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Menopause in women: symptoms, treatment of menopausal syndrome

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Climacteric syndrome is a complex of clinical signs that complicates the course of the physiological transitional period that occurs in the life of every woman. With age, reproductive function fades away, the glandular tissue of the ovaries undergoes reverse development, the secretion of sex hormones decreases, menstruation stops, the uterus decreases in size, endometrial hypoplasia occurs. The health of women in the period of menopause worsens, somatic, autonomic, metabolic, endocrine, urogenital, adaptogenic, vasomotor and mental disorders of varying severity develop.

Menopausal syndrome is otherwise called menopause, menopause or menopausal syndrome. This is a transitional phase, indicating the extinction of the childbearing function and the onset of old age. Climax is not a pathology, but a normal state of the female body, which characterizes a certain age period. and developing under the influence of the restructuring of the CNS. The pituitary gonadotropic hormone production process is impaired, which leads to ovarian dysfunction - the female sex glands. Their follicular phase changes, the ovarian reserve is depleted, the number of follicles decreases. The body has a shortage of sex hormones - progesterone and estrogen.

Menopause develops in 30-60% of women aged 45-55 years. This natural process of wilting of the body is caused by a decrease in the level of sex hormones in the blood. This phenomenon is often manifested quite sharply and delivers a lot of discomfort. The main symptoms of the disease are: hot flushes to the body, pulsation in the head, hyperhidrosis, cardialgia, persistent rise in blood pressure, rapid and irregular heartbeat, poor sleep. The syndrome has the code on ICD-10 95.1 and the name "Menopause and menopause in women".

Etiology and pathogenesis

The hypothalamus - the pituitary gland - the ovaries is a complete system, which works on the principle of feedback.

Hypothalamic structures lose their sensitivity to the normal concentration of estrogen secreted by the ovaries and involution invades. Hypothalamic hyperfunction develops to restore balance, which more actively stimulates the pituitary gland. The latter releases large quantities of gonadotropic hormones, especially follicle-stimulating. Ovarian dysfunction develops, which begin to secrete not only the functional fractions of estrogen, but also their intermediate components. Sex hormones are produced acyclically. Their number is not enough to inhibit the work of the hypothalamus and pituitary. An excess of FSH in the blood leads to the cessation of ovulation and fertility.

The structures of the hypothalamic-pituitary region regulate all the basic functions of the body. In case of violation of their work, osteoporosis, metabolic disorders, dysfunctions of the heart, blood vessels and peripheral nerves develop, which leads to the development of menopause.

In some women, menopause is relatively easy. This is due to the ability of the adrenal cortex to partially produce sex hormones during the involution of the ovaries. Mild syndrome due to the absence of pathological symptoms.

Factors leading to the development of the syndrome:

  1. Heredity,
  2. Acute infections
  3. Operations,
  4. Chronic somatic diseases,
  5. Bad habits,
  6. Hypodynamia,
  7. Excess weight,
  8. Poor nutrition
  9. Chronic poisoning of the body,
  10. Occupational hazards
  11. CNS diseases,
  12. Emotional overstrain, stresses,
  13. Lack of sleep
  14. Negative environmental factors,
  15. The number of births and abortions in history
  16. Long-term use of hormonal drugs and cytostatics.

Pathogenetic processes in menopause: involution of the glandular tissue of the ovaries, reduction in the number of maturing follicles, rare ovulation, cessation of menstruation. The glandular tissue of an organ is gradually replaced by connective tissue fibers. Ovarian hypoplasia after 40 years is due to the fact that whites remain in the place of the yellow bodies, which are not completely resolved. The glands shrink due to the growth of fibrous tissue, and then undergoes irreversible dystrophic processes. Cardiovascular, respiratory, emotional, behavioral and temperature reactions are disturbed in the body.

Symptomatology

The clinical picture of the climacteric syndrome includes signs of impaired vegetative regulation, hyperventilation syndrome, urinary system dysfunction, and slowing of the skin trophism.

Climacteric syndrome begins with pronounced neuropsychiatric manifestations and signs of vegetative-vascular dystonia. These include:

  • Sleep disturbances - sleeplessness and daytime sleepiness,
  • Anxiety, anxiety, obsessions,
  • Depression, indecision, forgetfulness, distraction,
  • Depressed mood, apathy, bursts of negative emotions, irritability, tearfulness, anger,
  • Weakness, fatigue, fatigue, malaise, headache, decreased performance,
  • Depression,
  • Intolerance to loud sound and sharp odors,

symptoms of menopausal syndrome

Anorexia or bulimia,

  • Oliguria and constant thirst,
  • Painful engorgement of the mammary glands,
  • Bloating,
  • Depression or increased sexual desire
  • Hot flashes to the head and chest,
  • Hyperemia of the face, the appearance of red spots on the neck - "vascular necklace",
  • Dizziness,
  • Hyperhidrosis at night,
  • Numbness and cramps in the legs,
  • Shortness of breath, asphyxiation, pain in the heart, radiating to the neck, collarbone, scapula,
  • Tachycardia and arrhythmia alone,
  • Feeling of a sinking heart
  • Blood pressure fluctuations.
  • By the end of the second year of menopause, menstruation ceases, and more pronounced symptoms occur. The following are added to the initial signs of the syndrome:

    1. Appearance of intermenstrual bleeding,
    2. Thinning and drying of the urogenital mucosa,
    3. Dyspareunia - painful intercourse,
    4. Spontaneous urine excretion,
    5. Atherosclerosis,
    6. Overweight,
    7. Disorders of carbohydrate metabolism with the development of diabetes mellitus,
    8. Decreased visual acuity and hearing
    9. Osteoporosis.

    Forms of climacteric syndrome:

    • Typical - hot flashes to the head, hyperhidrosis, insomnia, emotional lability, migraine. The number of tides reaches 4-10 per day.
    • Atypical - excess fatty tissue on the body, swelling in the legs and face, arthralgia, myalgia, dysuria, vaginal dryness, fear of death, arrhythmia, hypertension, allergy, hyper- or hypoglycemia, epipridation, hirsutism, nystagmus, visual hallucinosis.
    • Combined - develops in women with a history of signs of heart disease, hypertension, dysfunction of the hepatobiliary zone, and metabolic disorders.

    Tides - This is a specific clinical sign of menopause, which is an attack of heat, localized in the head, neck and chest. It gives way to chills and icy sweat. At the same time, blood pressure fluctuates dramatically, weakness arises, patients lose consciousness. Duration of tides - from a few seconds to ten minutes.

