Menopausa
conhecendo os mecanismos fisiológicos e sintomas
DOI:
https://doi.org/10.22409/nes.v2i1.66708Palavras-chave:
Menopausa, Estrogênio, Saúde sexual, Metabolismo energéticoResumo
A menopausa é um processo fisiológico em que a capacidade reprodutiva da mulher chega ao fim. É decorrente do esgotamento da reserva de óvulos nos ovários, que provoca o fim definitivo dos ciclos menstruais e a queda na concentração dos hormônios estrogênio e progesterona. A idade aproximada de entrada natural na menopausa é entre 46 e 52 anos, podendo ocorrer precocemente por volta dos 40 anos, ou mais tardiamente após os 55 anos, devido a fatores genéticos, socioeconômicos, biológicos e hábitos de vida. Antes da menopausa, o corpo da mulher passa por uma fase de transição chamada de peri-menopausa, em que as oscilações hormonais já provocam alterações corporais, incluindo ondas de calor, distúrbios no sono, alterações no apetite, oscilações de humor e ressecamento vaginal. Após a entrada na menopausa, a queda hormonal mais intensa, associada ao processo de envelhecimento, pode provocar outras alterações, como redução na massa óssea, complicações cardiovasculares, redução do desejo sexual, ganho de peso e alterações de memória. É importante destacar que uma mulher pode não sentir todos os sintomas e que estes podem ter intensidades diferentes entre as mulheres. Entender as mudanças hormonais e as consequências fisiológicas que ocorrem no corpo na pré e pós-menopausa, torna as mulheres mais informadas sobre tratamentos e cuidados com a saúde, fortalecendo a autonomia e a tomada de decisões de maneira mais ativa e confiante.
Referências
AN, SHUAIQI et al. Association of Depression with Age at Natural Menopause: A Cross-Sectional Analysis with NHANES Data. International Journal of Women s Health, v. 17, p. 211–220, 2025. doi: 10.2147/IJWH.S504748
AN, SUNG‐MIN et al. Adipose Tissue and Metabolic Health. Diabetes & Metabolism Journal, v. 47, n. 5, p. 595–611, 2023. 10.4093/dmj.2023.0011
ANDARZI, FOROUGH, and JAHROMI, MARYAM KOUSHKIE. Correlation between physical activity, appetite, and body composition during menopausal transition and postmenopause in Iranian women. Women s Health, v. 20, 2024. doi:10.1177/17455057241292859
APPIAH, DUKE et al. Trends in Age at Natural Menopause and Reproductive Life Span Among US Women, 1959-2018. JAMA, v. 325, n. 13, p. 1328, 2021. 10.1001/jama.2021.0278
BAEK, DONG-CHEOL et al. Linking alterations in estrogen receptor expression to memory deficits and depressive behavior in an ovariectomy mouse model. Scientific Reports, v. 14, n. 1, 2024. doi:10.1038/s41598-024-57611-z
BAKER, FIONA et al. Insomnia in women approaching menopause: Beyond perception. Psychoneuroendocrinology, v. 60, p. 96–104, 2015. doi:10.1016/j.psyneuen.2015.06.005
BARTH, CLAUDIA et al. Sex Hormones Affect Neurotransmitters and Shape the Adult Female Brain during Hormonal Transition Periods. Frontiers in Neuroscience, v. 9, n. 37, 2015. doi:10.3389/fnins.2015.00037
BENTON, MELISSA et al. Effect of menstrual cycle on resting metabolism: A systematic review and meta-analysis. PLOS ONE, v. 15, n. 7, p. e0236025, 2020. doi:10.1371/journal.pone.0236025
BJUNE, JAN-INGE et al. Metabolic and Epigenetic Regulation by Estrogen in Adipocytes. Frontiers in Endocrinology, v. 13, 2022. doi:10.3389/fendo.2022.828780
BRICENO SILVA, GABRIELA et al. Influence of the Onset of Menopause on the Risk of Developing Alzheimer’s Disease. Cureus, 2024. doi:10.7759/cureus.69124
BRINTON, ROBERTA et al. Perimenopause as a neurological transition state. Nature Reviews Endocrinology, v. 11, n. 7, p. 393–405, 2015. doi:10.1038/nrendo.2015.82
BROWN, LYDIA et al. Promoting good mental health over the menopause transition. The Lancet, v. 403, n. 10430, p. 969–983, 2024. doi: 10.1016/S0140-6736(23)02801-5
