles ovariectomized ovariectomy ovaries ovulation ovulatory parity peripheral physiological pituitary plasma postmenopausal postmenopausal women pregnancy premenopausal preovulatory primates primordial production progesterone rats receptors reprinted with permission Reprod reproductive responsible rhesus monkeys rise risk rodents secretion sex steroids sexual species stages studies testosterone tion tissue treatment trisomy uterine vaginal vitamin