The climacteric period in women and men is short. Menopause and menopausal syndrome: what happens in a woman’s body? Precursors, hot flashes, symptoms and manifestations, diagnosis of menopause (menopause)

23.06.2020 -

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Northern State Medical University

Department of Secondary Vocational Education

Course: Adulthood

Topic: Menopause in men and women

Completed by Lashina V.P.

1st year student, 2nd group LD

Arkhangelsk 2014

Introduction

1. What is menopause?

Conclusion

References

Introduction

The climacteric period as a whole can be considered as a period of complex age-related restructuring, primarily of neurohumoral regulation associated with the decline of reproductive function. The menopausal period occurs in both women and men, but in men it occurs later and develops more slowly. In women, the menopausal period occurs earlier, more acutely, and is much more pronounced, which makes it easier to study.

The occurrence of menopause and the development of age-related pathological processes caused by and depends on common factors, i.e. are united by one mechanism - the aging mechanism. Despite significant progress achieved in the study of the problem of aging, due to the great complexity of the problem, many unclear questions remain and there are still no generally accepted ideas about the laws age-related changes. Due to the commonality of developmental mechanisms and the brightness of manifestations, the menopausal period is a convenient model for studying these patterns; analysis of the processes occurring during the period of age-related adjustment allows us to establish why the body changes with age.

With age, both men and women experience menopause, I will talk about its causes, symptoms and treatment in my essay.

1. What is menopause?

Menopause, menopause, climacteric period (from the Greek klimakter - step of the ladder, age-related turning point) is a period in the life of a biological individual, characterized by involution, the extinction of the function of the reproductive system, occurring in connection with age-related changes.

Menopause occurs differently in men and women: women: 40 - 50 years, men - 50 - 60.

In terms of severity, menopause occurs differently in both sexes; for women it is more painful. Women lose their reproductive function.

2. Menopause in men and women

2.1 Menopause in men

According to the andrologist, menopause is a natural stage in the life of every person. Due to a decrease in the level of the main male hormone - testosterone, there is a gradual transition from puberty to the decline of sexual function. Doctors call this andropause, or male menopause. It begins around 50-60 years of age.

As a man ages, natural changes occur in one of the most important parts of the brain - the hypothalamus. It is he who regulates the activities of the main endocrine gland- pituitary gland. As a result, the production of hormones by the pituitary gland that stimulate the activity of the male gonads - that is, the testicles - is disrupted. They also age, because the tissue is gradually replaced by connective and fatty tissues.

2.1.1 Causes of menopause in men

As a result of changes in the functioning of the gonads in the male body, the function of producing the androgen hormone decreases. As a rule, menopause in men occurs between the ages of 40 and 60 years. It can be recognized or not, but you can’t argue with nature - irreversible changes occur in the testicles.

Male menopause can also simply be called the physiological process of aging of the body. That is, a natural process. The alarm should be sounded when male menopause is accompanied by severe deterioration in health, if it occurs before 45 years of age (early) or after 60 years of age (late).

However, late menopause is not scary, the man is even glad that he is more long term remains young in every sense of the word. Particular concern should be caused by pathological menopause, which is accompanied by changes in the functioning of the genitourinary and cardiovascular systems of the body. Neurotic disorders may also be associated with this condition.

Also, the male hormone testosterone has an important mission: it regulates the activity of the testicles, their appendages, seminal vesicles and prostate gland. Stimulates sperm production and even determines libido, sexual arousal and orgasm intensity.

Various diseases accelerate and complicate anthropause. At hypertension, atherosclerosis, sugar debit and alcoholism, old age takes a man unexpectedly and makes itself felt fully.

2.1.2 Symptoms of menopause in men

The symptoms of menopause in men and women are very similar. The main ones are: rapid heartbeat; dizziness; “hot flashes”, in which the skin of the face and hands turns red; differences are possible blood pressure, which threatens the development of hypertension.

It should be noted that with physical exertion and psycho-emotional changes, all these symptoms appear more clearly, and their consequences can be more severe.

But the most important thing is that most men (up to about 90%) note a decrease in libido. Some men gradually lose potency, sexual intercourse becomes shorter, ejaculation occurs faster, and sperm volume decreases. Representatives of the stronger half of humanity endure all this very painfully. And, as you know, strong emotional experiences only aggravate the situation - at least, excessive excitement has never made a single sexual act better.

Manifestations of menopause can also include a change in a man’s appearance - the appearance of loose skin and muscles, fat deposits on the hips and buttocks, and sometimes even enlargement of the mammary glands. But, of course, all men experience the symptoms of menopause very individually.

2.1.3 Treatment of menopause in men

The appearance of symptoms signaling the presence of menopause should provoke a man to think about a healthy lifestyle. This may be trivial, but sufficient rest, an active lifestyle, movement, walks fresh air, proper nutrition and weight control - all this contributes to good health.

