Akademik Veri Yönetim Sistemi
Exploring Menopause from a Multidisciplinary Perspective: Biology, Psychosocial Factors, and Clinical Insights, Nazan Yurtcu,Dilay Karademir,Fatih Durmuşoğlu, Editör, NOVA Science Publishers Inc. , New York, ss.43-57, 2024
Abstract
Ovarian follicle reserve, which is at its maximum in the neonatal period, shows a steady decline with atresia during the reproductive period and decreases to less than 1000 at menopause. This situation brings about some changes in ovarian physiology. The granulosa cells that secrete estrogen and inhibin are also lost along with the follicles, and as a result, the ovaries become increasingly resistant to gonadotropins. Furthermore, FSH levels increase with the weakening of negative feedback because of decreasing inhibin B production. This is one of the earliest hormonal changes in the transition to menopause. Although the depletion of ovarian reserve plays an important role in reproductive aging, there is increasing evidence that it is not only responsible alone but also has central neuroendocrine contributions to the process. The central mechanisms of the menopause transition have not yet been fully elucidated, but it has been reported that the feedback mechanisms weaken in the center and changes in neuroendocrine networks regulating GnRH secretion are observed with aging. Clarifying and well-known menopause physiology will pave the way for personalized treatments in menopausal symptomatology and approaches to delay reproductive aging.