Davis School of Gerontology, and Department of Neurobiology, Dornsife College, 3715 McClintock Ave, University of Southern California, Los Angeles, CA 90089-0191, United States.
J Steroid Biochem Mol Biol. 2014 Jul;142:132-41. doi: 10.1016/j.jsbmb.2013.03.010. Epub 2013 Apr 10.
The neuroendocrinology of menopause is reviewed from a comparative perspective, with emphasis on laboratory rodent models. These changes are compared by the 2011 STRAW criteria (Stages of Reproductive Aging Workshop). Ovarian cell loss begins prenatally in all mammals studied, with exponential depletion of primary follicles and oocytes in association with loss of fecundity by midlife. Rodents and humans also share progressively increasing irregularity in ovulatory cycles and increasing fetal aneuploidy as oocyte depletion become imminent. Hypothalamic impairments of the estrogen-induced surge of pituitary gonadotrophins (luteinizing hormone, LH; follicle stimulating hormone, FSH) are prominent in middle-aged rodents, but sporadic in peri-menopausal women. In aging rodents, hypothalamic impairments of the LH surge have been experimentally associated with prolonged phases of sustained estradiol (E2) and very low progesterone (P4) ('unopposed estradiol'). Although peri-menopausal women also show hyper-estrogenic cycles, there is no indication for irreversible hypothalamic desensitization by E2. Ongoing cognitive assessments in clinical trials of estrogen therapy with and without P4 or other progestins may further inform about possible persisting effects of unopposed estrogens.This article is part of a Special Issue entitled 'Menopause'.
从比较的角度回顾绝经的神经内分泌学，重点是实验室啮齿动物模型。这些变化通过 2011 年 STRAW 标准（生殖衰老研讨会）进行比较。在所有研究的哺乳动物中，卵巢细胞损失在产前就开始了，与生育能力丧失相关的初级卵泡和卵母细胞的指数消耗发生在中年。啮齿动物和人类也有共同的特点，即排卵周期的不规则性逐渐增加，卵母细胞耗竭即将发生时胎儿非整倍体的比例也逐渐增加。在中年啮齿动物中，雌激素诱导的促性腺激素（促黄体生成素，LH；卵泡刺激素，FSH）垂体激增的下丘脑损伤尤为突出，但在围绝经期妇女中则较为罕见。在衰老的啮齿动物中，LH 激增的下丘脑损伤已通过实验与持续雌激素（E2）和极低孕激素（P4）的延长阶段（“无孕激素拮抗的雌激素”）相关联。尽管围绝经期妇女也表现出高雌激素周期，但没有迹象表明 E2 会导致下丘脑不可逆脱敏。正在进行的临床试验中对雌激素治疗与孕激素或其他孕激素的认知评估可能会进一步了解无孕激素拮抗的雌激素可能持续存在的影响。本文是一个题为“更年期”的特刊的一部分。