In addition, you must undergo an examination by a doctor. After all, the presence of unpleasant symptoms can signal not only problems in the sexual sphere. Diseases of the cardiovascular system also cannot be left to chance.

In addition, the doctor may prescribe special examination, in particular, ultrasound of the prostate, as well as a blood test revealing prostate-specific antigen. Based on the results of the examination, in addition to recommendations on a correct lifestyle, a man may be prescribed drug therapy, including antidepressants or sedatives, biogenic adaptogens and hormonal drugs.

2.2 Menopause in women

During menopause, the female body is functionally reorganized to new way: Now the conception and birth of a child is no longer part of his “responsibilities”, so the woman’s reproductive system is gradually fading away. The ovaries are preparing to resign, which is facilitated by hormonal changes in the body - less and less estrogen is produced. Once menopause ends, the possibility of pregnancy will forever be a thing of the past. Therefore, many women tolerate it very hard.

Menopause is considered the beginning of a woman’s aging and withering, which in reality is not entirely true. With the right approach and attitude to the issue, as well as with advance preparation for the upcoming changes, a woman is able to experience all the charm of life at this time. Psychological attitude plays a big role.

As a natural biological process, menopause is inevitable: any woman who has lived to this age is “doomed” to survive this time. But how to survive is a question that largely depends on each of us. And you need to start preparing for the inevitable from a young age.

Menopause does not come suddenly, although many people think so. It develops and gains momentum gradually, moving from one manifestation to another.

Experts talk about 3 periods of menopause:

· premenopause – when certain disorders and disorders begin to appear, one of the most significant of which is considered to be a disruption in the regularity of the menstrual cycle; reproductive function gradually fades away, but pregnancy is still possible, so you cannot stop using protection;

· menopause—marked by the onset of the last menstruation in a woman’s life. Menopause is said to occur when no menstrual-like discharge is observed for 12 consecutive months;

· postmenopause - occurring after menopause, that is, after a year from the last menstruation, and lasting until the complete cessation of ovarian function.

The entire menopausal period lasts approximately 10-15 years.

All women experience menopause at at different ages and may have individual differences in manifestations and duration. However, for many centuries, medical scientists have noted that on average this turning point occurs between the ages of 45 and 55 years.

There is also a special type of menopause - artificial or surgical, caused by surgical removal ovaries and/or uterus at a young reproductive age.

2.2.1 Causes of menopause in women

From the moment of puberty until the moment of entering menopause, the female body undergoes multiple changes every month. Regularly in female ovaries the follicle matures, from which an egg ready for fertilization is “born” and released into abdominal cavity waiting for sperm. Until this moment, all the forces of the female body are directed towards creating conditions favorable for the maturation of the egg: maintaining optimal temperature conditions, the required level of humidity, etc.

Simultaneously with ovulation, the body adjusts to further protect the egg, theoretically fertilized after its release. Now conditions are being created to maintain the vital activity of the fertilized egg and provide it with the opportunity to successfully implant in the uterine cavity. If conception does not take place, then the female body receives the command “lights out” and begins preparing for the next cycle: begins menstrual bleeding, after which the attempt to realize herself as a mother is repeated again.

All the described processes occur under the constant guidance of hormones and under their strict control.

It’s simply amazing, but nature also provides for the natural completion of this persistent cyclical repetition: the birth of a child at a mature and old age is not only unnatural, but also unsafe - both for the woman and for the offspring. This is why the ability to conceive and bear children (reproductive function) declines over the years, which is called the menopause.

The main reason for the onset of menopause is, perhaps, a decrease in the production of sex hormones and the resulting change hormonal levels women. This process begins from the departments of the central nervous system, where all natural processes are programmed.

The onset of menopause is determined genetically, but the course of this period very much depends on how the woman took care of her health throughout her life and what condition it was in when she entered menopause.

2.2.2 Symptoms of menopause in women

The most pronounced and characteristic symptoms appear in the first phase of menopause - premenopause. These are changes not only at the physiological, but also at the mental level.

It can all start with a general malaise, which recurs with varying regularity and manifests itself with a different set of symptoms. Headaches are noted, weakness and dizziness are felt, work ability decreases, insomnia appears, and blood pressure surges are observed, usually upward.

The most striking symptom accompanying menopause is the so-called hot flashes, when the skin of the upper body - the face, neck, chest, back of a woman's head - suddenly turns red due to a sudden onset of heat. Hot flashes are accompanied by a rapid increase in body temperature (with a subsequent decrease), chills, profuse sweating, migraines, difficulty breathing, increased heart rate and even attacks of panic and fear - this condition persists for several minutes and disappears just as suddenly. The most frightening and exhausting thing is the tides that roll in at night. In general, they can occur several dozen times a day, truly weakening a woman.

