Abdul B. Saifuddin

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Vol 16, No 3, July – September 2007    Editorial note  137 Editorial note   The Indonesian census result in 2000 showed that total  number  of  Indonesia’s  population  was  206 million, and this put Indonesia at the fourth rank of the most populous countries in the world. The  population growth rate over the last three decades has continued to decline, reaching 1.49% per year during 1990-2000, and future estimation reaches 1.21% in 2010. In accordance with the population projection by the Central Bureau of Statistics, the Indonesian population in 2005 will reached 219.9 million, and would rise to 234,1 million in 2010. Increment  in  population  number  will  certainly change  the  outlook  of  population  pyramid. Demographically, a shift in the population structure has occurred from the young-aged to the old-aged population. By age groups, it was estimated that young-aged  population  (0-14  years)  decreased from  35.7%  in  1990  to  28.3%  in  2005,  and  to 26% in 2010. The percentage of productive-aged population (15-64 years) increased from 60.6% in 1990 to 66.7% in 2005, and to 68.6% in 2010. On the other hand, the old-aged population rose from 3.8%  in  1990  to  5%  in  2005,  to  5.3%  in  2010. Dependency ratio decreased from 49.8% in 2005 to 45.7% in 2010. In the meantime, life expectancy rate at birth over the last four decades tended to increase from 41 years in 1960 to 66.2 in 1999, to 69 years in 2005, and it was estimated to reach 70.8 years in 2010. For women, the above figures will show prolonged post-reproductive  period.  Approximately  by  the age of 45, the ovarian functions would decrease. Due to process, the ovaries become less sensitive to  the  gonadotropin  stimulation.  As  a  result, follicular maturation, ovulation, and the formation of  corpus  luteum  would  cease.  During  the climacteric  period,  a  decrease  in  estrogen  level would  occur  progressively,  accompanied  by  an increase in gonadotropin. The earliest symptoms that  may occur are  menstrual disorder, either in terms  of  its  regularity,  the  amount  of  blood,  or the lengths of cycles, the onset of dysfunctional bleeding, and the decrease in fertility. During the post-menopausal period, neurovegetative symptoms,  psychological  or  organic  disorders may  arise.  Neurovegetative  symptoms  and psychological  disorders  may  take  form  of  hot flushes,  cold  sweat,  palpitation,  numbness, emotional  disturbances,  being  offended  easily, lack  of  vitality,  fear,  and  depression.  Organic disorders  during  the  climacteric  period  may assume  the  form  of  genital,  skin  atrophy,  and osteoporosis. Other disorders  requiring attention are malignancies, heart diseases and urogynecologic diseases. The ever-increasing number of Indonesian women during the post-reproductive period in the decades ahead requires the efforts to improve their quality of life by overcoming their climacteric symptoms, preventing  and  treating  coronary  heart  disease, preventing  muscular  and  genital  atrophy,  preventing osteoporosis,  and  improving  healthcare  coupled with the efforts to maintain health. It is necessary to consider the appropriate use of estrogen substitutions and to develop appropriate technology  for  the  early  detection.  Healthy lifestyle  should  be  recommended  to  the  extent that disorders due to inactiveness or malnutrition could be prevented.  Saifuddin     Med J Indones  138 Those  medical  efforts  could  not  be  successfully made without the necessary adjustments made in the  socio-cultural  field.  The  elderly  people should be provided opportunity to dedicate their work and to develop their rich experiences so that they feel needed and won’t become unnecessary burdens in the twilight of their lives.  Abdul Bari Saifuddin                  

Medical Journal of Indonesia

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http://mji.ui.ac.id/journal/index.php/mji/article/view/570/553

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