WHAT CHANGES IN THE MENSTRUAL CYCLE CAN BE EXPECTED DURING THE CLIMACTERIC?

1. Early during the climacteric, the menstrual cycle may shorten to 21-24 days but the menstrual loss usually remains normal. Occasionally women may 'miss' a period for one or perhaps two cycles. These episodes tend to be associated with flushes and sweats. The vasomotor symptoms resolve when ovarian function returns, manifest as a resumption of menstruation.
2. Later on, the cycle may lengthen to any duration between 28 days and many months but it may still be ovulatory. The menstrual loss may be normal or scantier. A woman can get pregnant in this period.
3. Anovulatory cycles can be quite unpredictable, ranging in length from 14 days to many months. The duration of bleeding is also variable; it may last for only a few hours or may be heavy and last for many days.
4. Rarely, the menstrual cycle may be quite regular until menstruation ceases abruptly.
5. The timescale over which these changes may occur is extremely variable and may differ greatly from one woman to another.

WHAT ARE THE CONSEQUENCES OF OESTROGEN DEFICIENCY?

These are divided into

• IMMEDIATE
• INTERMEDIATE
• LONGTERM