Among the most common accompanying menopause, there are also a number of disorders, diseases and syndromes associated with the functioning of the limbs. Rheumatism, arthrosis wake up, numbness, tingling, trembling or pain is felt in the arms and legs. In the longer term, many women will experience osteoporosis if they have not taken care of regular calcium replenishment throughout their lives.

At the same time, the nervous system suffers, not only of the lady, but also of everyone around her. The established stereotype that a woman menopause characterized by increased irritability, anxiety, and often downright unbearable nervousness and suspicion and is subject to sudden, causeless mood swings, which has a well-founded basis.

Changes in sexual life, of course, also do not go unnoticed. First of all, transformations in the woman’s genital organs are observed: the labia (like the entire mucous membrane) become thinner and dry, the vagina narrows and itches, sexual intercourse becomes painful and often does not bring satisfaction, despite the fact that sexual desire during this period may noticeably increase . However, much more often a woman’s sexual libido decreases, rather than increases.

There are also genitourinary disorders: discomfort and pain in the bladder (in particular during urination), urinary leakage and incontinence, prolapse of the pelvic organs and others.

On top of that, the woman begins to suffer from dramatic changes in her appearance. It seems that the skin has dried out and become wrinkled in just one day, and the life preserver on the former waist has grown after another. Some women also develop mustaches. upper lip or acne on the face.

While female sex hormones are produced in sufficient quantities, they support the preservation of the figure and ensure the distribution of fat according to the female type - with an emphasis on the chest and hips. Ironically, women value this feature little, until the situation turns upside down: when male sex hormones gain privilege, fatty tissue begins to be redistributed according to the male type, going to the sides and abdomen. Over the course of this process, not only the figure disappears, but along with it the breasts: the glandular tissue in it is replaced by connective and fatty tissue, which is why the breasts lose their elasticity and noticeably sag.

Regarding overweight, then during menopause it also appears due to changes chemical reactions in the body. Due to the insufficiency of female sex hormones (estrogens), they have to be “extracted” from male hormones (androgens), and this complex process can only occur in adipose tissue, which is why the “field for activity” in the form of fatty deposits is so diligently prepared.

2.2.3 Treatment of menopause in women

The most correct thing, of course, would be to prevent a severe menopause. This can be done, among other things, with the help of natural phytohormonal preparations or dietary supplements containing female plant hormones. But if things do get to the point of severe menopause, then the woman is unlikely to be able to cope without the help of doctors. Treatment of menopause will not only reduce the violent manifestation of symptoms, but will also help the body prolong its period of youth.

Doctors always emphasize that menopause is not a disease, but only a natural stage in the evolution of the female body, as inevitable as, say, transition adolescence. And yet, treatment of menopause is a necessity, because the so-called climacteric syndrome(a set of signs characteristic of this period) significantly worsens a woman’s quality of life.

Treatment of menopause can and should only be carried out by specialists, since it is very specific and requires a special approach. A woman should definitely contact a gynecologist-endocrinologist, who deals with such issues, as well as a mammologist. This should be done already at the age of 40-45 to carry out preventive examinations: than formerly a woman begins to take care of herself, the easier she will enter the menopause and survive it with minimal damage to her health.

The main goal of treating menopause is to prevent a sharp drop in the level of sex hormones in a woman’s body, otherwise a malfunction in the functioning of the main organs and systems cannot be avoided. It can be achieved only with the help of hormone replacement therapy (HRT), which is recognized as the gold standard in the world of endocrine gynecology.

Can be used at the same time aids to eliminate pronounced painful symptoms: headaches, nervousness, depression, insomnia, uterine bleeding, leg pain and others.

IN complex treatment good effect Physiotherapy also demonstrates.

Conclusion

Menopause is not a death sentence. Everyone goes through this period in life. At the end of the menopausal period, new life. Women can devote more time to themselves, because the children have already grown up, their work experience has been completed, the “home” does not go out, and men, too, have more time for their hobbies.

To have an easier menopause in youth, you need to take care of your health: exercise, eat the right foods, give up bad habits.

menopause sexual involution age

References

1. Physiology and pathology of women’s menopause, L., 1965

2. Vikhlyaeva E.M., Climacteric syndrome and its treatment, M., 1966

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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 health worsens. By the end of menopause, female hormones such as estradiol, estradiol and estriol become fewer than male hormones.

The skeletal, cardiovascular, nervous and excretory systems function normally when they are in sufficient quantity; therefore, during postmenopause, disruptions are observed in their work.