    In women during menopause often atrophic vaginitis develops. This is due to a lack of estrogen and a slow synthesis of protective cells of the vagina. The number of lactic acid bacteria is reduced, vaginal discharge becomes abundant, and alkalization of the medium occurs. This allows pathogens and conditionally pathogens to actively grow and multiply in the vagina, causing acute inflammation. Urogenital pathology symptoms - vulvar dystrophy, vaginal inflammation, painful urination. These pathological changes are accompanied by itching, bleeding, copious discharge, frequent urging to the toilet.

    During menopause, changes occur in the genitals: the uterus, fallopian tubes and ovaries decrease, their mucosa becomes thinner. The ligaments and muscles of the pelvis weaken and stretch. They can not fully hold the organs, which leads to their omission. Sexual interventions become painful, accompanied by dryness and discomfort. To restore full-fledged sex life and attraction to the opposite sex will only hormonal drugs. Fibrous tissue grows in the mammary glands.

    In women of this age, the amount of collagen in the skin decreases, which is manifested by its aging - the appearance of wrinkles and age spots. The hair on the head, pubic and armpits begin to fall out, the nails become brittle and soft.

    Osteoporosis - late menopause complication, clinically manifested 3-7 years after the cessation of menstruation. Bone tissue loses its strength, fractures periodically occur. Women complain of frequent cold feet, numbness, tingling, crawling.

    A change in woman's behavior is associated with the perception of menopause as a sign of aging. Some become depressed, which is difficult to treat. In addition to therapeutic care, women at this time need the support of native people. She must still feel welcome for her husband, loved by children, attractive to others. After all, climax is not the end, but a new stage in life.

    In men, menopause occurs a little later - after 50 years. Involution of the glandular tissue of the testes leads to a lack of testosterone in the blood and an excess of gonadotropins. Such an imbalance is manifested in violation of the joint work of the central nervous system and endocrine glands. Men rarely have symptoms of the disease. It usually proceeds easily and painlessly. In some cases, the same clinic appears as in women: tachycardia, cardialgia, hypertension, migraine, sleep disturbance, inattention, decreased performance, progressive obesity, gout attacks, hyperglycemia, impotence.

    Diagnostic methods

    Diagnosis of pathology does not cause difficulties. Specialists evaluate the regularity of the menstrual cycle in accordance with age, study the clinical signs and complaints of patients, exclude concomitant diseases, determine the hormonal status of the patient. In most cases, additional consultation of specialists in the field of ophthalmology, neuropsychiatry and endocrinology is required.

    Doctors collect a hereditary and gynecological history, examine the woman's menstrual function, conduct a gynecological examination with a mandatory bimanual examination, and then send the patient to donate blood for an analysis that determines the hormonal background. Additionally palpated mammary glands.

    1. Hemogram
    2. Determination of hormonal levels.
    3. Cytological analysis of the cervix.
    4. Blood biochemistry - enzymes and markers of basal metabolism.
    5. Coagulogram.
    6. Microbiological examination of detachable vagina on the microflora.
    7. Instrumental methods:
    8. Mammographic study.
    9. Ultrasound of the genitals.
    10. ECG.
    11. X-ray of the chest organs according to indications.

    Medical events

    Recommendations, rules and measures to alleviate the course of menopausal syndrome:

    • Normalization of work and rest,
    • Properly low-calorie meals,
    • Reception of vitamins and minerals,
    • Fighting addiction,
    • Regular sex life preferably with one partner,
    • Periodic medical examinations,
    • Optimum physical activity.

    It is advisable to use special complexes of exercise therapy. General massage and walks before bed improve patient well-being. Dietary nutrition is recommended for women with a mild form of the syndrome. It is very important to pay attention to the calorie content of food eaten. In menopause, in persons who neglect the principles of proper nutrition, the amount of adipose tissue increases, which in excess is deposited on the back, sides, abdomen and hips.

    Dairy products, lean fish and meat should prevail in the diet. It is necessary to limit pork, duck, smoked meats, marinades, spices, chocolate, strong tea and coffee, alcohol, carbohydrates. It is useful to use fresh salads, normalizing intestinal motility, with a small amount of vegetable oil that protects cells from the negative effects of environmental factors.

    Vitamin therapy - retinol, vitamin C, E and B, sedative herbal remedies - motherwort, hawthorn, valerian tincture. Therapeutic massage and exercise therapy, physiotherapy, acupuncture, hydrotherapy, balneotherapy, aromatherapy will help to relax and improve your well-being. These techniques improve the psycho-emotional state of women in such a difficult life period.

    Drug therapy

    Moderate forms are treated with medication:

    1. Neuroleptics - Sonapaks, Fenothiazine, Aminazin,

    2. Tranquilizers - Fenozepam, Atarax,
    3. Antihypertensives - Enalapril, Bisoprolol,
    4. Antidepressants - Amitriptyline, Parexetine,
    5. With pronounced tides and sweating - "Klimalanin",
    6. To normalize feedback in the system of the hypothalamus - pituitary - ovaries - "Sagenit",
    7. Herbal Estrogenic Drugs - Climandione, Remens, Mastodinone,
    8. Vitamin and mineral complexes,
    9. Metabolics - Piracetam, Riboxin, Mildronat,
    10. Sedatives - Sedavit, Novopassit.

    Phytoestrogens have a mild effect on climacteric processes in the body: reduce the frequency of hot flashes, restore sleep, stabilize the psycho-emotional state, minimize the severity of the main clinical manifestations. These products are sold without a prescription and do not have side effects such as real hormones.

    In the absence of the effect of these drugs or in cases of severe course of the syndrome, hormone replacement therapy with estrogen-progestin drugs is prescribed - Lindinet, Mersilon, Femoston.

    Adequate medical correction makes the prognosis of the syndrome as a whole favorable. Neuropsychiatric disorders and depressive states are difficult to treat. If the illness occurs in severe form on the background of somatic diseases, serious complications from the heart, blood vessels and central nervous system develop. The treatment regimen is selected by a specialist individually for each patient, depending on the characteristics of the pathological process.

    If menopause occurs before 45 years, hormone replacement therapy is carried out, which allows to prolong the functioning of the ovaries. Klinon and Clemanorm contribute to the appearance of menstruation and reduce the risk of endometrial hyperplasia.

    Folk Syndrome Treatment

    The most common folk remedies to make the process of restructuring the female body less painful:

    • Infusion of valerian root relieves irritability and temper.

    • Decoction of valerian, peppermint and pharmacy chamomile has a general healing effect on the body.
    • Infusion of sage, horsetail and valerian root helps to get rid of the vegetative manifestations of the syndrome - hyperhidrosis and hot flashes.
    • Means from crushed lemons, eggshell and honey improves metabolism.

