Stages of Reproductive Aging

Posted by e-Medical PPT Friday, May 18, 2012

While there is a useful staging system for puberty (Tanner/Marshall system),

a similar staging system for late reproductive function has not been developed.

Confusion & duplication in the nomenclature of the reproductive aging e.g. climactric, perimenopause



Reproductive aging:

A natural process that begins at birth and proceeds as a continuum.

It is a process and not an event, and the end (menopause) is much easier to define than the beginning.

Chronological age is a very poor indicator of reproductive aging.



Etiology

Oocyte depletion in the ovary.

Reproductive aging consists of a steady loss of oocytes through atresia or ovulation, which does not necessarily occur at a constant rate.

The relatively wide age range (42–58 years) for menopause in normal women indicate that either

- Wide variation in number of follicles at birth or

-Wide variation in the rate of oocyte loss



Reproductive stages

After menarche (entry into stage -5) it usually takes several years for regular menstrual cycles to become established. Menstrual periods should then occur every 21 to 35 days for a number of years ( stages -4 & -3).

A woman’s peak fertility occurs in her mid- to late twenties, after which it progressively decreases until menopause (stage -4 to -1).

Loss of fertility is the first sign of reproductive aging that precedes the Monotropic increase in FSH and

Changes in menstrual cyclicity.

An elevated FSH level is the first measurable sign of reproductive aging. This initial elevation in FSH level is most prominent in the early follicular phase of the cycle; a single venous blood sample should be obtained between cycle days 2 and 5 and subsequently assayed for

FSH and estradiol. ..





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