SlideShare a Scribd company logo
1 of 32
Peri-menopausal period syndrome Zhanghuiying   Department Of Obstetrics & Gynecology Tianjin Medical University General Hospital
Staging of women  climacteric period adolescence 40yrs Final period 1yrs after the  Final period   60-65 yrs Life stop Pre menopause Post  menopause   Peri  menopause Transitional phase ( 参考 WHO 的定义 ) climacteric period
Definition ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object]
Negative Feedback ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Symptoms and signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis ,[object Object],[object Object],[object Object]
3)Physical examination:  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Treatment   1)   education, understanding, reassurance   ,[object Object],[object Object]
2)   hormone replacement therapy(HRT ) ,[object Object],[object Object],[object Object],3) traditional medicine therapy
[object Object],[object Object]
Contraindication ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The  common hormone of HRT ,[object Object],[object Object],[object Object]
Estrogen natural synthetic estradiol estrone estriol Conjugated estrogen ethinylestradiol mestranol
Progestogen ,[object Object],[object Object]
Tibolone ,[object Object],[object Object],[object Object]
Routes of administration of HRT ,[object Object],[object Object],[object Object],[object Object]
The types of  HRT ,[object Object],[object Object],[object Object],[object Object]
Combined sequential  therapy Estrogen  are given continuously(30 days) MPA 10-14 days Withdrawal bleeding Stop Next month
Continuous combined therapy Estrogen continuously MPA continuously No Withdrawal bleeding
Side-effects of HRT  ,[object Object],[object Object],[object Object]
Risk of HRT ,[object Object],[object Object],[object Object],Do  evaluation every year may find any abnormals ,  reduce the incidence of the above risk
Information ,[object Object],[object Object],[object Object],[object Object],[object Object]
Thank you!

More Related Content

What's hot (20)

Abnormal uterine bleeding
Abnormal uterine bleedingAbnormal uterine bleeding
Abnormal uterine bleeding
 
Amenorrhea
AmenorrheaAmenorrhea
Amenorrhea
 
Menstrual Disorders
Menstrual DisordersMenstrual Disorders
Menstrual Disorders
 
Menopause
MenopauseMenopause
Menopause
 
Menopause ppt
Menopause pptMenopause ppt
Menopause ppt
 
12.menstrual disorders & others
12.menstrual disorders & others12.menstrual disorders & others
12.menstrual disorders & others
 
Menopauseppt 130119091724-phpapp02
Menopauseppt 130119091724-phpapp02Menopauseppt 130119091724-phpapp02
Menopauseppt 130119091724-phpapp02
 
Menstrual disorders womens health
Menstrual disorders womens healthMenstrual disorders womens health
Menstrual disorders womens health
 
Menopause
MenopauseMenopause
Menopause
 
Premenstrual Syndrome (P.M.S.)
Premenstrual Syndrome (P.M.S.)Premenstrual Syndrome (P.M.S.)
Premenstrual Syndrome (P.M.S.)
 
Diseases of the ovaries
Diseases of the ovariesDiseases of the ovaries
Diseases of the ovaries
 
Amenorrhea
AmenorrheaAmenorrhea
Amenorrhea
 
Menopause
MenopauseMenopause
Menopause
 
Disorders of menstruation
Disorders of menstruationDisorders of menstruation
Disorders of menstruation
 
Dysfunctional uterine bleeding
Dysfunctional uterine bleedingDysfunctional uterine bleeding
Dysfunctional uterine bleeding
 
Endometriosis
EndometriosisEndometriosis
Endometriosis
 
Premature ovarian failure
Premature ovarian failurePremature ovarian failure
Premature ovarian failure
 
Endometriosis
EndometriosisEndometriosis
Endometriosis
 
Menorrhagia
MenorrhagiaMenorrhagia
Menorrhagia
 
Menopause
MenopauseMenopause
Menopause
 

Viewers also liked

讲课2 Blood Component
讲课2  Blood Component讲课2  Blood Component
讲课2 Blood ComponentDeep Deep
 
04 Neurologic
04 Neurologic04 Neurologic
04 NeurologicDeep Deep
 
Abnormal Early Pregnancies
Abnormal  Early  PregnanciesAbnormal  Early  Pregnancies
Abnormal Early PregnanciesDeep Deep
 
