Menopause: normal or pathological. Menopause Postmenopausal period in women symptoms and treatment

For citation: Serov V.N. Menopause: normal or pathological. breast cancer. 2002;18:791.

Scientific Center for Obstetrics, Gynecology and Perinatology, Russian Academy of Medical Sciences, Moscow

To Limacteric period precedes aging, and depending on the cessation of menstruation is divided into premenopause, menopause and postmenopause. Being a normal state, menopause is characterized by pronounced signs of aging. Climacteric syndrome, cardiovascular pathology, hypotrophic manifestations in the genitourinary system, osteopenia and osteoporosis - this is an incomplete enumeration of the pathology of the menopause, caused by aging and the shutdown of ovarian function. Almost a third of a woman's life passes under the sign of menopause. In recent years, the possibility of significantly improving the quality of life during menopause with the help of hormone replacement therapy (HRT), allowing to cure menopausal syndrome, reduce cardiovascular pathology, osteoporosis, urinary incontinence by 40-50%.

premenopause precedes menopause by somatic and psychological changes due to the extinction of ovarian function. Their early detection can prevent the development of severe menopausal syndrome. Perimenopause usually begins after age 45. At first, its manifestations are insignificant. Both the woman herself and her doctor usually either do not attach importance to them, or associate them with mental overstrain. Hypoestrogenism should be excluded in all women over 45 who complain of fatigue, weakness, irritability. The most characteristic manifestation of premenopause is menstrual irregularities. During the 4 years preceding menopause, this symptom occurs in 90% of women.

Menopause- part of the natural aging process, in fact, is the cessation of menstruation as a result of the extinction of ovarian function. The age of menopause is determined retrospectively, 1 year after the last menstrual period. The average age of menopause is 51 years. It is determined by hereditary factors and does not depend on the characteristics of nutrition and nationality. Menopause occurs earlier in smokers and nulliparous women.

Postmenopause follows menopause and lasts an average of a third of a woman's life. For the ovaries, this is a period of relative rest. The consequences of hypoestrogenism are very serious, they are similar in health significance to the consequences of hypothyroidism and adrenal insufficiency. Despite this, doctors do not pay due attention to postmenopausal HRT, although it is one of the most important components of the prevention and treatment of various pathologies in older women. This appears to be because the effects of hypoestrogenism develop slowly (osteoporosis) and are often attributed to aging (cardiovascular disease).

Hormonal and metabolic changes occur gradually in premenopause. After a period of almost 40 years, during which the ovaries secreted sex hormones cyclically, the secretion of estrogens gradually decreases and becomes monotonous. In premenopause, the metabolism of sex hormones changes. In postmenopausal women, the ovaries do not completely lose their endocrine function, they continue to secrete certain hormones.

Progesterone is produced only by the cells of the corpus luteum, which is formed after ovulation. In premenopause, an increasing proportion of menstrual cycles become anovulatory. Some women ovulate but develop corpus luteum insufficiency, resulting in a decrease in progesterone secretion.

The secretion of estrogen by the ovaries in postmenopause practically stops. Despite this, all women in the serum are determined by estradiol and estrone. They are formed in peripheral tissues from androgens secreted by the adrenal glands. Most estrogens are derived from androstenedione, secreted primarily by the adrenal glands and, to a lesser extent, by the ovaries. It occurs predominantly in muscle and adipose tissue. In this regard, with obesity, serum estrogen levels increase, which in the absence of progesterone increases the risk of cancer of the uterine body. Thin women have lower serum estrogen levels and therefore have an increased risk of osteoporosis. Interestingly, menopausal syndrome is possible even with high estrogen levels in obese women.

In postmenopause, progesterone secretion stops. In the childbearing period, progesterone protects the endometrium and mammary glands from estrogen stimulation. It reduces the content of estrogen receptors in cells. In premenopausal and postmenopausal women, estrogen levels remain high enough in some women to stimulate endometrial cell proliferation. This, as well as the lack of secretion of progesterone, leads to an increased risk of endometrial hyperplasia, cancer of the body of the uterus and mammary glands.

Psychological consequences associated with aging are usually much more pronounced than those associated with the loss of childbearing function. In modern society, youth is valued more than maturity, so menopause, as a tangible proof of age, causes anxiety and depression in some women. The psychological consequences largely depend on how much attention a woman pays to her appearance. Rapid skin aging, especially in postmenopausal women, worries many women. The results of numerous studies confirm that age-related skin changes in women are due to hypoestrogenism.

In menopause, many women report anxiety and irritability. These symptoms have even become an integral part of the menopausal syndrome. It is generally accepted that they are associated with hypoestrogenism. Despite this, in none of the studies carried out, the relationship of anxiety with menopause and its disappearance during hormone replacement therapy has not been confirmed. It is likely that anxiety and irritability are due to various social factors. The doctor should be aware of these common symptoms in older women and provide appropriate psychological support.

tides- perhaps the most famous manifestation of hypoestrogenism. Patients describe them as a periodic short-term sensation of heat, accompanied by sweating, palpitations, anxiety, sometimes followed by chills. Hot flashes last, as a rule, 1-3 minutes and are repeated 5-10 times a day. In severe cases, patients report up to 30 hot flashes per day. With natural menopause, hot flashes occur in about half of women, with artificial - much more often. In most cases, hot flashes slightly interfere with well-being.