Typical problems that await a woman during the postmenopausal period:

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.
The condition of hair, nails and teeth worsens.
Problems of the cardiovascular system. The walls of blood vessels become thin and inelastic, which affects blood circulation and high blood pressure. A significantly slower metabolism causes an increase in cholesterol levels, which forms blood clots. The latter, in turn, can lead to ischemic diseases, angina pectoris, cardiac arrhythmias.
Vision decreases, hearing becomes worse.
Are slowing down thought processes, memory deteriorates.
Unstable emotional state, nervousness, hysterics.
. Itching may be bothersome. Warts appear and hairiness increases on the face and body.
The reduced amount of secretion secreted by the genitals affects their microflora. In conditions of insufficient amount of protective mucus it is easier to get sexually transmitted infections or inflammatory diseases. Colpitis (vaginitis, inflammation of the vaginal mucosa) and cystitis are frequent companions of women at this time.
Availability at the final stage is very warning sign. They indicate high level estrogen in the body, which is considered an abnormality at this age. The most common cause of this phenomenon is the development of breast, cervical or ovarian cancer. Any opaque discharge with an odor is also dangerous.
Urinary incontinence, which occurs for two reasons: pelvic organ prolapse and rapid weight gain.

Postmenopausal syndrome develops differently for everyone. It is most clearly expressed in those who are too thin or too overweight women, smokers or abuse alcohol, have a physically or emotionally demanding job, and experience frequent stress.

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

Follow an age-appropriate diet. This is a kind of healthy balanced nutrition, whose diet must necessarily include foods containing healthy Omega acids: red fish, nuts, healthy vegetable oils, flax seeds, sesame seeds, chia. Also necessary are dairy and fermented milk products, which are indispensable for maintaining the condition of bone tissue. To speed up metabolism, you need to eat fresh fruits and vegetables in season, and to form muscle tissue- lean meats, all types of sea fish, seafood. The diet includes cereals and products from whole grain flour in limited quantities.
Use an additional source of essential microelements. Usually this vitamin complexes with calcium and vitamin D. It is recommended to use as prescribed by a doctor after blood tests.
Avoid nervous overstrain, hard work.
Provide yourself healthy sleep and leisure time full of positive impressions.
Implement regular physical activity. Ideal would be long walks, yoga, meditation, breathing exercises, aerobic exercise, if your health allows.
If necessary, use treatment with hormonal drugs. Gynecologists often prescribe them during menopause. These are estrogen substitutes that can be used internally or topically. Taking these drugs orally helps normalize hormonal levels. External application is effective in eliminating itching in the genital area.

The presence of women's problems characteristic of postmenopause should not affect one's attitude towards life. It continues, and it makes sense to enjoy it by doing things that you didn’t have time for before.

"Climax" translated from Greek means "stairs". At some point, due to the reverse development of the reproductive organs, a woman has to overcome this stage leading to extinction reproductive function. The hormonal changes that occur during menopause are a natural process and there is no need to be afraid of it.

Stages of menopause

Menopause is a period of life during which the functioning of the reproductive system ceases.

There are three stages of menopause in women:

Premenopause. It begins several years before the complete end of menstruation. The duration of the stage ranges from 1 year to 3 years. The functions of the ovaries gradually begin to fade, ovulation ends, and the process of conception becomes problematic. Irregular periods are observed. The interval between them increases, and the duration gradually decreases. The stage drags on.
Menopause. The period when a woman does not have periods for a year. At this time, a woman can gain a lot of weight, heart problems arise, and diabetes can develop. Menopause most often occurs between the ages of 45 and 50. Stopping menstruation before age 45 is considered early menopause, and before age 40 is considered premature.
Postmenopause. Time from the end of menopause to 69-70 years.

It is often believed that menopause and menopause are the same thing. However, menopause is defined as the loss of reproductive function, and menopause is a year without menstruation.

There are cases when menopause occurs unexpectedly, despite the fact that the woman planned to prepare for this stage. To avoid this situation, you need to know the symptoms of approaching menopause in women.

Symptoms

The table shows the main signs of impending menopause.

