Weiss G
Department of Obstetrics, Gynecology, and Women's Health, New Jersey Medical School, Newark, New Jersey 07103-2714, USA.
J Soc Gynecol Investig. 2001 Jan-Feb;8(1 Suppl Proceedings):S65-6. doi: 10.1016/s1071-5576(00)00113-1.
The perimenopause is defined as the phase of women's reproductive life between the time when cycles change and become irregular until menopause. Compared with younger women, follicle-stimulating hormone is elevated. In ovulatory cycles, luteal insufficiency frequently occurs. Estrogen secretion is elevated throughout the menstrual cycle during some phases of the perimenopause. Perimenopausal women are deficient in the hypothalamic-pituitary estrogen positive feedback mechanism on luteinizing hormone (LH) secretion. We challenged young and perimenopausal women with earlier follicular-phase estrogen boluses to attempt to induce LH surges. Whereas six of eight young women exhibited surges, only one of eight perimenopausal women had a surge of LH to estrogen challenge. Thus, perimenopausal changes involve mechanisms other than ovarian hypofunction. Complex central nervous system mechanistic changes also occur. A better understanding of the physiology in control mechanisms should allow for better symptom management of the perimenopause.
围绝经期被定义为女性生殖生命中从月经周期开始变化并变得不规律到绝经之间的阶段。与年轻女性相比，促卵泡激素水平升高。在排卵周期中，黄体功能不全经常发生。在围绝经期的某些阶段，整个月经周期中的雌激素分泌都会升高。围绝经期女性在下丘脑 - 垂体对促黄体生成素（LH）分泌的雌激素正反馈机制方面存在缺陷。我们用早期卵泡期雌激素推注对年轻女性和围绝经期女性进行刺激，试图诱导LH峰。八名年轻女性中有六名出现了LH峰，而八名围绝经期女性中只有一名在接受雌激素刺激后出现了LH峰。因此，围绝经期的变化涉及卵巢功能减退以外的机制。复杂的中枢神经系统机制变化也会发生。更好地了解控制机制中的生理学知识应有助于更好地管理围绝经期症状。
