“menopause” (not menopause, the cessation of menses) mechanism responsible for
its symptom complex (Menopausal Symptom Complex) (or, Climacteric Syndrome)
including chronic fatigue, fibromyalgia, depression, tension headache,
cervical vertigo, sleep disturbances, irritability, anxiety/panic attacks,
cognitive changes (decreased concentration to obsessional/delusional thought),
decreased libido, and vasomotor dysfunction remains elusive. And MSC, other
than vasomotor dysfunction, is not significantly altered by treatment with
sex hormones (estrogen/progesterone), which have major neoplastic and vascular
side effects. Thus at present, there are minimal indications for treatment with
these compounds. Confusion between menopause and “menopause” (MSC) as well
as research money made available by pharma advocating ERT/HRT (estrogen replacement
therapy/hormone replacement therapy) has produced both therapeutic and research
inertia. Presently, there would appear to be mismanagement of a symptom complex
which infers primary brainlimbic system dysfunction and for which there is no
correlation with falling sex hormone levels. Pharmacological modification of
the proposed aberrant limbic circuitry responsible for the MSC has been successfully
accomplished using specific NT/MMs (neurotransmission/modulation modifiers)
i.e. a combination of alpha-1 and norepinephrine reuptake blockers, and thus
providing initial elucidation of this particular brain pathophysiology as well
as an efficient treatment of a problem affecting up to 60% of women ages 35 to
55. Specific NT/MMs capable of affecting a number of neurotransmitter/receptor
types within limbic circuitry appear to reverse the MSC which includes chronic
fatigue and fibromyalgia, pointing to aberrant limbic circuitry as their
etiology as well.
Cite this paper
Jaffe, S. (2013) Menopause, cessation of menses, vs. “menopause”, a primary brain disorder?. Advances in Bioscience and Biotechnology, 4, 15-19. doi: 10.4236/abb.2013.46A003.
 Utian, W.H. (2005) The true symptoms associated with menopause confirmed after 33 years: Better late than never, but let’s move on now. Menopausal Management, 10, 7-8.
 Pansini, F., Albertazzi, P., Bonaccorsi, G., et al. (1994) Trazadone: A nonhormonal alternative for climacteric symptoms. Menopause, 1, 159-160.
 Loprinzi, C.L., Sloan, J.A., Perez, E.A., et al. (2002) Phase III evaluation of fluoxetine for treatment of hot flashes. Journal of Clinical Oncology, 6, 1578-1583.
 Thal, L.J., Thomas, R.G., Mulnard, R., et al. (2003) Estrogen levels do not correlate with improvement in cognition. Archives of Neurology, 60, 209-212.
 Popat, R.A., Van Den Eden, S.K., Tanner, C.M., et al. (2005) Effect of reproductive factors and postmenopausal hormone use on the risk of Parkinson disease. Neurology, 65, 383-390. doi:10.1212/01.wnl.0000171344.87802.94
 Riggs, B.L. and Melton III, L.J. (1986) Involutional osteoporosis. New England Journal of Medicine, 314, 1676-1686. doi:10.1056/NEJM198606263142605
 Kobchitt, L., Chompootweep, S., Chaikittisilpa, S., et al. (1995) Climacteric complaints of Thai women in various social classes. Menopause, 2, 278.
 Kasuga, M., Makita, K., Ishitani, K., et al. (2004) Relation between climacteric symptoms and ovarian hypofunction in middle-aged and older Japanese women. Menopause, 11, 631-638.
 Schnatz, P.F., Serra, J., O’Sullivan, D.M., et al. (2004) Menopausal symptoms in Hispanic women and the role of socioeconomic factors. Menopause, 11, 694.
 Hays, J., Ockene, J.K., Brunner, R.L., et al. (2003) Effects of estrogen plus progestin on health-related quality of life. New England Journal of Medicine, 348, 18391854. doi:10.1056/NEJMoa030311
 Woods, N.F. (1992) Menopausal distress: A model for epidemiologic investigation. In: Voda, A.M., Dinnistein, M. and O’Donnell, S.R., Eds., Changing Perspective on Menopause, University of Texas Press, Austin, 220-238.
 Lee, K.A. and Taylor, D.L. (1996) Is there a generic midlife woman? The health and symptom experience of employed midlife women. Menopause, 3, 154-164.
 Rasgon, N., Shelton, S. and Halbreich, U. (2005) Perimenopausal mental disorders: Epidemiology and phenomenology (Review). CNS Spectrums, 10, 471-478.
 Pearlstein, T.B. (1995) Hormones and depression: What are the facts about premenstrual syndrome, menopause and hormone replacement therapy? American Journal of Obstetrics and Gynecoogy, 173, 646-653.
 Sherwin, B.B. (1996) Hormones, mood, and cognitive functioning in postmenopausal women. Obstetrics and Gynecology, 87, 20S-26S.
 Soares, C.N., Prouty, J., Born, L. and Steiner, M. (2005) Treatment of menopause-related mood disturbances (Review). CNS Spectrums, 10, 489-497.
 Spiegelman, M., and Erhardt, C.L. (1974) Mortality and longevity in the United States. In: Erhardt, C.L., Ed., Mortality and Morbidity in the United States, Harvard University Press, Cambridge, 1-20.
 Department for Economic and Social Information and Policy Analysis (1994) 1992 Demographic Yearbook. United Nations Press, New York.
 Wise, P.M., Kashon, M.L., Krajnak, K.M., et al. (1997) Aging of the female reproductive system: A window into brain aging. Record of Progress in Hormone Research, 52, 279-305.
 Jaffe, S.L. (2000) Neurology and psychiatry: Closing the great divide. Neurology, 55, 603-604.
 Woods, N.F. and Mitchell, E S. (2011) Symptom interference with work and relationships during the menopausal transition and early postmenopause: Observations from the Seattle Midlife Women’s Health Study. Menopause, 18, 654-661. doi:10.1097/gme.0b013e318205bd76
 Freedman, R.R., Woodward, S. and Sabharwal, S.C. (1990) Alpha-2-adrenergic mechanism in menopausal hot flushes. Obstetetrics and Gynecology, 76, 573-578.
 Feld, J., Halbreich, U., and Karkun, S. (2005) The association of perimenopausal mood disorders with other reproductive-related disorders (Review). CNS Spectrums, 10, 461-470.
 Freeman, E.W., Samuel, M.D., Rinaudo,P.J. and Sheng, L. (2004) Premenstrual syndrome as a predictor of menopausal symptoms. Obstetrics and Gynecology, 103, 960-966. doi:10.1097/01.AOG.0000124804.81095.7f
 Skarsgard, C., Bjors, E., Nedstrand, E., et al. (1996) Do women’s premenstrual symptoms and their mother’s climacteric history predispose to their own vasomotor symptoms? Menopause, 3, 133-139.