12.Benign Tumors
12.Benign Tumors12.Benign Tumors
12.Benign TumorsDeep Deep
 
张结 1 1 2003
张结 1 1 2003张结 1 1 2003
张结 1 1 2003Deep Deep
 
8.Fetal Surveillance During Labor
8.Fetal Surveillance During Labor8.Fetal Surveillance During Labor
8.Fetal Surveillance During LaborDeep Deep
 
Disorders of the menstrual cycle 2
Disorders of the menstrual cycle  2Disorders of the menstrual cycle  2
Disorders of the menstrual cycle 2Magda Helmi
 
Final Slideshow Version
Final Slideshow VersionFinal Slideshow Version
Final Slideshow Versionprch08
 
Women's Disorders-Revised.ppt
Women's Disorders-Revised.pptWomen's Disorders-Revised.ppt
Women's Disorders-Revised.pptShama
 
INTRAUTERINE DEATH CME ON INDUCTION OF LABOUR ON 8TH NOVEMBER 2016, Dr sharda...
INTRAUTERINE DEATH CME ON INDUCTION OF LABOUR ON 8TH NOVEMBER 2016, Dr sharda...INTRAUTERINE DEATH CME ON INDUCTION OF LABOUR ON 8TH NOVEMBER 2016, Dr sharda...
INTRAUTERINE DEATH CME ON INDUCTION OF LABOUR ON 8TH NOVEMBER 2016, Dr sharda...Lifecare Centre
 
Etiology & prevention of stillbirth prof.salah
Etiology & prevention of stillbirth prof.salahEtiology & prevention of stillbirth prof.salah
Etiology & prevention of stillbirth prof.salahSalah Roshdy AHMED
 
Women's Health After 40: comprehensive overview, honest discussion, latest u...
Women's Health After 40:  comprehensive overview, honest discussion, latest u...Women's Health After 40:  comprehensive overview, honest discussion, latest u...
Women's Health After 40: comprehensive overview, honest discussion, latest u...Vandna Jerath, MD
 
Menopause copy joannie
Menopause copy   joannieMenopause copy   joannie
Menopause copy joannieJou011
 

Viewers also liked (20)

讲课2 Blood Component
讲课2  Blood Component讲课2  Blood Component
讲课2 Blood Component
 
17 Cpr
17 Cpr17 Cpr
17 Cpr
 
04 Neurologic
04 Neurologic04 Neurologic
04 Neurologic
 
Abnormal Early Pregnancies
Abnormal  Early  PregnanciesAbnormal  Early  Pregnancies
Abnormal Early Pregnancies
 
12.Benign Tumors
12.Benign Tumors12.Benign Tumors
12.Benign Tumors
 
张结 1 1 2003
张结 1 1 2003张结 1 1 2003
张结 1 1 2003
 
8.Fetal Surveillance During Labor
8.Fetal Surveillance During Labor8.Fetal Surveillance During Labor
8.Fetal Surveillance During Labor
 
Disorders of the menstrual cycle 2
Disorders of the menstrual cycle  2Disorders of the menstrual cycle  2
Disorders of the menstrual cycle 2
 
Final Slideshow Version
Final Slideshow VersionFinal Slideshow Version
Final Slideshow Version
 
1.menopause dr rabi
1.menopause  dr rabi1.menopause  dr rabi
1.menopause dr rabi
 
Menopaus1
Menopaus1Menopaus1
Menopaus1
 
Women's Disorders-Revised.ppt
Women's Disorders-Revised.pptWomen's Disorders-Revised.ppt
Women's Disorders-Revised.ppt
 
Gynecology 5th year, 4th lecture (Dr. Sindus)
Gynecology 5th year, 4th lecture (Dr. Sindus)Gynecology 5th year, 4th lecture (Dr. Sindus)
Gynecology 5th year, 4th lecture (Dr. Sindus)
 
INTRAUTERINE DEATH CME ON INDUCTION OF LABOUR ON 8TH NOVEMBER 2016, Dr sharda...
INTRAUTERINE DEATH CME ON INDUCTION OF LABOUR ON 8TH NOVEMBER 2016, Dr sharda...INTRAUTERINE DEATH CME ON INDUCTION OF LABOUR ON 8TH NOVEMBER 2016, Dr sharda...
INTRAUTERINE DEATH CME ON INDUCTION OF LABOUR ON 8TH NOVEMBER 2016, Dr sharda...
 