	Signs
Menstrual irregularities	With fading hormonal function ovaries, the duration of menstruation changes. They occur irregularly and sparingly. There can be an interval between menstruation of one to three months, and sometimes more. After a certain time, menstruation stops completely.
Tides	At such moments, the woman feels hot, which spreads to the face, neck, chest and arms. At this moment, the temperature rises, sweating and lack of air occur. The skin turns red or becomes blotchy. These symptoms may be accompanied by dizziness, nausea and tachycardia. The duration of hot flashes ranges from 30 seconds to 3 minutes.
Change of mood	In the premenopausal period, women experience disturbances in their psychoemotional state. They are expressed in aggressiveness, irritability, tearfulness, anxiety, and restlessness. For most women, such changes in mood appear before their period.
Change your appearance	Hormonal imbalance in the body leads to dull skin and hair loss. The nail plates become brittle, dry, and begin to peel.
Weight gain	Excess weight is not always a sign of menopause. Fatty, high-calorie foods also affect weight gain. Insulin resistance may develop. With age, muscles decrease and layers of fat increase.
Nocturnal hyperhidrosis	Manifests itself in severe sweating during sleep.
Vaginal dryness	With slowdown metabolic processes in the body there is a decrease in elasticity and tissue moisture. become loose and cracks appear. The pelvic organs may descend and fall out.
Insomnia	Peaceful sleep depends on the balance of estrogen and progesterone. A lack of the former leads to sweating, while the latter leads to insomnia.
Decreased libido	The first reason for decreased sexual desire is the unpleasant sensations that arise during sexual intercourse. The second is a decrease in the level of hormones responsible for sexual desire.
Heart problems	Low estrogen levels cause the development of heart disease during menopause in women.
Osteoporosis	Most dangerous symptom. Changes occur in bone tissue, characterized by its rarefaction and increased fragility. The risk of bone fractures increases. The woman feels increased fatigue and weakness.
Urinary incontinence	A deficiency of female hormones weakens the pelvic muscles and leads to sphincter relaxation. bladder
Muscle pain and headaches	During menopause, the tone of blood vessels changes, resulting in headaches. Muscle pain occurs when calcium metabolism is disrupted.
Memory problems	The reason is reduced level estrogen. When hormonal levels are normalized, the problem disappears.
Gynecological diseases	Affect the appearance of early menopause (primarily ovarian tumors).
Allergy	Its appearance is influenced by the connection between endocrine and immune systems. Hormonal changes may cause allergic rhinitis, asthma, dermatitis.

There are many more signs of the oncoming female menopause, but a woman should not be scared or worried about this. Timely consultation with a doctor and correct selection medicines will help alleviate the condition.

Complications of menopause

Not in all cases the normal course of menopause in women is observed. The following complications are possible during this period:

severe course of menopausal syndrome with disruption of work gastrointestinal tract, which causes a woman’s exhaustion;
pathological fractures (a symptom of osteoporosis);
breakthrough uterine bleeding due to hormonal imbalances;
endometrial hyperplasia;
development of uterine fibroids;
mastopathy, tumor-like formations of the mammary glands.

Due to the large number possible complications Regular preventative visits to the gynecologist are necessary.

Menopausal syndrome

This is one of the common problems of menopause. Menopausal syndrome is expressed in the occurrence of a complex of endocrine and neurological disorders. Symptoms of this syndrome include:

headaches, migraines, dizziness;
hot flashes to the head and upper body;
sudden mood swings;
insomnia;
exacerbation of existing chronic diseases;
disorders of the cardiovascular system;
hypertension, etc.

Taken together, these symptoms significantly worsen a woman’s quality of life and lead to decreased performance.

The severity of menopausal syndrome depends on the frequency of hot flashes. A mild degree is characterized by the occurrence of hot flashes up to 10 times over 24 hours; moderate – up to 20 times, severe – more than 20 times a day.

Causes of early menopause

Early menopause is called hormonal changes that begin before the age of 45. This may be due to a number of reasons:

ovarian depletion associated with a genetic abnormality (X chromosome defect);
inherited diseases (galactosemia, amenorrhea, blepharophimosis);
consequences surgical intervention– removal of fibroids along with the uterus, oophorectomy;
the effect of radiation and chemotherapy prescribed for the treatment of malignant neoplasms;
reduction of immune tension.

A woman should know which doctor to contact if she experiences early menopause. A professional gynecologist-endocrinologist will conduct a consultation and prescribe treatment.

How to delay the onset of menopause?

Experts have developed several methods to delay menopause. the period most suitable for applying deferment measures.

Hormone replacement therapy is prescribed by a doctor strictly according to indications. Estrogen preparations (Ovestin, Divigel, Klimonorm, Norkolut, etc.) can delay the onset of menopause.
The doctor may prescribe long-term use of phytoestrogens - plant substances similar in their mechanism of action to natural estrogen. Such drugs include Feminal, Estrovel, Femiwell, etc.
Herbal medicine - the use of decoctions and infusions of certain medicinal plants(thyme, lungwort, sage, horsetail and many others). Monastic tea is also effective for delaying menopause.
In addition, for effective result you must adhere to the following rules:

do not eat fatty foods sweet food; the diet should be dominated by fruits, vegetables, and fermented milk products;
engage in sports, thereby stimulating the production biological substances that prolong youth;
take care of women's health and regularly visit a gynecologist;
avoid stressful situations;
give up bad habits.

By following these tips, a woman has the opportunity to delay the onset of menopause.