CAMON, CELINE et al. Exploring the effects of estrogen deficiency and aging on organismal homeostasis during menopause. Nature Aging, v. 4, n. 12, p. 1731–1744, 2024. doi: 10.1038/s43587-024-00767-0
CHENG, CHU-HAN et al. Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover. International Journal of Molecular Sciences, v. 23, n. 3, p. 1376, 2022. doi: 10.3390/ijms23031376
CIARAMBINO, Tiziana et al. Gender Differences in Insulin Resistance: New Knowledge and Perspectives. Current Issues in Molecular Biology, v. 45, n. 10, p. 7845–7861, 2023. doi:10.3390/cimb45100496
DAVIS, SUSAN R et al. Menopause—Biology, consequences, supportive care, and therapeutic options. Cell, v. 186, n. 19, 1 set. 2023. doi: 10.1016/j.cell.2023.08.016
DUMAS, JULIE A. et al. Increased memory load-related frontal activation after estradiol treatment in postmenopausal women. Hormones and Behavior, v. 58, n. 5, p. 929–935, 2010. doi:10.1016/j.yhbeh.2010.09.003
ERDÉLYI, ALIZ et al. The Importance of Nutrition in Menopause and Perimenopause—A Review. Nutrients, v. 16, n. 1, p. 27, 2024. doi: 10.3390/nu16010027
FAUBION, STEPHANIE S et al. Long-term health consequences of premature or early menopause and considerations for management. Climacteric, v. 18, n. 4, p. 483–491, 2015. doi: 10.3109/13697137.2015.1020484
FENTON, ANNA. Weight, shape, and Body Composition Changes at Menopause. Journal of Mid-life Health, v. 12, n. 3, p. 187, 2021. doi:10.4103/jmh.jmh_123_21
FREEDMAN, ROBERT R. et al. Cortical activation during menopausal hot flashes. Fertility and Sterility, v. 85, n. 3, p. 674–678, 2006. doi:10.1016/j.fertnstert.2005.08.026
GATENBY, CHARLOTTE, and SIMPSON, PAUL. Menopause: physiology, definitions, and symptoms. Best Practice & Research Clinical Endocrinology & Metabolism, v. 38, n. 1, p. 101855–101855, 2023. doi: 10.1016/j.beem.2023.101855
GREEN, LAUREN. et al. Exploration of plasma adiponectin, leptin, and COMT genotype on blood pressure among women who are post-menopause. Journal of Nutritional Science, v. 12, 2023. doi:10.1017/jns.2023.75
HAMODA, HAITHAM, and SHARMA, ANGELA. Premature ovarian insufficiency, early menopause, and induced menopause. Best Practice & Research Clinical Endocrinology & Metabolism, v. 38, n. 1, p. 101823, 2023. doi:10.1016/j.beem.2023.101823
HARA, YUKO et al. Estrogen Effects on Cognitive and Synaptic Health Over the Lifecourse. Physiological Reviews, v. 95, n. 3, p. 785–807, 2015. doi:10.1152/physrev.00036.2014
HICKEY, MARTHA et al. Normalising Menopause. BMJ, v. 377, n. 377, p. e069369, 2022. doi:10.1136/bmj-2021-069369
HICKEY, MARTHA et al. An Empowerment Model for Managing Menopause. The Lancet, v. 403, n. 10430, p. 947-957, 2024. doi: 10.1016/S0140-6736(23)02799-X
JACOBS, EMILY G. et al. Impact of Sex and Menopausal Status on Episodic Memory Circuitry in Early Midlife. Journal of Neuroscience, v. 36, n. 39, p. 10163–10173, 2016. doi:10.1523/JNEUROSCI.0951-16.2016
KARGI, ATIL Y. Impact of long-acting growth hormone replacement therapy in adult growth hormone deficiency: Comparison between adolescent, adult, and elderly patients. Best Practice & Research Clinical Endocrinology & Metabolism, v. 37, n. 6, p. 101825, 2023. doi: 10.1016/j.beem.2023.101825
KHANDELWAL, SUNILA et al. Menopause hormone therapy, migraines, and thromboembolism. Best Practice & Research Clinical Obstetrics & Gynaecology, v. 81, p.31-44, 2021. doi:10.1016/j.bpobgyn.2021.11.011
KO, SEONG-HEE, and JUNG, YUNJAE. Energy Metabolism Changes and Dysregulated Lipid Metabolism in Postmenopausal Women. Nutrients, v. 13, n. 12, p. 4556, 2021. doi:10.3390/nu13124556
KRAVITZ, HOWARD M et al. Sleep, Health, and Metabolism in Midlife Women and Menopause. Obstetrics and Gynecology Clinics of North America, v. 45, n. 4, p. 679–694, 2018. doi: 10.1016/j.ogc.2018.07.008
