Menopause in women: how it proceeds normally and with pathology, ways to alleviate the symptoms of menopause

Young girls do not really think about menopause, believing that this period will come soon. Minimum years after 50. However, modern lifestyles, ecology, medical advances (widespread use of IVF, ovarian laparoscopy) are changing the traditional understanding of the functioning of the female body. Today, the first manifestations of menopause often affect women at the age of 43-45 years, and sometimes even earlier.

Stages of development

Extinction of reproductive function occurs as a result of aging of the ovaries. The process proceeds smoothly, covering all systems and organs. Menopause is experienced not only by women, but also by men. But in the latter, hormonal adjustment proceeds more systematically, without special health problems and uncomfortable sensations.

In women, changes begin with the hypothalamus and pituitary gland. It is these parts of the brain that regulate the flow of sex hormones into the blood. The ovarian follicular apparatus synthesizes less and less estrogens, while the male sex hormones of a certain period are produced in the same amount. For this reason, at the beginning of menopause, androgen levels prevail over estrogens. There is a hormonal imbalance, which provokes most of the changes. Including because of this, weight may increase.

The menopausal period consists of several stages.

• Premenopause. On average, this period lasts from 45 years to the onset of persistent menopause. At this time, the initial hormonal restructuring begins - the ovaries are still actively functioning, but the menstrual cycle becomes irregular. Already, mild flushing and other symptoms may be felt.
• Menopause (menopause). It comes from the moment of the last menstruation. Normally, it falls to 51 years, although in certain cases it may come sooner or later (up to 40 and after 50 years).
• Perimenopause. The period that covers premenopause and several years of menopause, when the symptoms of dying ovarian function are pronounced. It is characterized by a gradual decrease in the level of sex hormones, the termination of ovulation. At this time, it is almost impossible to get pregnant, even with IVF. Chances are only with the use of donor eggs. The first to “disappear” are gestagens that regulate menstrual function. Menstruation comes less often and now they will become much shorter. There may be delays, functional cysts, as well as heavy bleeding. During ovarian exhaustion, less than 17-beta-estradiol is produced, the level of which decreases as much as possible after the last menstruation. Its deficiency leads to menopausal disorders. Now the main role is played by follicle-stimulating hormone, the level of which increases after menopause.
• Postmenopause. It begins a year after menopause and lasts until the end of life. At this time, the ovaries finally decrease in size and “wrinkle”.After 60 years, they weigh half as much as their reproductive age (about 4 g), often they are difficult to visualize using ultrasound.

Kinds

Involution of reproductive function is possible in several ways.

• Physiological. This is a natural process of ovarian aging and cessation of reproductive function.
• Pathological. This is menopause with an abnormal course, impaired performance and a decrease in the quality of life.
• Medical or surgical. Varieties of pathological menopause, when the condition is artificially caused by taking drugs or by removing the ovaries. Most often, the process is associated with diseases of the genital organs, mammary glands.
• Early. It comes to 40 years due to internal and external factors. A synonym for the concept is depleted ovary syndrome.
• Late. It appears after 55 years and is mainly due to heredity. Up to this point, the woman is actively menstruating.

Symptoms

Reorganization of the hormonal background affects the whole body. Organs and their systems, which are affected by menopause, can conditionally be divided into two groups:

• reproductive - pituitary gland, hypothalamus, mammary glands, genitals;
• unproductive - cardiovascular system, brain, connective tissue, musculoskeletal tissue, liver, bladder and urethra, gastrointestinal tract, skin and hair.

The main criterion for the classification of menopausal symptoms is the time of their manifestation. Allocate:

• early
• deferred;
• late.

Early

Early menopausal symptoms include the following.

• Vasomotor. These are hot flashes, chills, expansion of capillaries on the skin of the face, neck, chest, hands, profuse sweating, changes in body temperature, headaches, heart palpitations, drops in blood pressure, nausea. Such symptoms appear in 80% of women who have reached the threshold of menopause.
• Psycho-emotional. This irritability, distraction, a sense of anxiety and loneliness, sudden changes in mood, insomnia, depression, lack of sexual desire. Found in 15-20% of patients.