Etiology & prevention of stillbirth prof.salah
Etiology & prevention of stillbirth prof.salahEtiology & prevention of stillbirth prof.salah
Etiology & prevention of stillbirth prof.salah
 
Women's Health After 40: comprehensive overview, honest discussion, latest u...
Women's Health After 40:  comprehensive overview, honest discussion, latest u...Women's Health After 40:  comprehensive overview, honest discussion, latest u...
Women's Health After 40: comprehensive overview, honest discussion, latest u...
 
Menopause copy joannie
Menopause copy   joannieMenopause copy   joannie
Menopause copy joannie
 
Iufd by dr shabnam
Iufd by dr shabnamIufd by dr shabnam
Iufd by dr shabnam
 
Isoflavones
IsoflavonesIsoflavones
Isoflavones
 
CONTRACEPTION OVERVIEW
CONTRACEPTION OVERVIEWCONTRACEPTION OVERVIEW
CONTRACEPTION OVERVIEW
 

Similar to 28.Peri Menopausa

Peri menopausal period syndrome
Peri menopausal period syndromePeri menopausal period syndrome
Peri menopausal period syndromeraj kumar
 
menopause.pptxfor bscnursing students pdf.
menopause.pptxfor bscnursing students pdf.menopause.pptxfor bscnursing students pdf.
menopause.pptxfor bscnursing students pdf.MANJUPAUL7
 
Womens Disorders.ppt
Womens Disorders.pptWomens Disorders.ppt
Womens Disorders.pptShama
 
Womens disorders.ppt
Womens disorders.pptWomens disorders.ppt
Womens disorders.pptShama
 
menopause.pptx
menopause.pptxmenopause.pptx
menopause.pptxUsha Rani
 
Menopause management seminar
Menopause management seminarMenopause management seminar
Menopause management seminarobsgynhsnz
 
hormonal replacement therapy.pptx
hormonal replacement therapy.pptxhormonal replacement therapy.pptx
hormonal replacement therapy.pptxhemachandra59
 
management of menopause cpg.pptx
management of menopause cpg.pptxmanagement of menopause cpg.pptx
management of menopause cpg.pptxMohamadAsraf6
 
10 - menop;kp;lk;lkkll;k'polp[o;lkause.pptx
10 - menop;kp;lk;lkkll;k'polp[o;lkause.pptx10 - menop;kp;lk;lkkll;k'polp[o;lkause.pptx
10 - menop;kp;lk;lkkll;k'polp[o;lkause.pptxAbdallahAlasal1
 
Menopause & hormonal replacement therapy
Menopause & hormonal replacement therapyMenopause & hormonal replacement therapy
Menopause & hormonal replacement therapyadham meikiy
 
Menopause & HRT1.pptx
Menopause & HRT1.pptxMenopause & HRT1.pptx
Menopause & HRT1.pptxBuzzTera
 
26- Menopausal health.ppt
26- Menopausal health.ppt26- Menopausal health.ppt
26- Menopausal health.pptKareemSaeed17
 
TBL 11 (AUB).pdf
TBL 11 (AUB).pdfTBL 11 (AUB).pdf
TBL 11 (AUB).pdfAfkarIshak
 
Menopause (Signs and Symptoms)
Menopause (Signs and Symptoms)Menopause (Signs and Symptoms)
Menopause (Signs and Symptoms)Shahab Riaz
 
Chapter 10 presentation
Chapter 10 presentationChapter 10 presentation
Chapter 10 presentationMaureen Sadim
 

Similar to 28.Peri Menopausa (20)

Peri menopausal period syndrome
Peri menopausal period syndromePeri menopausal period syndrome
Peri menopausal period syndrome
 
menopause
menopausemenopause
menopause
 
pragya.pptx
pragya.pptxpragya.pptx
pragya.pptx
 
menopause.pptxfor bscnursing students pdf.
menopause.pptxfor bscnursing students pdf.menopause.pptxfor bscnursing students pdf.
menopause.pptxfor bscnursing students pdf.
 