Diagnostics

Diagnosis of menopause includes consultations with a gynecologist, endocrinologist, cardiologist, and neurologist. The functional state of the ovaries is determined using histological analysis and cytological examination of smears. If necessary, ultrasound of the breast, pelvic organs, and mammography are performed.

Ways to eliminate menopause symptoms

Modern medicine offers the following methods to eliminate the unpleasant symptoms of menopause:

Hormonal drugs (estrogen) are indicated for severe menopause.
Phytoestrogens are a mild option for the treatment of menopausal disorders.
Physiotherapy – massage, physical therapy.
Traditional treatment.

What means are used to treat female menopause is shown in the video.

Menopause is an inevitable physiological process in a woman’s life. Therefore, sooner or later she is forced to go through this period.

– physiological period in a woman’s life, characterized by the decline of reproductive function due to hormonal changes in the body. It begins after 40 years of age and lasts about 10 years. It manifests itself as a gradual cessation of menstruation. May be accompanied by a complex of vegetative-vascular and endocrine disorders: sudden attacks a rush of blood to the upper half of the body and face (“heat”), sweating, tearfulness, irritability, fluctuations in blood pressure, increased dryness of the skin and mucous membranes, sleep disturbance. May cause dysfunctional uterine bleeding and serious neuropsychiatric disorders.

General information

is a natural stage in a woman’s life and is characterized by reverse changes in the reproductive system - the cessation of childbearing and menstrual functions. The word “menopause” comes from the Greek “klimax” - a ladder, expressing symbolic steps leading from the flourishing of specific female functions to their gradual extinction.

A woman's life consists of several age periods, having their own anatomical and physiological characteristics:

neonatal period - up to 10 days;
childhood period - up to 8 years;
period of puberty - from 8 to 17-18 years;
period of puberty (reproductive or childbearing) - from 18 to 45 years;
climacteric period (menopause), including:

premenopause - from 45 years to menopause;
menopause - cessation of menstruation (49-50 years);
postmenopause - from menopause - up to 65-69 years;

old age period - from 70 years.

With the average life expectancy of a woman being 75 years, a third of her life is spent during menopause.

In some women, menopause has a physiological course and does not cause pathological disorders, in others, the pathological course of menopause leads to the development of menopausal (menopausal) syndrome. Menopausal syndrome during menopause in women occurs with a frequency of 26–48% and is characterized by a complex of various disorders of the functions of the endocrine, nervous and cardiovascular systems, which often disrupts the normal functioning and ability of a woman to work. Issues of the pathological course of menopause are of great social and medical importance due to the increased average life expectancy of a woman and her socially active behavior.

Causes of menopausal syndrome

During menopause, changes occur throughout the body: it decreases immune defense, the frequency of autoimmune and infectious diseases increases, and the aging process progresses. But the woman’s reproductive system undergoes the most active changes during menopause. During menopause, the development of follicles in the ovaries stops, eggs stop maturing and ovulating, and intrasecretory activity decreases. The follicles in the ovaries are replaced by connective tissue, which leads to sclerosis and reduction of the ovaries in size.

The hormonal picture during menopause is characterized by an increase in the level of gonadotropic hormones (follicle-stimulating and luteinizing) and a decrease in the level of estrogen. During the year after menopause, the level of follicle-stimulating hormone increases by 13-14 times, luteinizing hormone by 3 times, followed by a slight decrease.

During menopause, changes in the synthesis of estrogen hormones include the cessation of estradiol production and the predominance of estrone. Estrogens have a biological effect on the uterus, mammary glands, urethra, bladder, vagina, pelvic floor muscles, brain cells, arteries and heart, bones, skin, mucous membranes of the conjunctiva, larynx, mouth, etc., and their deficiency during menopause can cause various disorders in these tissues and organs.

Menopausal syndrome during menopause is a manifestation of estrogen deficiency and is characterized by vegetative-neurotic, urogenital disorders, dystrophic changes in the skin, high risk development of atherosclerosis and vascular ischemia, osteoporosis, psychological disorders. With an increase in the average life expectancy of a woman, the menopause lengthens and, accordingly, the period of estrogen deficiency increases, which increases the likelihood of developing menopausal syndrome.

Classification

According to its manifestations, menopausal syndrome is divided into early, middle and late manifestations of menopausal disorders. Early manifestations of menopausal disorders during menopause include:

vasomotor symptoms– feeling of “hot flashes”, headaches, increased sweating, chills, fluctuations in blood pressure, palpitations;
psycho-emotional symptoms - weakness, anxiety, irritability, drowsiness, inattention, forgetfulness, depression, decreased libido.

Early manifestations during menopause include premenopause and 1-2 years of postmenopause. Women with vasomotor and psycho-emotional symptoms during menopause are often treated by a therapist for hypertension, coronary heart disease, or by a psychoneurologist diagnosed with neurosis or a depressive state.