However, approximately 25% of women, especially those who have undergone bilateral oophorectomy, note severe and frequent hot flashes, leading to increased fatigue, irritability, anxiety, depressed mood, and memory loss. In part, these manifestations may be due to sleep disturbance with frequent nocturnal hot flashes. In early premenopause, these disorders may occur as a result of autonomic disorders and are not associated with hot flashes.

Hot flashes are explained by a significant increase in the frequency and amplitude of GnRH secretion. It is possible that increased secretion of GnRH does not cause hot flashes, but is only one of the symptoms of CNS dysfunction leading to thermoregulation disorders.

HRT quickly eliminates hot flashes in most women. Some of them, especially those who have undergone bilateral oophorectomy, require high doses of estrogens. In mild cases, in the absence of other indications for HRT (for example, osteoporosis), treatment is not prescribed. Without treatment, hot flashes go away after 3-5 years.

The epithelium of the vagina, urethra, and base of the bladder is estrogen-dependent. 4-5 years after menopause, about 30% of women who do not receive hormone replacement therapy develop its atrophy. Atrophic vaginitis manifested by vaginal dryness, dyspareunia, and recurrent bacterial and fungal vaginitis. All these symptoms completely disappear on the background of hormone replacement therapy.

Atrophic urethritis and cystitis manifested by frequent and painful urination, urge to urinate, stress urinary incontinence, and recurrent urinary tract infections. Epithelial atrophy and shortening of the urethra caused by hypoestrogenia contribute to urinary incontinence. HRT is effective in 50% of postmenopausal patients with stress urinary incontinence.

Menopausal women often report attention disorders and short term memory. Previously, these symptoms were attributed to aging or sleep disturbances caused by hot flashes. It has now been shown that they may be due to hypoestrogenism. Hormone replacement therapy improves the functions of the central nervous system and the psychological state of postmenopausal women.

One of the most interesting areas for future research is to determine the role of HRT in the prevention and treatment of Alzheimer's disease. There is evidence that estrogens reduce the risk of this disease, although the role of hypoestrogenism in the pathogenesis of Alzheimer's disease has not yet been proven.

Cardiovascular diseases There are many predisposing factors, the most important of which is age. The risk of cardiovascular disease increases with age in both men and women. The risk of death from coronary artery disease in women of childbearing age is 3 times less than in men. In postmenopause, it rises sharply. Previously, the increase in the incidence of cardiovascular disease in postmenopausal women was explained only by age. It has now been shown that hypoestrogenism plays an important role in their development. It is one of the most easily eliminated risk factors for atherosclerosis. In postmenopausal women receiving estrogens, the risk of myocardial infarction and stroke is reduced by more than 2 times. A doctor observing a postmenopausal woman should tell her about cardiovascular diseases and the possibility of their prevention. This is especially important if she refuses HRT for any reason.

In addition to hypoestrogenism, one should strive to eliminate other risk factors for atherosclerosis. Perhaps the most significant of them are arterial hypertension and smoking. Thus, arterial hypertension increases the risk of myocardial infarction and stroke by 10 times, and smoking by at least 3 times. Other risk factors include diabetes mellitus, hyperlipidemia, and a sedentary lifestyle.

It has long been known that menopause, natural or artificial, leads to osteoporosis. Osteoporosis is a decrease in density and restructuring of bone tissue. For convenience, some authors propose to call osteoporosis such a decrease in bone density, in which fractures occur, or their risk is very high. Unfortunately, the degree of loss of compact and cancellous bone in most cases remains unknown until a fracture occurs. The number of elderly women with fractures of the radius, femoral neck and compression fractures of the vertebrae due to osteoporosis is high. With an increase in the average life expectancy, it, apparently, will only increase.

Despite the fact that the rate of bone resorption increases already in premenopause, the highest incidence of fractures due to osteoporosis occurs several decades after menopause. The risk of hip fracture in women over 80 is 30%. Approximately 20% of them die within 3 months after the fracture from complications of prolonged immobilization. It is extremely difficult to treat osteoporosis already at the stage of fractures.

There are many risk factors for osteoporosis. The most important of these is age. Another risk factor for osteoporosis is undoubtedly hypoestrogenism. As already noted, in the absence of HRT, postmenopausal bone loss reaches 3-5% per year. Most actively bone tissue is resorbed during the first 5 years of postmenopause. It is believed that during this period, 20% of the compact and spongy substance of the femoral neck lost during life is lost.

Low dietary calcium also leads to osteoporosis. Eating foods rich in calcium (especially dairy products) reduces bone loss in premenopausal women. In postmenopausal women receiving HRT, calcium supplements at a dose of 500 mg / day orally are sufficient to maintain bone density. Calcium intake in the indicated doses does not increase the risk of urolithiasis, although it may be accompanied by gastrointestinal disorders: flatulence and constipation. Exercise and smoking cessation also prevent bone loss and reduce the risk of osteoporosis.