Deferred

Mid-term symptoms include:

• urogenital disorders - frequent urination and urinary incontinence, burning, itching, vaginal dryness, discomfort and pain with intimacy;
• skin changes - wrinkles, loss of moisture, elasticity and firmness of the skin, brittle nails, hair loss, ptosis (drooping) of the chest.

They appear two to four years after menopause along with chronic urogenital diseases.

Later

Late symptoms include metabolic disorders - atherosclerosis, osteoporosis, cardiovascular disease, Alzheimer's disease. They appear five to six years after the onset of menopause, also caused by a lack of sex hormones.

Harbingers

Women who have reached the 45th anniversary can already notice the harbingers of menopause. Often this happens long before the regular period ends.

• The tides. In response to hormonal fluctuations, the thermoregulatory system starts the mechanism of “heat supply”, which is manifested by hot flashes, sudden changes in body temperature, trembling, chills. First, the sensations affect the face, décolleté area, which redden and tingle. Then the process extends to the upper and lower limbs. Against this background, palpitations may increase and sweat may intensify. Such heat flows last from five to ten minutes, can be repeated several times a day. The closer to menopause, the more often. In the case of a pathological course, up to 20-30 episodes per day can be recorded.
• Insomnia. It can provoke the same tides. Many people say that they wake up at night a few minutes before the attack, painfully experience it, and then they can not sleep for a long time.
• Cycle failures. The first sign of ovarian function depletion is a shortened cycle. Delays gradually appear, menstruation may be absent for a month or two in a row, then return to normal. In this case, the discharge is abundant, with clots, benign endometrial hyperplasia may occur.
• Neurotic disorders. Often there is irritation, anxiety, fatigue, aggression. All this happens imperceptibly for the woman herself, but palpably for her inner circle.
• Shape Changes. The predominance of male hormones can affect the shape of the body, manifest itself as an unreasonable weight gain. To maintain harmony, it is necessary to increase physical activity and adjust the diet.

In combination or separately, these symptoms indicate an approaching menopause. To confirm the assumptions, you should consult a doctor.

Diagnostics

Communication with the doctor begins with a medical history. Past surgery, concomitant endocrinological pathologies and somatic diseases, hereditary risks for breast cancer and thrombosis are established. Anthropometric indicators are studied: body weight and height, blood pressure and pulse are measured.

One of the diagnostic methods is the Kupperman index. This is a special table where, on a scale of 0 to 3 points, the severity of various menopausal symptoms is assessed. As a result, the severity of menopausal manifestations is revealed. The following studies are also relevant:

• blood test for estrogens, prolactin, FSH, LH, testosterone, TSH;
• biochemical research and analysis of the blood lipid spectrum;
• coagulogram;
• Ultrasound of the pelvic organs and mammary glands;
• mammography;
• osteodensitometry (study of bone mineral density).

The table shows the values ​​of laboratory tests that indicate an approaching menopause.

Table - Changes in tests with menopause

Treatment

Modern medical knowledge can minimize menopausal manifestations, preserve beauty and youth. Only the specialist can choose the most suitable treatment option, taking into account the indications and contraindications.

Hormone replacement therapy

The essence of HRT (hormone replacement therapy) is that a woman is prescribed drugs that contain synthetic analogues of natural sex hormones. They simulate their action, restoring the functions of organs and systems. Such therapy is considered the most effective, but has many contraindications. Among them:

• oncological diseases;
• mastopathy;
• diseases of the liver, pancreas and gall bladder;
• diabetes;
• thrombophlebitis, thromboembolism, stroke, history of heart attack.

HRT is used only as directed by a specialist after a series of tests. It is possible to take monohormonal or combination drugs. The main representatives of such funds are listed in the table.

