Case 28. Some (Don’t) Like It Hot: Menopause in Women with HIV

And we will provide links to all of those resources.

But as we work through today, I think one thing I'd love for you to do now is give us some basic definitions of what menopause is, what perimenopause is and what's happening during those times.

Yes, absolutely.

I always start with a basic overview of pathophysiology and I start with the ovaries.

Although most know the ovaries for their diligent work with producing, storing, and releasing eggs or ova, many folks are unfamiliar with their second important job, and that's producing hormones, particularly estradiol or what's known as E2.

This is produced in the ovaries and specifically what are called the granulosa cells.

And it is essential for regulating the menstrual cycle, breast development, neurologic system, the skeletal system, including the bone and the vascular system and many other systems as well.

In all individuals born female, ovarian aging occurs across the lifespan.

Females are born with millions of ova, and this number slowly declines and stops production at menopause.

Menopause marks the end of ovarian function and is characterized by what is typical to be a dramatic or accelerated drop in estrogen levels.

Menopause is often described in phases or stages, and each phase correlates with estrogen and another important hormone, which is called follicle-stimulating hormone, or FSH, the degree of menstrual irregularity.

And the last data point we look at is the timing of the final menstrual period.

In terms of stages of menopause, premenopause represents normal menses and hormonal regularity.

The word perimenopause literally means around menopause and represents irregular menses, irregular periods, and often the beginning of symptoms like hot flashes for some women.

During the perimenopause, we see dramatic fluctuations.

So an increase in follicle stimulating hormone and a drop in estradiol.

This occurs while the body tries to essentially jumpstart a period in the presence of these very low hormone levels.

This occurs particularly in the late perimenopause where the most acute symptoms occur.

Finally, postmenopause occurs after 12 consecutive months of amenorrhea, no period or greater.

And this is occurring because there's essentially a steady low to no estrogen in the female body.

And we will provide links to all of those resources.

But as we work through today, I think one thing I'd love for you to do now is give us some basic definitions of what menopause is, what perimenopause is and what's happening during those times.

Yes, absolutely.

I always start with a basic overview of pathophysiology and I start with the ovaries.

Although most know the ovaries for their diligent work with producing, storing, and releasing eggs or ova, many folks are unfamiliar with their second important job, and that's producing hormones, particularly estradiol or what's known as E2.

This is produced in the ovaries and specifically what are called the granulosa cells.

And it is essential for regulating the menstrual cycle, breast development, neurologic system, the skeletal system, including the bone and the vascular system and many other systems as well.

In all individuals born female, ovarian aging occurs across the lifespan.

Females are born with millions of ova, and this number slowly declines and stops production at menopause.

Menopause marks the end of ovarian function and is characterized by what is typical to be a dramatic or accelerated drop in estrogen levels.

Menopause is often described in phases or stages, and each phase correlates with estrogen and another important hormone, which is called follicle-stimulating hormone, or FSH, the degree of menstrual irregularity.

And the last data point we look at is the timing of the final menstrual period.

In terms of stages of menopause, premenopause represents normal menses and hormonal regularity.

The word perimenopause literally means around menopause and represents irregular menses, irregular periods, and often the beginning of symptoms like hot flashes for some women.

During the perimenopause, we see dramatic fluctuations.

So an increase in follicle stimulating hormone and a drop in estradiol.

This occurs while the body tries to essentially jumpstart a period in the presence of these very low hormone levels.

This occurs particularly in the late perimenopause where the most acute symptoms occur.

Finally, postmenopause occurs after 12 consecutive months of amenorrhea, no period or greater.

And this is occurring because there's essentially a steady low to no estrogen in the female body.