In order to prevent complications of menopause is most effective hormone replacement therapy. Climacteric syndrome, most often observed in the perimenopausal period, is characterized by vegetative-vascular, neurological and metabolic manifestations. Hot flashes, mood instability, a tendency to depression are characteristic, hypertension is often aggravated, type 2 diabetes mellitus progresses, exacerbations of peptic ulcer and lung pathology occur. Hypotrophic processes of the vaginal mucosa, urethra, bladder gradually progress. Conditions are created for frequent urinary and vaginal infections, sexual life is disturbed. Atherosclerosis progresses, the risk of myocardial infarction and strokes increases. In late menopause, due to progressive osteoporosis, bone fractures occur, especially the spine, femoral neck.

HRT is effective in menopausal syndrome in 80-90% of cases , it reduces the risk of myocardial infarction and stroke by half and increases life expectancy even in those patients in whom angiography reveals narrowing of the lumen of the coronary arteries. Estrogens prevent the formation of atherosclerotic plaques. The estrogens included in the combined preparations for HRT reduce bone loss and partially restore it, preventing osteoporosis and fractures.

HRT also has a negative effect. Estrogens increase the risk of hyperplasia and cancer of the uterine body, but the simultaneous administration of progestogens prevents these diseases. According to the literature, it is not possible to make a clear picture of the risk of breast cancer; many authors in randomized trials showed no increased risk, but in other studies it increased. In recent years, the beneficial effect of HRT against Alzheimer's disease has been shown.

Despite the clear benefits of HRT, it is not widely used. It is believed that only about 30% of postmenopausal women take estrogen. This is due to the large number of women who have relative contraindications and restrictions for HRT. In adulthood, many women have uterine fibroids, endometriosis, hyperplastic processes of the reproductive organs, fibrocystic mastopathy, etc. All this forces us to look for alternative methods of treating menopausal disorders (physical activity, limiting or quitting smoking, reducing the consumption of coffee, sugar, salt, balanced diet).

Long-term medical observations have demonstrated the high efficiency of a balanced diet and the use of multivitamin, mineral complexes, as well as medicinal plants.

climactoplane - a complex preparation of natural origin. The plant components that make up the preparation affect thermoregulation, normalizing the processes of inhibition in the central nervous system; reduce the frequency of sweating attacks, hot flashes, headaches (including migraine); relieve the feeling of embarrassment, internal anxiety, help with insomnia. The drug is used orally until complete resorption in the oral cavity half an hour before or one hour after meals, 1-2 tablets 3 times a day. There were no contraindications to the use of the drug, no side effects were detected.

Klimadinon is also a herbal preparation. Tablets of 0.02 g, 60 pieces per pack. Drops for oral administration - 50 ml in a vial.

A new direction in the treatment of menopause are selective estrogen receptor modulators. Raloxifene stimulates estrogen receptors while also having antiestrogenic properties. The drug was synthesized for the treatment of breast cancer, it is part of the tamoxifen group. Raloxifene prevents the development of osteoporosis, reduces the risk of stroke and myocardial infarction, and does not increase the risk of breast cancer.

For HRT, conjugated estrogens, estradiol valerate, estriol succinate are used. In the United States, conjugated estrogens are more commonly used, in European countries - estradiol valerate. The listed estrogens do not have a pronounced effect on the liver, coagulation factors, carbohydrate metabolism, etc. The cyclic addition of progestogens to estrogens for 10-14 days is mandatory, which avoids endometrial hyperplasia.

Natural estrogens, depending on the route of administration, are divided into 2 groups: for oral or parenteral use. With parenteral administration, the primary metabolism of estrogens in the liver is excluded, as a result, smaller doses of the drug are required to achieve a therapeutic effect compared to oral preparations. With parenteral use of natural estrogens, various routes of administration are used: intramuscular, cutaneous, transdermal and subcutaneous. The use of ointments, suppositories, tablets with estriol allows you to achieve a local effect in urogenital disorders.

Widespread throughout the world preparations containing estrogen and progestin. These include drugs of monophasic, biphasic and triphasic types.

Cliogest - monophasic drug, 1 tablet of which contains 1 mg of estradiol and 2 mg of norethisterone acetate.

For biphasic drugs supplied to the Russian pharmaceutical market currently include:

Divin. Calendar pack of 21 tablets: 11 white tablets containing 2 mg estradiol valerate and 10 blue tablets containing 2 mg estradiol valerate and 10 mg methoxyprogesterone acetate.

Clymen. A calendar pack of 21 tablets, of which 11 white tablets contain 2 mg of estradiol valerate, and 10 pink tablets contain 2 mg of estradiol valerate and 1 mg of cyproterone acetate.

Cycloprogynova. A calendar pack of 21 tablets, of which 11 white tablets contain 2 mg of estradiol valerate, and 10 light brown tablets contain 2 mg of estradiol valerate and 0.5 mg of norgestrel.

Klimonorm. Calendar pack of 21 tablets: 9 yellow tablets containing 2 mg estradiol valerate and 12 turquoise tablets containing 2 mg estradiol valerate and 0.15 mg levonorgestrel.

Triphasic drugs for HRT are Trisequens and Trisequens-forte. Active substances: estradiol and norethisterone acetate.