    Spa treatment is indicated for women during menopause. After climatic and balneotherapy, the general condition of the body improves, headache disappears, hot flashes, working capacity is restored, sleep, pressure, and the gastrointestinal tract and kidneys are normalized.

    Climacteric syndrome is a condition that can be managed. Clinical recommendations of specialists, medications and traditional medicine will help to do this. Menopause is an irreversible process, because time cannot be reversed. Climacteric syndrome is the transition of a woman from a young to a mature age. Comprehensive treatment allows smoothing the course of this process and making it painless.

    Age when menopause begins in women

    Climax is the natural extinction of the main female function - childbearing. A gradual reverse development of the organs necessary for this: the breasts, ovaries, uterus and the decrease in the level of estrogen in the body.

    In the ovaries of every woman, a certain number of follicles are genetically incorporated, and the time of menopausal syndrome depends on this. Usually, menopause occurs between the ages of 50 and 55 years. If his symptoms are observed before the age of 40 - this is an early syndrome (see women cleaners risk bringing their menopause). All reactions of the body to this last hormonal “storm” are different for each woman.

    One is experiencing this period hard and long, the other it passes almost unnoticed. There is a clear inheritance link to the beginning of the extinction of the childbearing function in the female line, if a woman wants to know how this process will take place she has enough to address this question to her mother. This will allow you to psychologically prepare and help to move this period more easily (see the first signs of menopause).

    Early menopausal syndrome is diagnosed in women under 40 years of age, which is a deviation and not a natural process (a frequent occurrence in recent decades). At risk include:

    • smoking women
    • suffered a large number of medical abortions (consequences)
    • leading not regular sex life
    • suffering from alcoholism, obesity
    • not observing the regime of work and rest
    • often stressed and fond of diets, starvation
    • having autoimmune diseases, endocrine disorders (thyroid disease, diabetes)
    • gynecological diseases, including oncological

    Periods of hormonal adjustment

    The time it takes for a complete hormonal adjustment takes place in three stages:

    Premenopause At the first stage with a duration of up to 6 years, the follicles become more resistant to the action of hormones that stimulate them to mature. Disrupted the usual cyclical menstrual cycle. Menstruation can occur with significant delays, decreases or increases the number of days, until complete cessation. Changes and the amount of discharge, bleeding becomes more scarce or abundant. Gynecologists call this period - premenopausal.

    In the pathological course of premenopause, there is an increased production of estrogens - hyperestragenia. Therefore, on a prophylactic onco-examination by a gynecologist, such patients may have the following signs:

    • excessive production of cervical mucus, pronounced folding of the vaginal wall
    • the uterus is not reduced in size, but enlarged and compacted
    • when examining the mammary glands is determined by the tightness and medium-sized seals, they are somewhat enlarged and painful
    • in the walls of the uterus reveal myoma nodes and other tumor tumors in the genitals
    • menstruation may be longer and more abundant, there are not rare cases of dysfunctional bleeding (see the causes of uterine bleeding)

    Menopause - the second stage is the shortest, complete cessation of the onset of menstruation.
    At the third stage, hormonal changes are finally completed, the ovaries stop producing hormones completely, the level of estrogen is steadily reduced by 50% of the level of the reproductive phase. Continuing age involution of the organism. This is an early postmenopause (1 - 2 years).

    Postmenopause - At the third stage, hormonal changes are finally completed, the ovaries stop producing hormones completely, the level of estrogens is steadily reduced by 50% of the level of the reproductive phase. Continuing age involution of the organism. This is an early postmenopause (1 - 2 years). Organs, in the functioning of which the sex hormones took part, undergo smooth hypotrophic changes:

    • pubic hair thinning
    • vaginal walls lose their tone and folding
    • vaults are flattened
    • the size of the uterus decreases
    • the volume of secreted mucus from the cervical canal decreases, a complete cessation is possible.

    Significant changes also occur in the mammary glands, which is a physiological process - the involution of the mammary glands occurs through fatty or fibrous replacement of glandular tissue. Under normal climacteric period, well-being remains satisfactory for a long time. Directly postmenopause lasts the rest of his life.

    What are the symptoms of menopausal syndrome

    Estrogens take an active part in the life of the organism as a whole, receptors sensitive to these hormones exist in many organs, hence the variety of symptoms. If this period occurs in a woman with complications, then the following menopause symptoms will be observed:

    • Changes in the emotional sphere

    The ancient Greeks directly associated the emotional state of the woman with the uterus, this is reflected in the origin of the word hysteria from the Greek hystera - the uterus. In some women, menopausal disorders of the emotional sphere occur according to the astheno-neurotic syndrome. This state is manifested by unmotivated crying, irritability, anxiety, fear, insomnia, intolerance to certain sounds and smells.

    Other patients have pronounced depressive disorders that are poorly amenable to traditional treatment, and are in severe form. Individual women may experience significant behavioral changes, up to the caller. They make flashy hairstyles, wear revealing outfits, prefer bright makeup, in the hope of delaying the leaving youth.

    • Disorders of the autonomic nervous system

    The most vivid and specific, with severe menopausal syndrome, the symptoms are "tides", which arise as a reaction of vegetative neuroregulation to the effects of external and internal factors (see how to get rid of tides during menopause). Clinically "hot flashes" appear:

    • anxiety
    • feeling of a sinking heart
    • lack of air
    • excessive sweating,
    • reddening of the skin
    • nausea
    • dizziness and increasing weakness.

    Hyperventilation Syndrome (GVS) - characterized by arrhythmias, depth, respiratory rate disorders. Patients complain of lack of air, chest tightness, a lump in the throat. In this syndrome persistent headaches are noted, in the type of migraine, pain of tension, mixed types. Such patients do not tolerate stuffiness, humidity, heat. GVS is associated with impaired metabolism of minerals, namely calcium and magnesium, which is caused by a persistent decrease in the level of estrogen.

    Recently, to the GVS include sleep apnea syndrome, frequent bouts of short-term spontaneous breath during sleep. Indirect symptoms of menopause are:

    • night snoring
    • frequent awakenings
    • increased sleepiness during the day
    • high blood pressure figures in the morning.

    The function of estrogen includes the preservation and restoration of nerve cells that are destroyed during Alzheimer's disease, improvement of neuronal function, anti-inflammatory and antioxidant effects, normalization of blood circulation in the brain, and regulation of glucose levels.