Table - Preparations for HRT

There are also agents that imply local and transdermal effects. These are hormonal creams, spirals, plasters. Among the latter are widely known "Klimara", "Estraderm", "Menorest." Of the gels prescribed "Divigel", "Estrogel."

Local urogenital disorders are eliminated by Ovestin, presented in the form of oral tablets, vaginal cream and suppositories. Can be used flaxseed andsea ​​buckthorn oil.

Phytohormones

HRT has an impressive list of contraindications and side effects. An alternative is phytoestrogens. These are preparations containing substances of plant origin that simulate the functions and effects of female sex hormones. Such funds include:

• Klimadinon - based on the extract of rhizomes of tsimitsifuga, the most famous phytohormone that recreates the effects of estrogen;
• Qi-Klim - also developed on the basis of tsimitsifugi;
• Feminal - phytoestrogen based on clover extracts;
• Inoclim - The basis is soybeans.

Herbs

For the correction of disorders, herbal medicines based on herbs containing phytoestrogens can be used. The most effective tools based on:

• red brush;
• oregano;
• hog uterus.

Homeopathy

The basis of such drugs are synthetic, plant and other substances in microconcentrations. Homeopathic remedies do not have a powerful effect on the relief of menopause syndrome, but it has an important placebo effect during this period. Among these drugs are known “Klimaksan”, “Remens”, “Klimakt-Hel”, “Stannum”.

Psychotherapy

It is important to have the right attitude. To achieve the desired effect and adjust the psycho-emotional state helps classes with a specialist. Despite the low popularity of these sessions in the post-Soviet space, they are very effective.

At the same time, sedatives (for example, tinctures of motherwort, valerian) and antidepressants are used, especially with an unstable psycho-emotional state.

Lifestyle

It is necessary to get rid of bad habits, pay maximum attention to your health, review the schedule, remove emotional and physical stress.

A major role in well-being is played by proper nutrition. The diet should have plenty of fresh vegetables and fruits, dried fruits, milk and foods high in calcium.

Useful complexes with magnesium, folic acid, vitamins D, E, group B, calcium. Showing frequent walks in the fresh air and airing the room.

Effects

Hormonal changes and the extinction of reproductive function affect all body systems.

• Mucous and skin integument. The skin color becomes dull, wrinkles, stretch marks, dryness appear. Searing of the mucous membranes leads to the development of inflammatory processes of an atrophic nature in the vagina, cervix. Frequent vaginosis, candidiasis, itching, burning in the genital area, problems with urination, inflammation of the bladder occur. Dry gastrointestinal mucosa is perspiration, digestion, pain, and a “lump” sensation along the esophagus.
• Bones and spine. Bones become weak and brittle, their density decreases. Osteoporosis increases the risk of injuries and enhances degenerative processes. Later, joint and muscle pains begin to bother, posture changes.
• The cardiovascular system. The risk of vascular endothelial injury increases, later cholesterol plaques are deposited here. All this leads to differences in blood pressure, a decrease in the resistance of the vascular walls to fluctuations, their elasticity decreases. As a result, the likelihood of heart attacks and strokes increases.The situation is aggravated by increasing body weight, which at this age is more difficult to control.
• Brain. Lack of hormones also affects the cerebral cortex, some parts of the central nervous system. Frequent hot flashes, vascular pathologies, neurosises - all this worsens brain activity, reduces memory, and the ability to concentrate.

Features of pathological menopause

Menopause can be natural and artificial. In medicine, these types of extinction of ovarian function are defined as physiological and pathological. The latter is due to the following factors.

• Surgical intervention. It involves the removal of the ovaries separately or together with the uterus. In the case when only appendages are removed or only the uterus, menopause does not come immediately, but before the natural time. If two ovaries are cut at once, the extinction of reproductive function occurs within a few days.
• Drug exposure. Taking potent drugs for infertility endometriosis temporarily inhibits ovarian function. Hormone deficiency helps reduce symptoms. This treatment returns the chances of becoming pregnant and having a favorable perinatal period.
• Radiation exposure. Menopause occurs due to excessive radiation exposure, often after radiation therapy.

