Menopause

There is still no known biochemical signal that reliably indicates the onset of menopause.However, serum FSH levels tend to rise in regularly menstruating as well as premenopausal women (42–50 years of age). The pulsatility and orderliness of LH release also change before menstrual cyclicity falters [10]. Estrogen secretion in perimenopause is variable and includes intervals of increased production. A greater stimulation by FSH may increase follicular aromatase activity and induce estrogen excess while inhibin concentrations fall perimenopausally and contribute to heightened FSH release.

Physical complaints such as breast tenderness, irregular menstrual bleeding, dyspareunia, and hot flushes may precede the onset of anovulatory cycles in perimenopause in addition to emotional concerns such as disrupted sleep, fatigue, tension, and irritability,which are equally represented among menopausal women in North America [11]. Skin changes that may occur include hyperpigmentation as well as wrinkles, laxity, pallor, and pruritus. These changes are associated with estrogen deprivation, which leads to decreased skin elasticity and blood supply [12]. Histologically, although the stratum corneum is unaltered in thickness, there is apparently a slow replacement of neutral lipids adversely affecting the barrier function [13, 14].