    • Impaired function of the urogenital system and changes in the trophism of the skin

    Atrophic vaginitis - estrogen deficiency, with menopausal syndrome, leads to a decrease in blood flow in the vaginal walls to ischemia. The lumen of the arteries narrows, the number of functioning capillaries decreases, the production of natural mucus is disturbed, this explains the pathological dryness of the vagina, as a result of itching, burning, omission of the walls.

    Atrophic changes in the pelvic ligament apparatus alter the normal anatomical location of the urethra and bladder, which contributes to the prolapse of the walls of the vagina and uterus.

    Symptoms of atrophic cystourethritis - increased urination with the release of a small amount of urine, pain, burning urination during urination, cutting pains in the bladder. Frequent urination, more than once per night, urinary incontinence.

    Disruption of normal skin nutrition. The skin becomes thinner, loses its elasticity, becomes dry, wrinkled and flabby. Pigment spots and small skin growths appear. The amount of hair on the head decreases, the growth of hair on the face increases.

    Osteoporosis and functional disorders of the cardiovascular system.
    The cardiovascular system responds to menopause with a gradual increase in blood pressure, pain in the region of the heart is subjectively felt.

    Postmenopausal osteoporosis - in the occurrence of osteoporosis, estradiol deficiency takes the leading role - the hormone from the estrogen group. During menopause, there is an imbalance in the processes that ensure the renewal of bone tissue. Clinically it manifests itself:

    • slouching
    • a decrease in growth, due to osteoporotic compression of the vertebral bodies,
    • frequent bone fractures from a minor mechanical effect,
    • pain in the joints, sacrum, back pain during a long walk, while standing.

    Treatment of menopause in women - medical care for women of menopause

    For the treatment of menopause in women using drugs, herbal medicine, physiotherapy and physical therapy. Before you begin treatment with medications, they recommend massage, diet and hydro-procedures, if there is no noticeable effect, they begin therapy with drugs, including therapy with hormonal and non-hormonal means (see the list of all drugs for menopause).

    • Drugs that reduce emotional lability: Belloid or Bellaterin n 2-3 times a day, one tablet, for a long time.
    • Vitamins and ATP
      • B1 - 30 days for 1 ml / m
      • B6 - 30 days for 1 ml / m
      • E - 30 days 100 mg 2 times a day inside
      • ATP - 30 days for 1 ml / m

    For disorders of the emotional sphere of neuroleptics:

    • tazepam 0.01 g up to 3 times a day
    • frenolone 2.5 mg up to 2 times a day

    • Replacement therapy:
      • the use of "pure" estrogens - proginova, estraphem, premarin and other
      • combined cyclic therapy - divina, clemen
      • continuous treatment - kligogest
      • estrogen – androgen combination therapy - amboix, ginodian depot
    • Modulators of estrogen receptors are prescribed, if there are contraindications to hormone replacement therapy, anti-estrogen drugs.
    • Tissue selective estrogen activity regulator.
    • Phytoestragenes and phytohormones (Estrovel, Klimadinon, Feminal, Femicapes, Chi-Klim, Red Brush, Inoklim, Tribestan, Menopace, Bonisan, Klimalanin, Femivell, Remens, Ledis Formula Menopause, Klimaksan, Ovarimin 9mmam, Ovimoinme 9m menopause).
    • There is also a medication - Ovestin, these are natural and semi-synthetic estrogens (candles, vaginal cream, tablets).

    • Psychotropic stimulants for 2-4 months (nootropil, Aminalon)
    • Antidepressants (Lerivon, Tsipramil, Efevelon, Velaksin, Velafaks)
    • Homeopathic remedies - menopause, menopause, menopause.

    • An effective combination is calcium 1 - 1.5 mg per day in combination with vitamin D, at a dose of 400 - 600 IU.

    • Walking on the toes with retracting the anus.
    • Walk with the object sandwiched between the legs.
    • Lying on your back alternately lift straight legs.
    • The same position, raise the pelvis above the floor with a retracting anus.
    • Sitting tilted bent legs at the knees.

    Effective yoga classes, as well as gymnastics "Bodyflex", which allows you to eliminate the prolapse of organs if you already have the initial signs, strengthens the muscles of the pelvis and abdominal wall, improves blood circulation, increases the overall tone.

    • Have a soothing effect: lemon balm, mint, motherwort, hawthorn, valerian, zamaniha high.
    • Hemostatic effect with minor dishormonal bleeding and heavy menstruation: water pepper, nettle, shepherd's grass bag, yarrow, corn. barberry ordinary.
    • Toning: Ginseng, Schizandra Chinese, Echinacea.

    All herbal remedies can be purchased at pharmacies, methods of preparation, dosage indicated on the packaging.

    How long can menopausal syndrome last?

    Climax in women is not a disease. This is a physiologically normal age (at 45 - 55 years of age) and a genetically determined state of the body, consisting in the restructuring of the higher parts of the central nervous system. The result of this transformation is a decrease in intensity and a change in the cyclical nature of the synthesis and secretion of the pituitary gonadotropic hormones, the development of the insufficiency of the functions of the sex glands.

    The climacteric period consists of three phases:

    • premenopausal, preceding the cessation of menstruation and lasting from 2 to 5 years, pathological syndrome develops in this phase in 35% of women,
    • menopausal, which represents the final cessation of menstruation, which is estimated after 1 year of their complete absence, the symptoms of menopausal syndrome in this period are found in 38-70% of women,
    • postmenopausal, characterized by a lack of estrogen, elevated levels of gonadotropic hormones and the final physiological morphofunctional restructuring of all systems and organs of the body, primarily reproductive.

    During menopause, there are various pathological conditions, combined by the term "menopausal syndrome". "Early-term" its manifestation is menopausal syndrome, which, as a rule, begins to develop gradually shortly before menopause (in premenopause) and lasts an average of 2-3 years. However, in some individual cases, its duration may be up to 10-15 years.

    Pathogenesis and contributing factors

    In the modern concept of the mechanisms of the development of climacteric syndrome, the main importance as a causative factor is attached to changes in the age-related nature in hypothalamic structures.

    The hypothalamus is the main gland that regulates the cyclical nature of the menstrual cycle. It synthesizes neurohormones Gonadoliberin, or gonadotropin-releasing hormone (GnRH), under the action of which the follicle-stimulating (FSH) and luteinizing (LH) hormones are produced by the adenohypophysis. They affect the maturation and function of the follicles and corpus luteum of the ovaries.

    The hypothalamus - the pituitary gland - the ovaries form a coherent self-regulating system, the basis of which is based on the principles of feedback. Age-related involutive changes in hypothalamic structures cause a decrease in the sensitivity of the latter to the effects of the normal concentration of estrogen secreted by the ovaries.