LI, LIYUAN et al. The Signaling Pathways Involved in Ovarian Follicle Development. Frontiers in Physiology, v. 12, p. 730196, 2021. doi:10.3389/fphys.2021.730196
MARLATT, KARA L et al. Body composition and cardiometabolic health across the menopause transition. Obesity, v. 30, n. 1, p. 14–27, 2021. doi:10.1002/oby.23289
MARSH, MEGAN L et al. Adipocyte Metabolism and Health after the Menopause: The Role of Exercise. Nutrients, v. 15, n. 2, p. 444, 2023. doi:10.3390/nu15020444
MONTELEONE, PATRIZIA et al. Symptoms of menopause — global prevalence, physiology and implications. Nature Reviews Endocrinology, v. 14, n. 4, p. 199–215, 2018. doi:10.1038/nrendo.2017.180
MONTERROSA-CASTRO, ÁLVARO et al. Possible association between subclinical hypothyroidism and age at menopause in Colombian women. Gynecological Endocrinology, v. 40, n. 1, 2024. doi:10.1080/09513590.2024.2334798
MOSCONI, LISA et al. Menopause impacts human brain structure, connectivity, energy metabolism, and amyloid-beta deposition. Scientific Reports, v. 11, n. 1, p. 10867, 2021. doi:10.1038/s41598-021-90084-y
MOU, HONG et al. Effects of key physiological parameters on cardiovascular disease and osteoporosis risk in perimenopausal and postmenopausal women. Scientific Reports, v. 15, n. 1, p. 2814, 2025. doi:10.1038/s41598-025-86613-8
NIE, XUBIAO et al. Estrogen Regulates Duodenal Calcium Absorption Through Differential Role of Estrogen Receptor on Calcium Transport Proteins. Digestive Diseases and Sciences, v. 65, n. 12, p. 3502–3513, 2020. doi: 10.1007/s10620-020-06076-x
O’NEILL, SHEILA, and EDEN, JOHN. The pathophysiology of menopausal symptoms. Obstetrics, Gynaecology & Reproductive Medicine, v. 27, n. 10, p. 303–310, 2017. doi: 10.1016/j.ogrm.2017.07.002
PORTAS, CHIARA M et al. Serotonin and the sleep/wake cycle: special emphasis on microdialysis studies. Progress in Neurobiology, v. 60, n. 1, p. 13–35, 2000. doi:10.1016/s0301-0082(98)00097-5
RAPKIN, ANDREA. J. Vasomotor symptoms in menopause: physiologic condition and central nervous system approaches to treatment. American Journal of Obstetrics & Gynecology, v. 196, n. 2, p. 97–106, 2007. doi: 10.1016/j.ajog.2006.05.056. PMID: 17306645
RUBINOW, DAVID R et al. Estrogen–serotonin interactions: implications for affective regulation. Biological Psychiatry, v. 44, n. 9, p. 839–850, 1998. doi:10.1016/s0006-3223(98)00162-0
RUSSELL, JASON K et al. The Role of Estrogen in Brain and Cognitive Aging. Neurotherapeutics, v. 16, n. 3, p. 649–665, 2019. doi:10.1007/s13311-019-00766-9
SANTORO, NANETTE et al. Menopausal Symptoms and Their Management. Endocrinology and Metabolism Clinics of North America, v. 44, n. 3, p. 497–515, 2015. doi: 10.1016/j.ecl.2015.05.001
SANTORO, NANETTE et al. The Menopause Transition: Signs, Symptoms, and Management Options. The Journal of Clinical Endocrinology & Metabolism, v. 106, n. 1, p. 1–15, 2021. doi: 10.1210/clinem/dgaa764
SCHROEDER, RACHEL A. et al. Endogenous Estrogens and Brain Activation During Verbal Memory Encoding and Recognition in the Postmenopause. The Journal of Clinical Endocrinology & Metabolism, v. 110, n. 2, p. 452–461, 2025. doi:10.1210/clinem/dgae467
SCHOENAKER, Danielle A J M et al. Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents. International Journal of Epidemiology, v. 43, n. 5, p. 1542–1562, 2014. doi:10.1093/ije/dyu094
SOCHOCKA, MARTA et al. Cognitive Decline in Early and Premature Menopause. International Journal of Molecular Sciences, v. 24, n. 7, p. 6566–6566, 2023. doi: 10.3390/ijms24076566
STRELOW, BRITTANY et al. Menopause Decoded: What’s Happening and How to Manage It. Journal of Primary Care & Community Health, v. 15, p. 21501319241307460, 2024. doi:10.1177/21501319241307460
TALAULIKAR, VIKRAM. Menopause transition: Physiology and Symptoms. Best Practice & Research Clinical Obstetrics & Gynaecology, v. 81, n. 81, p. 3–7, 2022. doi: 10.1016/j.bpobgyn.2022.03.003