Womens Disorders.ppt
Womens Disorders.pptWomens Disorders.ppt
Womens Disorders.ppt
 
Womens disorders.ppt
Womens disorders.pptWomens disorders.ppt
Womens disorders.ppt
 
menopause.pptx
menopause.pptxmenopause.pptx
menopause.pptx
 
Menopause management seminar
Menopause management seminarMenopause management seminar
Menopause management seminar
 
hormonal replacement therapy.pptx
hormonal replacement therapy.pptxhormonal replacement therapy.pptx
hormonal replacement therapy.pptx
 
management of menopause cpg.pptx
management of menopause cpg.pptxmanagement of menopause cpg.pptx
management of menopause cpg.pptx
 
10 - menop;kp;lk;lkkll;k'polp[o;lkause.pptx
10 - menop;kp;lk;lkkll;k'polp[o;lkause.pptx10 - menop;kp;lk;lkkll;k'polp[o;lkause.pptx
10 - menop;kp;lk;lkkll;k'polp[o;lkause.pptx
 
Menopause & hormonal replacement therapy
Menopause & hormonal replacement therapyMenopause & hormonal replacement therapy
Menopause & hormonal replacement therapy
 
Menopause & HRT1.pptx
Menopause & HRT1.pptxMenopause & HRT1.pptx
Menopause & HRT1.pptx
 
Menopause overview
Menopause overviewMenopause overview
Menopause overview
 
Menopause geet. 1
Menopause geet. 1Menopause geet. 1
Menopause geet. 1
 
26- Menopausal health.ppt
26- Menopausal health.ppt26- Menopausal health.ppt
26- Menopausal health.ppt
 
TBL 11 (AUB).pdf
TBL 11 (AUB).pdfTBL 11 (AUB).pdf
TBL 11 (AUB).pdf
 
Menopause (Signs and Symptoms)
Menopause (Signs and Symptoms)Menopause (Signs and Symptoms)
Menopause (Signs and Symptoms)
 
Chapter 10 presentation
Chapter 10 presentationChapter 10 presentation
Chapter 10 presentation
 
Harmone replacement therapy
Harmone replacement therapyHarmone replacement therapy
Harmone replacement therapy
 

More from Deep Deep

Poison2 1285794193199-phpapp01
Poison2 1285794193199-phpapp01Poison2 1285794193199-phpapp01
Poison2 1285794193199-phpapp01Deep Deep
 
Mayo Clinic Notes On Tof
Mayo Clinic Notes On TofMayo Clinic Notes On Tof
Mayo Clinic Notes On TofDeep Deep
 
Orthopaedics Surgery Tutor.Com
Orthopaedics Surgery Tutor.ComOrthopaedics Surgery Tutor.Com
Orthopaedics Surgery Tutor.ComDeep Deep
 
Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...
Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...
Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...Deep Deep
 
Introduction
IntroductionIntroduction
IntroductionDeep Deep
 
What Is Jaundice
What Is JaundiceWhat Is Jaundice
What Is JaundiceDeep Deep
 
Stress Ulcer Prophylaxis Introduction
Stress Ulcer Prophylaxis IntroductionStress Ulcer Prophylaxis Introduction
Stress Ulcer Prophylaxis IntroductionDeep Deep
 
Infectious Disease
Infectious DiseaseInfectious Disease
Infectious DiseaseDeep Deep
 
SEXUALLY TRANSMITTED DISEASES
SEXUALLY TRANSMITTED DISEASESSEXUALLY TRANSMITTED DISEASES
SEXUALLY TRANSMITTED DISEASESDeep Deep
 
Infections Of The Skin And Its Appendages
Infections Of The Skin And Its AppendagesInfections Of The Skin And Its Appendages
Infections Of The Skin And Its AppendagesDeep Deep
 
Urinary Tract Infection
Urinary Tract InfectionUrinary Tract Infection
Urinary Tract InfectionDeep Deep
 
Infectious Disease
Infectious DiseaseInfectious Disease
Infectious DiseaseDeep Deep
 
Infectious Disease Git
Infectious Disease GitInfectious Disease Git
Infectious Disease GitDeep Deep
 
Sexually Transmitted Diseases ...
Sexually Transmitted Diseases                                                ...Sexually Transmitted Diseases                                                ...
Sexually Transmitted Diseases ...Deep Deep
 
Chapter 3 Lower Respiratory Tract Infections
Chapter 3 Lower Respiratory Tract InfectionsChapter 3 Lower Respiratory Tract Infections
Chapter 3 Lower Respiratory Tract InfectionsDeep Deep
 
金教案2 3
金教案2 3金教案2 3
金教案2 3Deep Deep
 
Upper Respiratory Infections
Upper Respiratory InfectionsUpper Respiratory Infections
Upper Respiratory InfectionsDeep Deep
 
张结教案4
张结教案4张结教案4
张结教案4Deep Deep
 
张结 3 1 1
张结 3 1 1张结 3 1 1
张结 3 1 1Deep Deep
 

More from Deep Deep (20)