    In order to restore equilibrium, the hypothalamus (through an increase in GnRH production) in the excited state increasingly stimulates the secretion by the pituitary gonadotropic hormones, especially follicle-stimulating.

    As a result, ovarian function is gradually disturbed, and they release into the blood not only directly functioning fractions of estrogen (estrone, estradiol and estriol), but also intermediate components of their synthesis. In addition, the cyclical nature of sex hormone production is disturbed. At some point, the ovarian sex hormones are no longer enough to inhibit the hypothalamus and pituitary. The remaining high production of FSH leads to the cessation of ovulation and, consequently, reproductive function.

    Since the hypothalamic and pituitary sections of the brain are associated with the rest of the endocrine glands and the cerebral cortex, this affects the function of the latter - osteoporosis develops, the regulation of the cardiovascular and peripheral nervous system and metabolic processes, metabolic processes, etc., are disturbed. leads to the development of menopausal syndrome.

    However, due to the fact that part of the sex hormones are produced by the reticular zone of the adrenal cortex, the latter take on part of the function of the ovaries during the period of their extinction (according to the principle of "feedback"). This contributes to a mild menopause in a certain percentage of women, as a result of which pathological symptoms do not occur.

    The emergence of a violation of the physiological course of menopause is promoted mainly by such factors as:

    1. Professional work in conditions of constant long-term and frequent physical or / and mental overwork.
    2. Stress states and disorders of the endocrine and central nervous system functions, dysfunction of the internal organs by the time of menopause.
    3. Complications during periods of pregnancy and childbirth, in the postpartum period.
    4. Inflammatory diseases of the pelvic organs, menstrual disorders, volume surgical interventions.
    5. Infectious diseases and long-term pain syndromes of various origin
    6. Increased body weight, even moderate.
    7. Occupational hazards and abuse of smoking and alcoholic beverages.

    How is menopausal syndrome manifested?

    In the clinical course, especially in the initial stages, against the background of menstrual disorders (1-3 months after they begin), neuropsychiatric disorders and autonomic-vascular dystonia (VVD), or vasic-vegetative manifestations, are dominant.

    The first are:

    • various sleep disorders and short-term memory disorders,
    • sense of unexplained anxiety and obsessive ideas,
    • the appearance of depression and self-doubt,
    • emotional lability, expressed in the instability of mood, causeless irritability and tearfulness,
    • headaches, fatigue, decreased performance and ability to concentrate,
    • depression and change (deterioration or vice versa, increase) of appetite,
    • oppression, absence or increase in libido.

    Vegetative manifestations of menopausal syndrome are usually accompanied by neuropsychiatric disorders and are expressed in:

    • sensation of hot flushes to the face, head and upper body,
    • sudden reddening of the skin of the face, neck and upper chest,
    • dizziness,
    • severe sweating, paroxysmal sweating, especially at night,
    • numbness of fingers, paresthesia, feeling of "crawling goosebumps" in the limbs, especially at night, jerky contractions of the muscle fibers of the legs,
    • feeling of lack of air right up to suffocation, tingling and unexplained painful sensations in the heart area, sometimes radiating to the neck, shoulder, shoulder blade, and subscapular region,
    • heart attacks and heart rhythm disturbances unprovoked by exercise,
    • Blood pressure imbalance - increase in systolic A / D to 160 mm. Hg Art. and above, which can be quickly replaced by normal and even reduced, and vice versa,
    • стойкий красный или белый дермографизм.

    Симптомы ВСД, как правило, возникают в периоды «приливов» и приступов потливости. Some authors distinguish three forms of menopausal syndrome, depending on the nature and number of symptoms:

    1. Typical - a feeling of "hot flashes" of heat to the head, face and neck area, abnormal sweating, sleep disorders, dizziness and headache.
    2. Atypical, characterized by both typical symptoms, and even or regional fatty tissue deposition, swelling of the lower extremities and face due to fluid retention in the body, pain in the bones and joints, especially femoral, dysuric phenomena, vaginal mucous membrane dryness, dyspareunia. Less common is the reduction in body weight against the background of a fairly rapid deterioration of general well-being. Among individual women, episodes of sympatho-adrenal crises are possible, accompanied by a sense of fear of death, heart rhythm disturbances, as well as high blood pressure numbers, allergic reactions, asthma attacks, hyper- or hypoglycemia in blood tests.
    3. Combined, which develops among women who already suffer from diseases of the heart and blood vessels, hypertension, impaired function of the liver and gall bladder, metabolic and endocrine disorders, allergic diseases.

    However, in this classification there is no clear difference between the early-term and the moderate-and late-time manifestations of the pathological menopause. Therefore, in practice, the traditional classification is mainly used, which was developed by Vikhlyaeva V.P. based on determining the severity of the current in accordance with the frequency of tides:

    It consists in assessing the severity of menopausal syndrome based on the determination of the frequency of "tides":

    • I severity, or mild form, occurring on average in 47% of women with this pathology - the number of tides during the day is not more than 10,
    • II severity, or moderate form - from 10 to 20 tides during the day (35%),
    • Grade III, or severe climacteric syndrome - the number of hot flashes per day is more than 20. This form occurs on average in 18%.

    According to research data, vegetative-vascular disorders occur in 13% of all women, and depressive states - in 10%.

    Diagnostics

    Diagnosis of menopausal syndrome does not constitute a special difficulty. It is based on:

    • taking into account the regularity / irregularity of the menstrual cycle or the absence of menstrual bleeding in accordance with the age period,
    • identifying a complex of the above symptoms,
    • exclusion of concomitant diseases or, in the presence of the latter, determining their connection with the existing symptoms of menopausal syndrome,
    • additional laboratory study of the hormonal status of the patient, as well as consultation of the therapist, oculist (examination of the state of the fundus vessels), the psychoneurologist and endocrinologist.

    Prevention and treatment of menopausal syndrome

    Prevention consists in the normalization of the mode of work and rest, a full balanced balanced diet, a rational motor mode and gymnastic exercises, timely treatment of concomitant somatic diseases and correction of disorders of the central nervous system function.

    Recommendations for mild menopausal syndrome inherently do not differ from preventive measures. In addition, it is recommended diet food with a predominance of lactic acid, fish and boiled meat products, the restriction of pork, duck, extractive dishes, spicy and pickled foods, spices, chocolate, strong tea or coffee, etc.

    Vitamins “A” with 800 µg courses and retinol in dosage increasing from 20 to 300 mg, ascorbic acid and vitamins of group “B” have a positive effect.