VATANKHAH, HAJAR et al. Prevalence of early and late menopause and its determinants in Rafsanjan cohort study. Scientific Reports, v. 13, n. 1, p. 1847, 2023. doi:10.1038/s41598-023-28526-y
VEGA, JENNIFER N et al. Altered Brain Connectivity in Early Postmenopausal Women with Subjective Cognitive Impairment. Frontiers in Neuroscience, v. 10, 2016. doi:10.3389/fnins.2016.00433
VERDE, LUDOVICA et al. Chronotype and Sleep Quality in Obesity: How Do They Change After Menopause? Current Obesity Reports, v. 11, n. 4, p. 254–262, 2022. doi:10.1007/s13679-022-00479-9
TANDON, VISHAL et al. Menopause and sleep disorders. Journal of Mid-life Health, v. 13, n. 1, p. 26, 2022. doi:10.4103/jmh.jmh_18_22
VOEDISCH, AMY J et al. Menopause: A Global Perspective and Clinical Guide for Practice. Clinical Obstetrics & Gynecology, v. 64, n. 3, p. 528–554, 2021. doi:10.1097/GRF.0000000000000639
WANG, LING et al. Exploring the causal association between epigenetic clocks and menopause age: insights from a bidirectional Mendelian randomization study. Frontiers in Endocrinology, v. 15, p. 1429514, 2024. doi:10.3389/fendo.2024.1429514
WEBER, MIRIAM T et al. Cognition and mood in perimenopause: A systematic review and meta-analysis. The Journal of Steroid Biochemistry and Molecular Biology, v. 142, p. 90–98, 2014. doi: 10.1016/j.jsbmb.2013.06.001
WOODS, NANCY FUGATE et al. Depressed mood during the menopausal transition and early postmenopause. Menopause, v. 15, n. 2, p. 223–232, 2008. doi:10.1097/gme.0b013e3181450fc2
YGNATIOS, NAIR TAVARES MILHEM et al. Age at natural menopause and its associated characteristics among Brazilian women: cross-sectional results from ELSI-Brazil. Menopause The Journal of The North American Menopause Society, vol. 31, n.8, p. 693-701, 2024. doi:10.1097/GME.0000000000002385
ZHOU, JIN et al. Effects of Estrogen Treatment on Expression of Brain-Derived Neurotrophic Factor and cAMP Response Element-Binding Protein Expression and Phosphorylation in Rat Amygdaloid and Hippocampal Structures. Neuroendocrinology, v. 81, n. 5, p. 294–310, 2005. doi:10.1159/000088448
ZOLFAGHARI, SHEIDA et al. Effects of menopause on sleep quality and sleep disorders: Canadian Longitudinal Study on Aging. Menopause, v. 27, n. 3, p. 295–304, 2020. doi:10.1097/GME.0000000000001462
ZSIDO, RACHEL G et al. Association of Estradiol and Visceral Fat With Structural Brain Networks and Memory Performance in Adults. JAMA Network Open, v. 2, n. 6, p. e196126, 2019. doi:10.1001/jamanetworkopen.2019.6126
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2025 Neurociências & Sociedade
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Todas as publicações da Revista Neurociências e Sociedade estão licenciadas sob a licença Creative Commons Atribuição-Não-Comercial-Compartilhamento pela mesma Licença 4.0 Internacional CC BY-NC-SA 4.0
Você é livre para:
- Compartilhar – copie e redistribua o material em qualquer meio ou formato
- Adaptar – remixar, transformar e desenvolver o material
- O licenciante não pode revogar essas liberdades desde que você siga os termos da licença.
Nos seguintes termos:
- Atribuição — Você deve dar o devido crédito , fornecer um link para a licença e indicar se foram feitas alterações . Você pode fazê-lo de qualquer maneira razoável, mas não de forma que sugira que o licenciante endossa você ou seu uso.
- Não Comercial — Você não pode usar o material para fins comerciais .
- ShareAlike — Se você remixar, transformar ou desenvolver o material, deverá distribuir suas contribuições sob a mesma licença do original.
- Sem restrições adicionais — Você não pode aplicar termos legais ou medidas tecnológicas que restrinjam legalmente outras pessoas de fazerem qualquer coisa que a licença permita.
