THE HELP OF THE CLINICAL LABORATORY IN MEDICAL DIAGNOSIS: Menarche ,Menopause and Climaterium

 Menarche: It is the appearance of the first menstruation. It is the date in which the first episode of vaginal bleeding of menstrual origin occurs, or the first menstrual bleeding of the woman.

Menopause: It is the time of a woman’s life in which her periods (menstruation) cease. In most cases, it is a normal and natural body change that almost always occurs between 45 and 55 years of age.

                                                                                      After menopause, a woman can no longer get pregnant.

       During menopause, a woman’s ovaries stop producing ovules. The body produces a smaller amount of the female hormones estrogen and progesterone. The lower levels of these hormones cause the symptoms of menopause.

Climaterium: It is a transitional period that lasts for years, before and after menopause, as a result of ovarian depletion, associated with a decrease in estrogen production and loses over the years the ability to produce hormones, follicles and oocytes .

                                                     By the beginning of the climacterium all the ovarian follicles have already been used and the hormones that regulate the monthly cycle are not produced.

In women, it is often confused with menopause, which is the last menstrual period

                                                                                In menopause, having a significant decrease in the production of estrogen. 

The estrogen  decreases with which there are problems with calcium fixation in the bone and decreases bone mass. It can increase the Arterial tension ( hypertension)  and levels of “bad” cholesterol and appear atheroma plaques in the arteries.

THE HELP OF CLINICAL LABORATORY  :

The laboratory has reliable and reproducible objective techniques to accurately determine the rate of female hormones

The hormonal studies that are performed are:

  • Progesterone: Progesterone is produced mainly by the corpus luteum, which remains of the follicle containing the ovum released by the ovary.
  • Luteinizing Hormone (HL): The luteinizing hormone increases before the ovary releases the egg.
  • Follicle stimulating hormone (FSH): FSH is produced in the ovaries and stimulates the maturation process of the ovules.

 

  • Estrogens and estradiol

Female hormones produced mainly in the ovaries; Its main function is the maturation of the female genital apparatus to make it fertile. Estradiol is a type of estrogen that is produced in the ovaries (female reproductive organs).

In the fertile time, estrogens are responsible for the secondary “female traits”

Estrogen acts on the mucosa of the bladder and urethra in maintaining the tension of the urethra at levels higher than that of the interior of the bladder and can alter the regular and normal urinary frequency

Decreasing estrogen also decreases collagen levels and vascular proliferation of the dermis, responsible for the healthy appearance of the skin, giving, not to take care of the sensation of non-turgor and freshness of the skin.

 

THE ANTIMULLERIAN HORMONE: THE GREAT UNKNOWN

The hormone antimülleriana (AMH), is a substance that secrete the ovarian follicles. Its determination is a relatively new way to measure the ovarian reserve

The ovarian reserve is a concept that encompasses both the quantity of oocytes (ovules) that the woman still has and the quality thereof. In other words, the analysis of this hormone serves to see how many valid ovules still have the woman in the ovaries.

There are other techniques for measuring ovarian reserve, such as age, FSH concentration on the third day of the cycle, antral follicle count, and ovarian response to stimulant medications. All of them data provide useful information for the specialist to advise the couple on the treatments that are best for them.

The determination of AMH is becoming a very important tool and presents several advantages in relation to the other tests, since it can be performed any day of the menstrual cycle (not only the third one, like FSH) and it is not accompanied by ultrasound  ( as opposed to follicle counts).

While no single test is perfect by itself or predicts 100% accuracy with what will happen in women’s bodies, AMH analysis is increasingly being used in endocrinology to guide treatment options and to estimate the likelihood of gestation.