    Also appointed are general therapeutic massage and physical therapy, physiotherapy with a sedative effect, acupuncture courses, hydrotherapy, aromatherapy with jasmine, lavender, orange, patchouli and some other oils that help improve the psycho-emotional state, reduce irritability, depression.

    Infusions and tinctures of motherwort, hawthorn fruit, valerian rhizomes, dietary supplement complex "Relax", which is an adaptogen and consisting of rhizome powders of valerian, lemon peel, chamomile flowers, extracts of passionflower incarnate, motherwort herb, hop, etc., have a slight sedative effect.

    How to relieve moderate form menopausal syndrome?

    The above recommendations in these cases are added medication drugs - neuroleptics and tranquilizers (Frenolon, Metaperazin, Relium, Eperapine, Relanium, etc.), Melatonin, contributing to the normalization of sleep, reducing fatigue and mild depression, Enap (for normal blood pressure), for normal blood pressure). (by appointment of the neuropsychiatrist).

    Used in menopausal syndrome beta-alanine "Klimalanin"

    Climalanin is also used, blocking the release of biologically active substances of histamine and bradykinin by fat cells and exerting a quick effect with pronounced tides and sweating, Sagenit, the active component of which (sigitin) contributes to the implementation of both positive and negative feedback in the hypothalamus-pituitary-ovaries system.

    In addition, plant estrogen preparations of various groups (flavonoids and isoflavonoids, lignans, cimedranes, stilbenes), which are plant nonsteroidal compounds similar in structure to estradiol, are also used. These include Klimandion, Klimaktoplan and Remens, containing cimicifugu extract, Klimafen, obtained from hop and clover, Mastodinon - from prutnyak, Estrovel, Inoklim, Klimasoya, Innotech, Femwell, and many others.

    In cases of severe course and lack of effectiveness of the listed methods of therapy, the use of hormone replacement therapy by means of natural estrogens (Estradiol valerate, Estriol, Estradiol-17-beta, Estrogens conjugated), as well as their combination with gestagens (Utrogestan, Norgestrel, Progesterone, Didrogesteron, etc.) is recommended. .).

    If the prognosis with an adequate correction of menopausal syndrome is generally favorable, then psychoneurotic disorders, in particular, especially depressive states, are among the most severe clinical symptoms that are difficult to treat.

    In addition, a pathological complex of symptoms that is protracted in time, occurring in a moderate or severe form or, especially, against the background of other diseases, represents a threat of complications from the cardiovascular and central nervous system in the form of heart attacks and disorders of the cerebral circulation.

    Treatment of menopausal syndrome

    • Hormone replacement therapy with sex hormones:
      • estrogen therapy (female hormones), as a rule, is prescribed for menopausal women who have their uterus removed,
      • Gestagen therapy (female hormones) is more often prescribed to women with endometriosis (a disease in which the tissue of the uterine mucosa (endometrium) grows outside its inner layer and undergoes monthly cyclic changes, forming endometrioid cysts (foci) - cavities filled with liquid contents) or uterine bleeding (not menstrual),
      • intake of combined drugs: estrogen with gestagens for the remaining women.
    • Phytotherapy with plant hormones (phytohormones), which are found in legumes, dates, pomegranates, sunflower seeds, clover, cabbage, cereals, flax seeds, nuts, cherries, apples, garlic, carrots, etc. These products enrich the diet and take them as medicines phytomeans

    Complications and consequences

    • Tumors of the mammary gland, genitals.
    • Urinary incontinence.
    • Fractures of the bones.
    • Increased blood pressure.
    • The risk of atherosclerosis.
    • The risk of stroke (cerebrovascular accident), myocardial infarction (rupture of the heart muscle).
    • The risk of thrombosis (blockage of blood vessels).
    • Vaginal dryness, which leads to pain during intercourse.
    • The development of diabetes (metabolic glucose - carbohydrate).
    • Reducing the quality of life and working capacity of women.

    Prevention of menopausal syndrome

    • Healthy lifestyle:
      • rational and balanced nutrition (eating foods rich in vitamins, proteins, fats and carbohydrates, minerals),
      • weight control,
      • regular exercise
      • hardening of the body,
      • elimination of excessive physical and psycho-emotional stress
    • Timely and sufficient treatment of infectious, inflammatory and colds.
    • Compliance with the regimen of hormonal drugs.
    • Regular visits to the gynecologist (2 times a year).

    1. Gynecology: National leadership / Ed. V.I. Kulakov, G.M. Savelyeva, I. B. Manukhina. - GOETAR-Media, 2009.
    2. Gynecology. Textbook for universities / Ed. Acad. RAMS, prof. G. M, Savelieva, prof. W. G. Breusenko. - GOETAR-Media, 2007.
    3. Practical gynecology: a guide for physicians / V.K. Likhachev. - Medical Information Agency Ltd., 2007.
    4. Gynecology. A textbook for students of medical universities / V. I. Kulakov, V. N. Serov, A. S. Gasparov. - “Medical Information Agency LLC”, 2005.

    What is menopausal syndrome

    The syndrome occurs as a result of age-related decline in the level of female sex hormones (estrogens) in the body and changes in the work of the hypothalamus. The duration of this pathological condition can be from one and a half to 10 years. On average, symptoms occur about 2–5 years. Their severity depends on the overall health of the woman and the individual characteristics of her body.

    Menopause, that is, the cessation of menstruation, occurs in all women, without exception, but not all of them have menopausal syndrome. It is more likely to occur in women:

    • while reducing the body's adaptation system,
    • with hereditary diseases
    • with cardiovascular problems.

    The occurrence and course of menopausal syndrome is affected by the presence of gynecological diseases such as uterine fibroids and endometriosis. Psychosocial factors are also important - problems at work, disorder in personal life. Often the onset of the syndrome provokes a stressful situation. There is also a wave-like and seasonal manifestations of the climacteric syndrome, its peak occurs in spring and autumn.

    Degrees of severity

    Experts identify three forms of menopausal syndrome, depending on the severity of its course.

    • Easy form. It is diagnosed only in 16% of women suffering from menopausal syndrome [5]. With such a course, up to 7–10 tides per day are noted, the general condition and working capacity of the woman remain almost unchanged.
    • Medium shape. This form is typical for 33% of women [6]. The number of tides increases from 10 to 20 per day. At the same time, pronounced symptoms appear: headaches and dizziness, impaired memory, sleep, etc. The general condition worsens, working capacity decreases.
    • Heavy form. Severe course is typical for 51% of women [7]. In this case, a complete or almost complete loss of health, a sharp deterioration in the general condition is possible. Especially hard and long menopausal syndrome occurs in the event that it appeared with the early development of menopause, at the age of 38-43 years. The disorders arising in this case can lead to serious violations of psychosocial adaptation in all spheres of life, including family and intellectual.

