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                     MENOPAUSE
Definition:
This is the final cessation of Menstruation. It is preceded by a period of about three to four years called climateric. At this climateric period, the menses becomes more and more irregular, occuring in once in two or three months.
The average age of menopause varies from community to community. It ranges from 45 years to 55 years with an average of 51 years.
Just before the climateric period, there occur some hormonal changes in the female. The oestrogen level fall and there is therefore a corresponding increase in folicular stimulating hormone and Leutenising hormone.
Factors affecting onset of menopause are race , familial, unknown factor and socio economic status. it has been found that high social class promote early menarche and this is associated with late menopause.
The pelvic organ such as vulva, vagina cervic, uterus undergo some changes which are readily observed.
              Symptommatology of Menopause:
1. Vasomotor changes:
a . Hot flushes
b. Night sweats
c. Precordial pain
d. Palpitation
e. Headache
f. Loss of sleep. 

2. Emotional disturbances:
a. Loss of energy and drive
b. Irritable with fluctuating mood
c. Lack of concentration
d. Loss of sleep.

3. Sexual Problems:
a. Decreased libido
b. Painful coitus because vagina is dry, not well lubricated and has decreased distensibility.

4. Gastro intestinal symptoms
a. Loss of appetite
b. constipation
c. Dyspepsia

5.Musculo skeletal system
a. Aches and pains
b. Osteoporosis
Treatment: Appropriate hormone replacement therapy. 

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