Medium-term manifestations of menopausal disorders during menopause include:

urogenital symptoms - vaginal dryness, painful sexual intercourse, burning, itching, dysuria (increased urination and urinary incontinence);
symptoms from the skin and its appendages - wrinkles, brittle nails, dry skin and hair, hair loss.

Medium-term manifestations during menopause are observed 2-5 years after menopause and are characterized by atrophic changes in the skin and urogenital tract. As a rule, symptomatic treatment urogenital and skin symptoms during menopause does not give the desired effect.

Late-time manifestations of menopausal disorders during menopause include:

metabolic (metabolic) disorders - osteoporosis, atherosclerosis, Alzheimer's disease, cardiovascular diseases.

Late-time manifestations during menopause develop 5-10 years after the onset of menopause. Insufficient levels of sex hormones during menopause lead to disruption of the structure of bone tissue (osteoporosis) and lipid metabolism (atherosclerosis).

Symptoms of menopausal syndrome

The development and severity of menopausal syndrome is influenced by hormonal, environmental, hereditary factors, general condition women towards menopause.

Vegetative-vascular (vasomotor) symptoms during the pathological course of menopause are observed in 80% of women. They are characterized by sudden “hot flashes” with a sharp expansion of the capillaries of the scalp, face, neck, chest, an increase in local skin temperature by 2-5°C, and body temperature by 0.5-1°C. “Hot flashes” are accompanied by a feeling of heat, redness, sweating, and palpitations. The state of “hot flashes” lasts 3-5 minutes, repeating from 1 to 20 or more times a day, intensifies at night, causing sleep disturbance. A mild degree of vasomotor disorders during menopause is characterized by the number of “hot flashes” from 1 to 10 per day, moderate – from 10 to 20, severe – from 20 or more in combination with other manifestations (dizziness, depression, phobias), leading to decreased ability to work.

In 13% of women with a pathological course of menopause, asthenoneurotic disorders occur, manifested by irritability, tearfulness, feelings of anxiety, fear, intolerance to olfactory and auditory sensations, and depression. Psycho-emotional symptoms during menopause develop before or immediately after menopause, while vasomotor symptoms continue for about 5 years after menopause.

The course of menopausal syndrome during menopause can develop in the form of atypical forms:

sympatho-adrenal crises, characterized by a sharp headache, increased blood pressure, urinary retention followed by polyuria;
myocardial dystrophy, characterized by constant pain in the heart in the absence of changes on the ECG, ineffectiveness of conventional therapy;
urticaria, vasomotor rhinitis, allergies to medicines And food products, indicating changes in the body’s immunological reactions, etc.

The course of menopause falls during important events in a woman’s life: children growing up and getting married, achievements at work, retirement changes, and menopausal disorders are layered with increased emotional stress and social problems. Almost 50% of women with a pathological course of menopause have a severe form of the disorder, in 35% the disorder is moderately expressed, and only in 15% the menopausal syndrome has mild manifestations. Light form Menopause disorders are usually found among practically healthy women, while women with chronic diseases are susceptible to atypical forms of manifestation of menopausal syndrome, a tendency to a crisis nature of the course, which disrupts the general health of patients.

The development of menopausal syndrome during menopause is facilitated by genetic factors, endocrinopathies, chronic diseases, smoking, menstrual irregularities during puberty, early menopause, physical inactivity, and a woman’s lack of a history of pregnancy and childbirth.

Diagnostics

Diagnosis of the pathological course of menopause is based on complaints from patients who appear at the age of approaching or approaching menopause. Exacerbations of concomitant diseases sometimes complicate the diagnosis of menopausal syndrome during menopause, aggravating its course and causing the development of atypical forms. If there are concomitant diseases, a woman, in addition to consulting a gynecologist, is advised to consult other specialists: cardiologist, neurologist, endocrinologist.

In order to correctly diagnose the complicated course of menopause, a study of the levels of follicle-stimulating and luteinizing hormones and estrogens in the blood is carried out. To clarify the functional state of the ovaries during menopause, a histological analysis of scrapings of the endometrium of the uterus and cytological studies of vaginal smears over time are carried out, plotting basal temperature. Identification of anovulatory ovarian cycles makes it possible to associate functional disorders with menopausal syndrome.

Treatment of disorders during menopause

The approaches adopted in modern gynecology to the problem of treating the pathology of menopause are based on reducing its manifestations and symptoms. Reducing the severity and frequency of “hot flashes” during the pathological course of menopause is achieved by prescribing antidepressants (venlafaxine, fluoxetine, paroxetine, citalpram, sertraline, etc.).