    In addition, there is a classification of the syndrome, depending on the characteristics of clinical manifestations. In this case, there are also three forms.

    • Typical (uncomplicated). It is characterized only by hyperhidrosis (excessive sweating) and hot flashes. It is observed in practically healthy women experiencing prolonged physical or mental stress. The typical form is characterized by the timely onset of menopause and the appearance of the classic symptoms of menopause, which disappear on average in a year or two. The general condition of the woman does not change. There is a moderate-excessive deposition of subcutaneous fat, a decrease in skin elasticity and other signs of changes in the body, fully consistent with age. The state of the reproductive system in this form also corresponds to the age.
    • Complicated form It is found on the background of diseases of the digestive system, cardiovascular system, diabetes, thyroid dysfunctions in women over 45 years of age. With a complicated form, the frequency of tides increases, and the severity of their flow increases. There may be pain or a feeling of fading in the heart, increased heartbeat, memory and sleep disorders. According to studies, in women suffering from hypertension, the complicated form of menopausal syndrome occurs twice as often as in healthy people [8].
    • Atypical form occurs not too often, mainly in women who have suffered in the past physical or mental trauma, serious illness, surgery, or those who worked for a long time under the influence of harmful factors. For atypical forms characterized by a violation of the menstrual cycle, and then persistent absence of menstruation. After some time, typical climacteric syndromes appear: sleep disturbance, tearfulness, memory and performance deterioration. In addition, there is dry skin, hair loss and fragility; pigment spots appear on the skin of the hands, head and chest. Itching of the skin of the limbs or in the genital area may begin. Practically in all patients the weight increases, there are swelling, pain in the joints, urination becomes more frequent, sometimes painful. The condition worsens quickly enough, causing a complete loss of health. Women with atypical form may develop asthma attacks, osteoporosis, hypoglycemia, osteochondrosis, panic attacks.

    OTC phytoestrogens in the treatment of menopausal syndrome

    Symptoms of menopausal syndrome in women can and should be addressed. One of the most effective ways is to compensate for the estrogen deficiency during the perimenopause. But is hormone therapy always inevitable?

    Modern science has invented a method of extraction from plants of natural analogues of female sex hormones, called phytoestrogens. One of the most promising and studied is isoflavone-genistein [9]. Studies show that it can reduce the number and duration of hot flashes by a factor of 2 [10], as well as increase bone density in almost the same way as hormone therapy drugs. Unlike endogenous estrogen, which primarily resists the destruction of bones, genistein helps to strengthen bones by supporting the processes of bone formation and mineralization, increasing collagen synthesis, increasing bone mineral density.

    Of course, in pharmacies today you can find different types of drugs with legume extracts, phytoestrogens, etc., but you should pay special attention to those drugs that contain a combination of calcium and vitamin D3 with genistein, such as the biologically active complex Complivit ® Calcium D3 GOLD ". The use of this combination, according to a double-blind, placebo-controlled clinical study, leads to a more pronounced increase in bone strength, due to the effects on the metabolism and mineralization of bone tissue

    In addition, it makes sense to support health during menopause in two ways: relieving menopause symptoms and reducing the risk of late complications, such as osteoporosis, joint disease, and, as a result, reducing the quality of life. “Complivit Calcium D3 GOLD” can help in solving both tasks.

    Remember, menopause is not a sentence, with unpleasant symptoms that need to be put up with. Take the situation into your own hands, armed with modern drugs, vitamins and ... sportswear!

    It is not a drug.

    What it is?

    Menopausal syndrome in women is able to manifest more than 60% of the beautiful half of humanity, which has entered the threshold of menopausal changes. It represents the pathological changes of the entire female body associated with hormonal changes and the deficient level of production of female sex hormones. Accompanied by violations in the field of adaptogenic, psycho-emotional, cardiovascular, endocrine and neuro-vegetative state of the body with different manifestations of the duration and severity.

    Sometimes, menopausal syndrome, or as it is also called menopause syndrome, can develop as a result of the surgical intervention in the female reproductive system.

    The life position of many representatives at the time of these changes in the body is still positive. And despite the fact that many of the peaks of the path of life are already conquered, but there is still something to learn and to strive for. Именно поэтому первые проявления климактерия в большинстве случаев кажутся чем-то ужасным и пугающим, означающим приближающийся старческий период.And the appearance of wrinkles, frequent depressions and stresses contribute to a decrease in vitality.

    But do not forget that the course of the menopausal period is an inevitable and natural process that occurs in the body of each woman and lasts for 2 to 5-6 years. Therefore, in order to transfer it more gently, while retaining your life optimism, you need to be well-informed, to treat these changes correctly, and, following the recommendations of qualified specialists, to take the necessary measures to improve the general condition.

    Manifestations of atypical forms

    Symptoms of an atypical form of menopausal syndrome, mainly manifested in women just over 30 years, along with the occurrence of the early stage of menopause.

    Its manifestation can sometimes begin with the development of diabetes mellitus and other pathologies on the part of the vazevegetative systems of the body. This pathology of menopause may be accompanied by a tendency to allergic manifestations, impaired processes of body thermoregulation, visual hallucinations, nystagmus and the development of vegetative polyneuritis.

    In the diagnosis of early menopause, active excitation of the subcortical diencephalic structure of the brain with the formation of free particles of adrenaline and a high content of acetylcholine is observed. Bladder attacks in women with the development of this form of menopausal syndrome are surprisingly extremely rare: only a couple of such manifestations can occur per day. And this is with the development of a high degree of severity of the rest of the symptoms.

    This form of menopause occurs in 50% of cases in young women with the onset of early menopause.

    The reason for the development of signs of menopausal syndrome is a gradual decrease in the production of female sex hormones - estrogen, which is a consequence of the termination of the functional capacity of the ovaries under the influence of age-related changes in the female body.