To monocomponent drugs for oral administration include: Proginova-21 (calendar pack with 21 tablets of 2 mg of estradiol valerate and Estrofem (tablets of 2 mg of estradiol, 28 pieces).

All of the above remedies suggest bleeding, reminiscent of menstruation. This fact confuses many women in menopause. In recent years, continuous-acting preparations Femoston and Livial have been presented in the country, with the use of which spotting either does not occur at all, or after 3-4 months the intake is stopped.

Thus, menopause, being a normal phenomenon, lays the foundation for many pathological conditions. The most noticeable change in menopause is the extinction of ovarian function. A decrease in estrogen levels contributes to aging. That is why the effect of hormone replacement therapy on the female body is being actively studied. It would be naive to think that all the troubles of aging can be eliminated by hormonal means. But it should be recognized as unreasonable to refuse the great possibilities of hormone therapy to preserve the health of women in menopause.

Menopause I Climacteric period (Greek klimakter stage; age transition period; synonym:, menopause)

the physiological period of a person's life, during which, against the background of age-related changes in the body, involutional processes in the reproductive system dominate.

Menopause in women. In menopause, premenopause, menopause and postmenopause are distinguished. Premenopause usually begins at the age of 45-47 years and lasts 2-10 years until menstruation stops. The average, in which the last () is noted, is 50 years. Early menopause before the age of 40 and late - over the age of 55 are possible. The exact date of menopause is set retrospectively, not earlier than 1 year after the cessation of menstruation. Postmenopause lasts 6-8 years from the moment of cessation of menstruation.

The rate of development of K. p. is determined genetically, but such factors as the state of health of a woman, working and living conditions, nutritional characteristics, can influence the time of onset and course of different phases of K. p. for example, women who smoke more than 1 pack of cigarettes a day go through menopause on average 1 year 8 months. earlier than non-smokers.

Age-related changes lead to the cessation of reproductive and a decrease in the hormonal function of the ovaries, which is clinically manifested by the onset of menopause. Postmenopause is characterized by progressive involutional changes in the reproductive system. Their intensity is much higher than in premenopause, since they occur against the background of a sharp decrease in estrogen levels and a decrease in the regenerative potential of target organ cells. In the first year of postmenopause, the size of the uterus decreases most intensively. By the age of 80, the size of the uterus, determined by ultrasound, is 4.3 × 3.2 × 2.1 cm. The mass of the ovaries by the age of 50 decreases to 6.6 G, by the age of 60 - up to 5 G. In women over 60, ovarian weight is less than 4 G, volume about 3 cm 3. The ovaries gradually shrivel due to the development of connective tissue, which undergoes hyalinosis and sclerosis. 5 years after the onset of menopause, only single follicles are found in the ovaries. There are atrophic changes in the vulva and vaginal mucosa. Thinning, fragility, slight vulnerability of the vaginal mucosa contribute to the development of Colpitis .

In addition to these processes in the genital organs, changes occur in other organs and systems. One of the main reasons for these changes is a progressive deficiency of estrogens - hormones with a wide biological spectrum of action. Atrophic changes develop in the muscles of the pelvic floor, which contributes to the prolapse of the walls of the vagina and uterus. Similar changes in the muscle layer and mucous membrane of the bladder and urethra can cause urinary incontinence during physical exertion.

Prevention of complications K. p. includes the prevention and timely diseases of various organs and systems - cardiovascular diseases, diseases of the musculoskeletal system, biliary tract, etc. Importance is attached to physical exercises, especially in the fresh air (, skiing, jogging), dosed in accordance with the recommendations of the therapist. Useful walking. In connection with meteorological lability and peculiarities of adaptation for recreation, it is recommended to choose zones whose climate does not have sharp differences from the usual one. Obesity deserves special attention. The daily diet for women in excess of body weight should contain no more than 70 G fats, incl. 50% vegetable, up to 200 G carbohydrates, up to 1 1/2 l liquids and up to 4-6 G table salt with a normal protein content. Food should be taken at least 4 times a day in small portions, which contributes to the separation and evacuation of bile. To eliminate metabolic disorders, hypocholesterolemic agents are prescribed: polysponin 0.1 G 3 times a day or cetamiphene 0.25 G 3 times a day after meals (2-3 courses for 30 days at intervals of 7-10 days); hypolipoproteinemic drugs: linetol 20 ml(1 1/2 tablespoons) per day after meals for 30 days; lipotropic drugs: 0.5 each G 3 times a day before meals or 20% solution of choline chloride, 1 teaspoon (5 ml) 3 times a day for 10-14 days.

In Europe and North America, women in K. p. are widely prescribed estrogen-progestin drugs to compensate for hormonal deficiency and to prevent age-related disorders associated with it: uterine bleeding, fluctuations, vasomotor disorders, osteoporosis, etc. Epidemiological studies conducted in these countries have shown that the risk of developing endometrial, ovarian and breast cancer in women taking estrogen-progestogen drugs is lower than in the general population. In the USSR, a similar method of preventing the pathology of K. p. is not accepted, these funds are used mainly for therapeutic purposes.

