The climacteric covers the gradual ending of the reproductive period and results from failing ovarian production of oestrogen. Symptoms associated with it may precede or follow the menopause, which is a single event during the climacteric, and they are therefore better called climacteric rather than menopausal symptoms. They include hot flushes; depression or emotional instability, sometimes with insomnia as the most prominent feature; and dyspareunia. Changes in libido apart from dyspareunia are often of psychological origin and are probably caused as much by ageing as by a fall in oestrogen production. Though obesity often develops at the time of the climacteric it seems not to be specifically related to it.
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