Poison2 1285794193199-phpapp01
Poison2 1285794193199-phpapp01Poison2 1285794193199-phpapp01
Poison2 1285794193199-phpapp01
 
Mayo Clinic Notes On Tof
Mayo Clinic Notes On TofMayo Clinic Notes On Tof
Mayo Clinic Notes On Tof
 
Orthopaedics Surgery Tutor.Com
Orthopaedics Surgery Tutor.ComOrthopaedics Surgery Tutor.Com
Orthopaedics Surgery Tutor.Com
 
Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...
Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...
Certain Gastrointestinal Disorders Can Be Life Threatening And Require Emerge...
 
Introduction
IntroductionIntroduction
Introduction
 
What Is Jaundice
What Is JaundiceWhat Is Jaundice
What Is Jaundice
 
Stress Ulcer Prophylaxis Introduction
Stress Ulcer Prophylaxis IntroductionStress Ulcer Prophylaxis Introduction
Stress Ulcer Prophylaxis Introduction
 
Infectious Disease
Infectious DiseaseInfectious Disease
Infectious Disease
 
SEXUALLY TRANSMITTED DISEASES
SEXUALLY TRANSMITTED DISEASESSEXUALLY TRANSMITTED DISEASES
SEXUALLY TRANSMITTED DISEASES
 
Infections Of The Skin And Its Appendages
Infections Of The Skin And Its AppendagesInfections Of The Skin And Its Appendages
Infections Of The Skin And Its Appendages
 
Urinary Tract Infection
Urinary Tract InfectionUrinary Tract Infection
Urinary Tract Infection
 
Infectious Disease
Infectious DiseaseInfectious Disease
Infectious Disease
 
Infectious Disease Git
Infectious Disease GitInfectious Disease Git
Infectious Disease Git
 
Sexually Transmitted Diseases ...
Sexually Transmitted Diseases                                                ...Sexually Transmitted Diseases                                                ...
Sexually Transmitted Diseases ...
 
Chapter 3 Lower Respiratory Tract Infections
Chapter 3 Lower Respiratory Tract InfectionsChapter 3 Lower Respiratory Tract Infections
Chapter 3 Lower Respiratory Tract Infections
 
金教案2 3
金教案2 3金教案2 3
金教案2 3
 
Upper Respiratory Infections
Upper Respiratory InfectionsUpper Respiratory Infections
Upper Respiratory Infections
 
张结教案4
张结教案4张结教案4
张结教案4
 
张结 3 1 1
张结 3 1 1张结 3 1 1
张结 3 1 1
 
张结 1 1
张结 1 1张结 1 1
张结 1 1
 

Recently uploaded

Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableCall Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableJanvi Singh
 
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableGENUINE ESCORT AGENCY
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Dipal Arora
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Sheetaleventcompany
 
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Anamika Rawat
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...chandars293
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Anamika Rawat
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...karishmasinghjnh
 
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls ServiceGENUINE ESCORT AGENCY
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...Arohi Goyal
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...GENUINE ESCORT AGENCY
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Sheetaleventcompany
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...parulsinha
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...chandars293
 
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...BhumiSaxena1
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...mahaiklolahd
 
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service AvailableGENUINE ESCORT AGENCY
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...parulsinha
 

Recently uploaded (20)

Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableCall Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
 
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
 
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
 
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
 
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
Saket * Call Girls in Delhi - Phone 9711199012 Escorts Service at 6k to 50k a...
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 

28.Peri Menopausa

  • 1. Peri-menopausal period syndrome Zhanghuiying Department Of Obstetrics & Gynecology Tianjin Medical University General Hospital
  • 2. Staging of women climacteric period adolescence 40yrs Final period 1yrs after the Final period 60-65 yrs Life stop Pre menopause Post menopause Peri menopause Transitional phase ( 参考 WHO 的定义 ) climacteric period
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22. Estrogen natural synthetic estradiol estrone estriol Conjugated estrogen ethinylestradiol mestranol
  • 23.
  • 24.
  • 25.
  • 26.
  • 27. Combined sequential therapy Estrogen are given continuously(30 days) MPA 10-14 days Withdrawal bleeding Stop Next month
  • 28. Continuous combined therapy Estrogen continuously MPA continuously No Withdrawal bleeding
  • 29.
  • 30.
  • 31.