Menopause in men occurs more often at the age of 50-60 years. Atrophic changes in testicular glandulocytes (Leydig cells) in men of this age lead to a decrease in testosterone synthesis and a decrease in the level of androgens in the body. At the same time, the production of gonadotropic hormones of the pituitary gland tends to increase. The rate of involutional processes in the gonads varies considerably; conditionally it is considered that K. the item at men comes to an end approximately to 75 years.

In the vast majority of men, the age-related decline in the function of the gonads is not accompanied by any manifestations that violate the general habitual state. In the presence of concomitant diseases (for example, vegetovascular dystonia, hypertension, coronary heart disease), their symptoms are more pronounced in K. p. Often, the symptoms of these diseases are mistakenly regarded as menopause. The possibility of a pathological course of K. p. in men is discussed. A number of researchers believe that with the exclusion of organic pathology, certain cardiovascular, neuropsychiatric and genitourinary disorders can be attributed to the clinical manifestations of pathological menopause. Cardiovascular disorders characteristic of pathological menopause include sensations of hot flashes to the head, sudden redness of the face and neck, pain in the heart, shortness of breath, increased, dizziness, and an intermittent increase in blood pressure.

Among the manifestations of dysfunction of the genitourinary organs, there are also violations of the copulatory cycle with a predominant weakening of erection and accelerated ejaculation.

A gradual decrease in sexual potency is observed in K. p. in most men and, in the absence of other manifestations of pathological menopause, is considered a physiological process. When evaluating sexual function in men in K. p., it is also necessary to take into account its individual characteristics.

Treatment of pathological menopause is usually carried out by a therapist after a thorough examination of the patient with the participation of the necessary specialists and the exclusion of the connection of existing disorders with certain diseases (for example, cardiovascular, urological). It includes the normalization of the regime of work and rest, dosed physical activity, the creation of the most favorable psychological climate. An obligatory component of treatment is. In addition, prescribe means that normalize the function of the central nervous system. (sedatives, psychostimulants, etc.), biogenic stimulants, drugs containing antispasmodics. In some cases, anabolic is used; in order to normalize the disturbed endocrine balance, preparations of male sex hormones are used.

Bibliography: Gynecological, ed. K.N. Zhmakina, p. 396, M., 1988; Gynecological disorders, ed. K.J. Powerstein, . from English, p. 510, M., 1985; Dilman V.M. Endocrinology, p. 140, M., 1983; Krymskaya M.L. Menopause, M., 1989; Smetnik V.P., Tkachenko N.M. and Moskalenko N.P. , M., 1988; Tiktinsky O.L., Novikov I.F. and Mikhailenko V.V. Diseases of the genital organs in men, L., 1985; Yunda I.F. and human health, Kyiv, 1985.

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what the "menopausal period" is in other dictionaries:

A period in a woman's life characterized by the cessation of menstruation. It comes about 45 years of life. Accompanied by a tendency to obesity. Depends on the cessation of maturation of eggs in the ovaries. Dictionary of foreign words included in the Russian ... ... Dictionary of foreign words of the Russian language

- (Greek klimakter stage, a turning point; synonyms for menopause, menopause), a physiological period in a person’s life, characterized by the reverse development of the sexual sphere (see. Sexual involution), occurring against the background of general age ... ... Sexological Encyclopedia

- (menopause) the period of life during which the cessation of reproductive function occurs, is characterized by a gradual cessation of menstrual function, and then the hormonal function of the ovaries against the background of general age-related changes in the body. ... ... medical terms

Menopause- (Greek klimakter - step, turning point). The period of life, characterized by the cessation of the generative function. In some cases, it proceeds with endocrine, vegetative-vascular and mental disorders (Kp pathological, menopausal ... ... Explanatory Dictionary of Psychiatric Terms

The postmenopausal period is the final, third stage of menopause. It, in turn, is divided into early and late. After the extinction of the reproductive function, aging of the body becomes inevitable. It is accompanied by many unpleasant physiological and psychological symptoms, which are more or less familiar to all women. Fortunately, this difficult condition can be alleviated with simple and effective methods.

The postmenopausal period (postmenopause) is fixed 12 months after the last menstruation, and it lasts about a decade. There is no clear time frame, as well as a strict norm for the age of a woman. Individual characteristics and genetics largely determine these indicators.

The main signs of menopause begin to manifest changes in the body associated with a decrease in the functioning of the ovaries:

• with accompanying excessive sweating;
• mood swings, unstable emotional state;
• , headaches and others.

The climacteric syndrome of the initial and final stages are different. With postmenopause, hormonal restructuring ends, and the amount of estrogen in the body becomes fixedly small, which affects the operation of literally all systems. In rare cases, when a woman's health is poor, they remain in the postmenopausal period.

Women's problems in postmenopause

The postmenopausal period is, first of all, aging. The body at this stage is tired, worn out, the range of its abilities is significantly narrowed, and overall well-being is deteriorating. By the end of menopause, female hormones such as estradiol, estradnom and estriol become less than male ones.

Bone, cardiovascular, nervous and excretory systems function normally if there are enough of them, respectively, during postmenopause, failures are observed in their work.

