The symptoms of the perimenopause are similar to those of the menopause. Although perimenopausal women are still fertile, pregnancy becomes more difficult.
This perimenopausal phase, which can last 2-10 years, is often accompanied by increasing irregularity of the menstrual cycle. Before the menopause, when menstruation ceases and women become infertile, the hormones that drive the menstrual cycle start to fluctuate.
The prime child-bearing years correspond to the period between menarche and perimenopause (Dutton and Rymer, 2015). In women, the first episode of menstrual bleeding (menarche) marks the onset of puberty. Premature ovarian failure (POF) can be triggered by surgery, radio- or chemotherapy, autoimmune reactions, and infections caused, for example, by the mumps virus and cytomegalovirus (Amanvermez and Tosun, 2016 Broekmans et al, 2009). The speed of ovarian ageing is determined primarily by genetics, although oxidative stress, apoptosis and environmental factors also play a role. This article examines these changes and explores some of the treatments available to alleviate their consequences.Īs women age, there is a progressive decline in the number of ovarian follicles, which gains speed in the fourth decade of life the number and quality of ova diminish and oestrogen production declines, which in most women triggers the menopause around the age of 51. In middle and old age, the reproductive systems undergo significant changes: a gradual decline in fertility and fluctuations in the production of sex hormones, the latter triggering anatomical and physiological changes in distant organs and tissues. The production of gametes is orchestrated by a cascade of hormones and growth factors, many of which have complex effects on the body. Throughout the fertile years, the male and female reproductive organs (testes and ovaries) produce gametes (sperm and ova) which, through sexual intercourse, may fuse to form an embryo.