To prevent and treat the development of osteoporosis during menopause, non-hormonal biophosphonate drugs (alendronic and risedronic acids) are used, which reduce bone loss and the risk of fractures. Biosphosphonates effectively replace estrogen therapy in the treatment of osteoporosis in women during menopause.

To reduce the manifestation of urogenital symptoms during the pathological course of menopause, local (vaginal) administration of estrogen in the form of cream or tablets is recommended. The release of small doses of estrogen into the vaginal tissue reduces the sensation of dryness, discomfort during sexual intercourse and urinary disorders.

The most effective method of treating menopausal syndrome during menopause is hormonal therapy individually prescribed by a doctor. Taking estrogen drugs effectively eliminates, in particular, “hot flashes” and discomfort in the vagina. For hormone therapy in the treatment of menopause pathology, natural estrogens (estradiol valerate, 17-beta-estradiol, etc.) are used in small doses in intermittent courses. For prevention hyperplastic processes in the endometrium during menopause, a combination of estrogens with gestagens or (less often) with androgens is indicated. Courses of hormone therapy and hormonal prophylaxis are carried out for 5-7 years in order to prevent myocardial infarction and mammography, cytological analysis of smears of discharge from the cervix, biochemical research blood test indicators and coagulation factors (coagulogram).

Hormone therapy regimen

The choice of hormone therapy regimen depends on the stage of menopause. In premenopause, hormone therapy not only replenishes estrogen deficiency, but also has a normalizing effect on menstrual cycle, therefore it is prescribed in cyclic courses. In postmenopause, when atrophic processes in the endometrium, to prevent monthly bleeding, hormone therapy is carried out in a regimen of continuous medication.

If the pathological course of menopause is manifested only by urogenital disorders, estrogens (estriol) are prescribed locally in the form of vaginal tablets, suppositories, and cream. However, in this case there remains a risk of developing other menopausal disorders of menopause, including osteoporosis.

A systemic effect in the treatment of the pathological course of menopause is achieved by prescribing combined hormone therapy (for example, tibolone + estradiol + norethisterone acetate). In combination hormone therapy, hormones are combined with symptomatic drugs(hypotensive, cardiac, antidepressants, bladder relaxants, etc.). Combination therapy for the treatment of menopause disorders is prescribed after consultation with specialists.

Solving the problems of the pathological course of menopause is the key to prolonging women's health, beauty, youth, performance and a real improvement in the quality of life of women entering the wonderful “autumn” time of their lives.

One of the most difficult health problems for middle-aged and older women today is the question of whether or not to take post-menopausal hormones. Post-menopausal hormones can influence the risk of diseases that are the leading causes of death among women - cancer, heart disease and a number of other conditions and diseases. Unfortunately, not all of these effects are beneficial, forcing women to consider how to reap the health benefits of postmenopausal hormones with minimal risk.

What is menopause

Menopause is a complex process in a woman's life. And while menopause is often defined as the cessation of menstruation, menopause is a gradual process that lasts several months and is often accompanied by irregular periods. This process serves as the body's response to significant changes in the level of female hormone estrogen.
Although every woman is unique, typical menopausal symptoms are hot flashes, vaginal dryness, insomnia. In fact, one in three women in four experience these symptoms, although their presentation and duration vary widely. If you have these symptoms and are not uncomfortable and are not comfortable with alternative therapies - herbs, relaxation - you may want to consider taking post-menopausal hormones. Some women decide to take hormones temporarily to ease the transition. Others find it appropriate to remain on hormone therapy.

The role of estrogen

Before menopause, estrogen plays vital role not only in reproductive function, but also in the maintenance of various tissues and organs. Like other hormones, estrogen is produced and released by tissues in one part of the body, in this case the ovaries, and then carried by the blood to other parts of the body. In women, estrogen affects the cells of blood vessels, brain, skin, breast, liver and skeleton, the mucous membrane of the vagina and urinary tract. Estrogen stimulates the release of protein from cells to maintain the condition of organs and tissues.

When estrogen levels decrease during menopause, the functioning of these tissues and organs changes significantly. For example, estrogen stimulates tissue in the vaginal wall. It is very elastic and releases lubricant during intercourse. When estrogen levels decrease, the vaginal walls become thinner, losing their elasticity and ability to lubricate. As a result, vaginal dryness, the most common symptom, causes pain during intercourse, vaginal soreness, and irritating itching. This is just one of many results of decreased estrogen production in the female body.

By taking postmenopausal hormones to increase estrogen levels in the body, women can alleviate the symptoms described above. The combination of estrogen and progestin was and is still the treatment of choice for women who have not had a hysterectomy.

The climacteric period in women and men is short. Menopause and menopausal syndrome: what happens in a woman’s body? Precursors, hot flashes, symptoms and manifestations, diagnosis of menopause (menopause)

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