Typical problems that await a woman in the postmenopausal period:

1. risk of osteoporosis. Due to the decrease in estrogen, bone tissue becomes more fragile. This also explains the frequent bone fractures in women over 60.
2. The condition of hair, nails and teeth worsens.
3. Problems of the cardiovascular system. The walls of blood vessels become thin and inelastic, which affects blood circulation and high blood pressure. Significantly slow metabolism affects the increase in cholesterol, which forms blood clots. The latter, in turn, can lead to ischemic diseases, angina pectoris, and cardiac arrhythmias.
4. Vision is deteriorating, hearing is getting worse.
5. Thought processes slow down, memory worsens.
6. Unstable emotional state, nervousness, tantrums.
7. . May be bothered by itching. Warts appear and hairiness on the face and body increases.
8. A reduced amount of secretion secreted by the genitals affects their microflora. In conditions of insufficient amount of protective mucus, it is easier to get sick with sexual infections or inflammatory diseases. Colpitis (vaginitis, inflammation of the vaginal mucosa) and cystitis are frequent companions of women at this time.
9. The presence at the final stage is a very alarming sign. They indicate a high level of estrogen in the body, which is considered an anomaly at this age. The most common cause of this phenomenon is the development of breast, cervical or ovarian cancer. Danger is also any opaque discharge with a smell.
10. Urinary incontinence, which occurs for two reasons: prolapse of the pelvic organs and rapid weight gain.

Postmenopausal syndrome develops differently for everyone. It is most pronounced in women who are too thin or too fat, smoke or abuse alcohol, have physically or emotionally hard work, and experience frequent stress.

The most important thing that a postmenopausal woman can do for herself is to comprehensively improve her lifestyle. To alleviate your condition, you must:

1. Follow a diet appropriate for your age. This is a kind of healthy balanced diet, the diet of which must necessarily include foods containing useful Omega acids: red fish, nuts, healthy vegetable oils, flax seeds, sesame, chia. Dairy and sour-milk products are also needed, which are indispensable for maintaining the condition of bone tissue. To speed up the metabolism, you need to eat fresh fruits and vegetables according to the season, and to form muscle tissue - lean meats, all types of sea fish, seafood. The diet includes cereals and whole grain flour products in limited quantities.
2. Use an additional source of essential trace elements. Usually these are vitamin complexes with calcium and vitamin D. It is recommended to use it as directed by a doctor after a blood test.
3. Avoid nervous strain, hard work.
4. Ensure yourself a healthy sleep and leisure full of positive impressions.
5. Introduce regular physical activity. Walking long walks, yoga, meditation, respiratory exercises, aerobic exercise, if health permits, will be ideal.
6. If necessary, use hormonal therapy. Gynecologists often prescribe them during menopause. These are estrogen substitutes that can be used internally or topically. Oral intake of these drugs helps to normalize hormonal levels. External application is effective for eliminating itching in the genital area.

The presence of postmenopausal women's problems should not affect the attitude to life. It continues, and it makes sense to enjoy it by doing things for which there was not enough time before.

The postmenopausal period is accompanied by the extinction of ovarian function. A decrease in estrogen in the blood causes a complete restructuring of the body, accompanied by the occurrence of unpleasant symptoms and diseases. Consultation with a doctor, appointment of treatment will help a woman survive this difficult time.

Postmenopausal period in women - what is it?

Changes in a woman's body are reflected both in her appearance and in her internal state. The development of possible diseases and the approach of old age causes fear.

With the onset of 45 years of age, a gradual extinction of the reproductive function of a woman occurs, menstruation disappears, and the size of the uterus and ovaries decreases. A decrease in estrogen levels, changes in the functioning of the hypothalamus lead to unpleasant neurovegetative and psychosomatic symptoms. The postmenopausal period begins from the moment of the absence of menstrual flow and ends after the full adaptation of the body. There is no clear time frame, genetics and individual characteristics determine this indicator. At this time, a woman is faced with hot flashes, excessive sweating, insomnia, psycho-emotional disorders, and pain in the limbs.

The period after menopause and hormones

The hormonal function of the ovaries begins to restructure long before the last menstruation. Cyclic changes are due to the development of follicle resistance to FSH with a decrease in inhibin secretion. In the postmenopausal period, progesterone is not produced in women, estrogen production decreases, which is accompanied by hormonal imbalance. In some of the fair sex, this stage is asymptomatic, while others experience pain in the lower abdomen, dizziness.

The female body produces more than 70 types of hormones, estrogens are responsible for the restructuring in menopause.

During menopause, estradiol, estriol and estrone are synthesized in the adrenal glands and adipose tissue. After the onset of menopause, the amount of the former decreases, and the latter increases, which leads to an increase in male hormones in the female body. When analyzing blood, the indicators should correspond to the following level: the amount of estradiol 10-20 lg / ml, estrol 30-70 lg / ml, androstenedione 1.25 to 6.3 nmol / l, testosterone 0.13 to 2.6 lg / ml.

Postmenopausal period in women: symptoms and treatment of pathologies

Memory problems, dry skin, forgetfulness, inability to concentrate are associated with a decrease in estrogen levels. Some symptoms may impair performance.