Also, the concept of pre-climax state is used to characterize severe climacteric syndrome, you can read about this by visiting the premenopause forum. This period is accompanied by pronounced symptoms, exacerbation of chronic diseases and the development of new, affecting the target organs of menopause.

Reviews

My restructuring began at 47. At first the cycle went astray, then the menstruation was once every six months, and then it completely stopped a year ago. there is myoma. While not decreasing, but not growing. Tides are sometimes, but not pronounced. Worried about six months ago: the weight began to grow, migraines began, and generally somehow withered from the face. My peer friend looks great, her gynecologist has developed a whole program of nutritional supplements. I know that she drinks soy milk (by the way, I really liked it, it just costs a little), takes certain vitamins and doppelgerts "menopause". A friend says that on her table everything is arranged in boxes - morning, day, night. Plus she does Carol Maggio gymnastics and does yoga once a week. Fifteen years ago, she looked 50 and was sluggish and gloomy, today she is given 35 and she is cheerful and energetic. I am not lying. Inspired by her example, I made an appointment with a gynecologist-endocrinologist at a cool medical center. All gynecologists there turned out to be young women. (I tried to get to the elderly). We spoke different languages, and the conversation concluded that there was no need to drink anything. And analysis for hormones is also not necessary. And in general, she did not understand what I want. I’ll ask my friend to write all her recommendations and let you know.

Age 51, http://www.woman.ru/health/woman-health/thread/3871164/

I am 54 years old. If the cycle just started to go astray, it would be much easier. But the tides cause such a state that you do not want to live. The pressure jumps up and down, sometimes drops to fainting, periodically - a frantic heartbeat. And I understand how easy it is to get a heart attack or stroke. Previously, never even in the bath, so I did not sweat. Now almost every hour I get all red and sweaty. Yeststo, irritability, because it exhausts it all terribly. I'm not talking about the fact that I can’t afford all the “sweat” of previous physical exertion, and without them, no diet helps. And no homeopathic remedies help at all !!! And the doctor does not prescribe hormones, because fibromyoma says that it will be better if the menstruation ends at all. I just don’t know how to survive it and how long it will last ...

Age fun, http://www.woman.ru/health/woman-health/thread/3871164/

My mom's climax lasted quite a while.Nervousness and hot flashes removed homeopathy capsules with phytoestrogens Klimafit-911, about a month later, when she could not endure all this and still decided to undergo treatment. Therefore, the main thing is to choose the right funds for menopause, and then everything will be fine. But since these are not hormones, you first need to drink them at least 2 months.

Alyona, http://www.divomix.com/forum/klimaks-u-zhenshhin-simptomy-vozrast/

A severe climacteric syndrome was delivered to me in the medical center. I felt so bad that I thought I was dying. weakness, palpitations, fever, high blood pressure, depression. thanks to the gynecologist. after the prescribed treatment, it immediately became better. so contact your gynecologist.

48, http://forum.ykt.ru/viewmsg.jsp?id=23389480

Masha, Yes, I’ve had it for 5 years now, it’s a nightmare, hot flashes, pressure failure, then low, then very high, I’ve sat on Angelica for 4 years, everything was fine, but there was a problem with the breast, a tumor in my chest, urgent need to abandon hormonal and hell began again, not life. I can’t do physical education, because it is stormy, there is noise in my head, pressure rises, it’s impossible to sleep, hot flashes, then in heat, then in cold, I don’t know what else to drink during this period, I tried all non-hormonal drugs, they generally dead poultice. I don’t know how much longer I can endure this execution, and not life, and most importantly, doctors cannot help anything.

Tatyana, http://forum.ykt.ru/viewmsg.jsp?id=23389480