Upon reaching menopause, the restructuring of the hormonal background comes to an end, the number of estrogens becomes extremely small, which affects the functioning of all systems, is accompanied by the appearance of deep wrinkles, a violation of the hair structure, loss of tone and elasticity of the skin. Metabolic disorders, constipation, problems with motor coordination, difficulties with the thought process, nervousness, insomnia, depression in the postmenopausal period are symptoms that require a visit to a doctor.

Postmenopausal period in women: symptoms that indicate the development of diseases

Treatment in the postmenopausal period is required for:

• Increased risk of cardiovascular disease - rapid heartbeat, rhythm disturbances, high blood pressure (hypertension); the walls of blood vessels become thin and inelastic, which affects blood circulation; slow metabolism provokes an increase in cholesterol, which forms blood clots, so there is a possibility of developing angina pectoris, coronary heart disease.
• Risks of osteoporosis - a decrease in the amount of estrogen affects bone tissue; it becomes brittle, so fractures become more frequent.
• The development of Alzheimer's disease, which is accompanied by a decrease in memory, followed by progressive dementia.

There are also problems in the gynecological area - in the post-menopausal period in women, discharge with blood is an alarming sign of elevated estrogen levels, which can lead to cancer of the breast, cervix, and ovaries. Any opaque discharge with a smell is also dangerous.

With minor deviations, it is necessary to consult a doctor, because many diseases at the initial stage are masked and practically asymptomatic.

Postmenopausal period: treatment and elimination of symptoms

To reduce the intensity of symptoms, eliminate the likelihood of diseases, it is necessary to review the diet and include yoga in the daily routine.

A comprehensive change in life will help a woman improve her condition during such a period. An age-appropriate diet must be followed. A balanced diet should include foods that contain beneficial omega acids. They are found in nuts, red fish, flax seeds, sesame seeds. To maintain bone tissue, you need to consume dairy and sour-milk products. Fresh fruits and vegetables will help speed up your metabolism. The diet includes cereals and whole grain flour products.

Avoiding stressful situations, the absence of overstrain at work will help ensure a healthy, sound sleep. Hiking, regular exercise, yoga and breathing exercises can improve well-being.

By quitting smoking, you can reduce the risk of breast cancer by 1/3.

If the symptoms interfere with leading a fulfilling life, doctors prescribe hormone replacement therapy, which normalizes the hormonal background.

Why should you see a doctor?

Menopause is not a disease, but a natural process in a woman's body. If symptoms occur, it is necessary to consult a doctor in order to undergo a diagnosis and identify possible risks of diseases. Gynecological examination, ultrasound will help determine the condition of the external genitalia, ovaries. As a result of hormonal studies, the doctor will determine the need for hormone replacement therapy. You can make an appointment for a consultation or appointment with a doctor.

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It is extremely important for women to know everything about their health - especially for primary self-diagnosis. This rapid test will allow you to better listen to the state of your body and not miss important signals in order to understand whether you need to contact a specialist and make an appointment.

As women age, hormonal changes occur naturally. But many women are afraid of menopause, because there is an opinion that menopause is always malaise, hot flashes, loss of emotions from intimate relationships. Is it so? Or is the menopausal period just the next stage in a woman's life and development? What is the menopausal condition of a woman, when does it occur and how does it manifest itself, what treatment is indicated during menopause, read below.

What is menopause in women

Menopause is the natural state of a woman when she reaches a certain age. Every woman has a certain formed stock of eggs in the ovaries. The ovaries produce the female hormones estrogen and progesterone, which regulate female reproductive function, and as a result, ovulation and menstruation occur cyclically every month. When the supply of eggs is used up, menstruation stops, hormone production decreases significantly and menopause begins.

Symptoms

A woman should know information about how the menopause manifests itself, what hot flashes are. It is important to be able to get rid of hot flashes quickly so as not to feel discomfort in public, in the office, etc. As a rule, they manifest themselves in a sensation of unexpected heat, which lasts for several minutes and is replaced by a feeling of cold, perspiration appears on the woman's body - this is a reaction of the nervous system to a decrease in hormone production. Washing with cold water helps to relieve an attack of heat, if this does not help, you need to choose a medicine with the help of a doctor.

Other possible signs of the onset of menopause:

• irregular menstruation;
• uterine bleeding;
• sudden mood changes;
• heartbeat quickens;
• pressure surges;
• nausea;
• headache;
• pain in the joints and muscles;
• dryness of the vagina;
• decrease in sexual desire;
• fast fatiguability;
• sleep disorder;
• neurosis;
• depression may develop.

When it comes

At what age and how does menopause begin? After 40 years, women enter premenopause: rare or frequent menstruation is observed, dysfunctional bleeding is possible, the development of menopausal cardiopathy, spotting spotting is possible between menstruation. It is important to know why this period is dangerous: changes in the body can be symptoms of gynecological diseases, such as uterine fibroids. A menopause test will help confirm the onset of premenopause. A stable basal temperature also indicates the onset of a menopause period.

Nevertheless, there is no unambiguous answer to the question of how old a woman begins menopause, because genetic factors, working conditions, climate, lifestyle, and the presence of bad habits influence the onset of menopause. But in most women, menopausal changes begin after 45 years, if after 50 years it is a late menopause. Today, many specialists in gynecology are inclined to believe that late menopause should be called its onset after 55 years.

A common occurrence these days is an early menopause. The causes of early menopause, which can begin at the age of 30, are heredity, immunity disorders, or the results of medical intervention. Premature menopause in exceptional cases can occur even at 25 years of age as a result of damage to the ovaries after chemotherapy or surgical removal of the ovaries for medical reasons. But such a menopause is pathological and necessarily requires treatment in order to even out the hormonal failure of the female body at a young age.

How long is menopause

In menopause, the phases of premenopause, menopause and postmenopause are distinguished. How long does hormonal changes in the body take?

• Premenopause lasts 2-10 years, until menstruation stops.
• Menopause occurs 1 year after the cessation of menstruation.
• The postmenopausal period begins at the onset of menopause and lasts 6-8 years, during which time the symptoms of menopause - such as hot flashes - may persist, but are easier.

Treatment for menopausal syndrome

To alleviate the manifestations of menopause, you need to know what to take when a headache pesters, how to relieve hot flashes or other unpleasant symptoms, and stop uterine bleeding. One of the commonly used drugs in the treatment of menopausal syndrome is homeopathic tablets "Remens". A woman, after consulting a doctor, will be able to choose which means it is better for her to use.

homeopathic medicines

Homeopathy for menopause offers remedies in the form of tablets or drops. In the menopause, a whole range of health problems are manifested, which are based on vegetovascular symptoms - hot flashes, excessive sweating, palpitations, and psycho-emotional - irritability, insomnia, increased fatigue. It is possible to solve a complex of problems with menopause due to the natural components in the composition of the drug Klimaktoplan. The action of the drug is aimed at eliminating two main problems: manifestations of autonomic dysfunction and neuro-emotional discomfort. The drug is of European quality, does not contain hormones, is available without a prescription, is well tolerated, and is produced in Germany.

Folk remedies

Traditional medicine recipes are often shared by women based on their experience. To maintain physical tone and good mood, water procedures are good - soothing herbal baths (Potentilla root, lovage). For the prevention of general health, teas and decoctions from medicinal plants are used: chamomile, mint, pine forest, nettle, hawthorn. For optimal well-being during this transitional period, you need to plan your daily routine, eat right, and fully relax.

Hormonal drugs

Hormone therapy is used only after a medical examination of a woman and as prescribed by a doctor, since it has a number of contraindications. But if complications such as obesity, osteoporosis, cardiovascular diseases occur during the menopause, additional hormone intake is necessary. Doses of hormones contained in the preparations "Klimonorm", "Femoston", "Kliogest" replace the missing production of the body's own hormones.

Phytopreparations

With menopause, plant-based medicines are also used, for example, Inoklim, Klimadinon, Feminal, and in addition, vitamin-mineral complexes can be used alone or as part of hormone therapy. The composition includes phytoestrogens - substances similar in structure and function to female sex hormones, but phytohormones have a much less pronounced effect on the female body. Vitamins and trace elements have a strengthening function and help to remove the negative manifestations of age-related metabolic disorders.

vitamins

A woman is always pleased to know that she is taken care of. It's even nicer to feel it. In the field of women's well-being, Lady's Formula Menopause Enhanced Formula has proven itself ideally. A well-known complex of traditional vitamins, the most important minerals and extracts of rare medicinal plants effectively helps women cope with the problems that arise during menopause. Thanks to a comprehensive approach to the elimination of menopausal symptoms, gentle effects and the absence of side effects, Lady's Formula Menopause Enhanced Formula has become the drug of choice for many women to maintain a high quality of life during this period.

When you take Lady's Formula Menopause Enhanced Formula, you will no longer be bothered by hot flashes, tachycardia, irritability, insomnia, you will say "no" to excess weight and frequent urge to urinate. In addition, you will enjoy a healthy, fresh complexion and elasticity of the skin, shine and strength of the hair.

Lady's Formula Menopause Strengthened Formula step by step restore high vitality, good health and great appearance.

What is premenopause

The premenopausal period is the period of transition to menopause, during which a woman's level of estrogen produced by the ovaries decreases over several years. Harbingers of premenopause:

• delayed menstruation;
• exacerbation of premenstrual syndrome, a sudden change in mood;
• painful sensitivity of the mammary glands;
• itching and dryness of the vagina, discomfort during intercourse;
• decrease in sexual desire;
• frequent urination;
• urinary incontinence when sneezing or coughing.

Doctors diagnose the premenopausal period based on the symptoms that a woman has and on the basis of a blood test for hormone levels, which must be taken several times due to unstable hormonal levels during this period. Premenopause is a natural state for women in their 40s and 50s, continuing until menopause, when the ovaries stop producing eggs.

Pregnancy with menopause

Is it possible to get pregnant during menopause? Yes it is possible. The childbearing function of a woman during the premenopausal period is significantly reduced, but there is a chance of pregnancy. If this turn of fate is undesirable, it is necessary to continue the use of contraceptives for 12 months after the last menstruation. But sex after menopause is still able to bring bright colors to a woman's life, and sex life should by no means end in the postmenopausal period.