    Diagnostic methods

    Diagnosis of menopausal syndrome may consist of the following steps:

    1. Analysis of information on the history of gynecological and hereditary factors of menopause, as well as existing diseases and complaints.
    2. Analysis of the menstrual functionality of the female body (the age at which the first menses appeared, their duration and frequency of regularity at the moment. If there is no menstrual function, then information is collected about the date of the last menstruation).
    3. Conducting a gynecological examination using a two-handed examination of the cavity of the vagina, which determines the correctness of the development of the genital organs, their size, the area of ​​pain, etc.
    4. Examination of the mammary glands to identify pathological changes in their structure.
    5. Examination of the general condition of the body to identify concomitant pathologies that are not related to the reproductive system of organs. As well as the assessment of external indicators (condition of the skin, hair, nail plates, body weight), measurement of blood pressure, pulsation and evaluation of the health of the cardiovascular system.
    6. Delivery of tests to determine the level of hormones in the blood, biopsy, coagulogram and cytology.
    7. The study of mammary glands for mammography, which allows to identify the development of serious pathological changes in the early stages, by x-ray examination.
    8. Ultrasound examination of organs located in the pelvic area,
    9. The passage of densitometry - a highly informative method of studying the state of the skeletal part of the body, in particular the bones of the spinal column, thighs and forearms, conducted to determine the likelihood of osteoporosis.

    In addition, mature women entering the threshold of menopausal changes are advised to consult with an optometrist, a neuropsychiatrist and an endocrinologist.

    Possible treatments

    Treatment of menopausal syndrome of mild form of severity mainly consists of a proper balanced diet, a rational approach to the mode of physical activity, taking vitamin complexes containing vitamins A and B.

    Also as a treatment can be prescribed such procedures as:

    1. Exercise therapy,
    2. massotherapy,
    3. physiotherapy,
    4. acupuncture,
    5. hydrotherapy,
    6. aromatherapy with the use of oils that actively affect the psycho-emotional state of a woman and contribute to its normalization.

    As a sedative, tinctures of the following medicinal plants can be used:

    • valerian roots,
    • flowers and hawthorn fruit,
    • motherwort grass.

    As well as high popularity has an effective biological additive "Relax", consisting of phytocomponents and contributing to the improvement of the general condition of women.

    In cases with moderate form of menopausal syndrome, additional drugs of tranquilization and neuroleptic spectrum of influence can be prescribed, among which Relium, Stage Razin, Frenolon, Renalarium are the most effective. And for the normalization of a normal mode of healthy sleep and relieve feelings of depression and fatigue, the drug Melatonin is prescribed, as well as Enap to restore blood pressure and sedatives.

    In addition, such drugs may be prescribed as treatment:

    • Pills Climalaninethat have a blocking effect on the release of free radicals of pathological compounds and help reduce the symptoms of hot flashes and excessive sweating.
    • Klimadinonbelonging to the group of phytoestrogens, containing in its composition extracts of the cimifuga racimoza, contributing to the overall reduction of menopausal manifestations.
    • Climafencontaining in its composition extracts of clover and hops.
    • As well as drugs such as ESTROVEL, Inoklim, Femwell other.

    Treatment of pathological menopause severe course is the use of hormone replacement therapy based on the use of drugs, including natural estrogens, of the following types:

    • valerate estradiol,
    • estriol,
    • 17 beta estradiols,
    • conjugated estrogen.

    And also used the combined interaction of natural estrogens with gestagens, among which the most popular drugs are:

    1. Progesterone.
    2. Utrozhestan.
    3. Didrogesterone.
    4. Norgestrel.

    In order for the climacteric syndrome to completely pass, it is absolutely necessary to observe all the appointments of a qualified specialist.

    But, it is necessary to take into account the fact that with the general positive dynamics of correction of the menopausal syndrome, the most problematic are disorders of the psychoemotional state, which are almost not influenced by drugs. Therefore, to mitigate menopause, it is necessary to eliminate to the maximum the probability of occurrence of depressive and stressful situations in the body.

    Possible complications

    In case of delayed treatment of menopausal syndrome or its incorrect treatment, the following complications and possible consequences of the climacteric syndrome may occur:

    • Neoplasms of various etiologies in the mammary glands and the reproductive system of organs, including cancer, which represents a great threat to the life of a woman.
    • Urogenital pathological changes characterized by urinary incontinence.
    • Increased risk of osteoporosis with subsequent high probability of the formation of chronic fractures.
    • Increased probability of occurrence and development of atherosclerosis, stroke, thrombosis, diabetes and ischemia.
    • Significant deterioration in the quality and level of vital activity of the fair sex.

    Symptoms of the disease

    Early signs of menopausal syndrome include:

    • headaches,
    • decrease in sexual desire (libido),
    • sweating, hot flushes,
    • heart palpitations and drops in blood pressure,
    • inattention, apathy, irritability, tearfulness, forgetfulness, sleep disturbances.

    Delayed manifestations (1-2 years after the last menstruation) are:

    • pain during intercourse (dyspareunia),
    • the appearance of wrinkles, dryness and peeling of the skin, hair loss,
    • urinary incontinence,
    • atrophy (dryness, thinning) of the mucous membranes of the urinary system and genital tract.

    Late signs (after 2-5 years from the last menstruation) are:

    • arterial hypertension,
    • an increase in the content of harmful fats in the blood (hyperlipidemia),
    • disruption of carbohydrate metabolism,
    • atherosclerosis (fat accumulation on the vascular walls, leading to their fragility and blockage),
    • osteoporosis (thinning and loss of bone strength),
    • decrease in hearing, sight, mental abilities.

    How to reduce the appearance of menopause

    Climacteric syndrome therapy begins with a healthy lifestyle. In order to reduce the intensity of the symptoms already present, the following recommendations should be followed.

    Engage in physical culture. It has been proven that everyday half-hour exercises contribute to the prevention of osteoporosis, diabetes, obesity and cardiovascular diseases. To reduce the number of tides is very useful yoga, aimed at learning to relax, control breathing.

    The pelvic floor muscles can be strengthened by performing Kegel exercises. Their meaning lies in the alternate relaxation and contraction of intimate muscles. These exercises should be performed at least 3 times a day. The number of repetitions is 15–20, and the duration of muscle contraction is 5 s. Such exercises help eliminate incontinence.

    Eat right. The food you eat should contain vegetable fats, fiber, and fiber (legumes, vegetables, fruits, whole grains, bran bread, wholemeal bread). As for foods that contain carbohydrates, they are recommended to be excluded from the diet.

    Full sleep. Our health depends on the duration and quality of sleep. To normalize it, try to refuse caffeinated beverages.

    Medicinal menopause therapy

    Treatment of the menopause with the medication method involves the use of hormonal drugs, antidepressants, vitamins and sedatives.

    Hormone replacement therapy (HRT). It is proved that estrogen in combination with progestogens alleviate emotional and mental, vasomotor (vegetative-vascular) disorders, as well as problems of the urinary system and genital organs. Arsenal of hormonal agents is quite large, in each case, their choice is carried out individually. Such drugs are prescribed orally (orally) and parenterally (transdermally in the form of gels and patches, intramuscularly, into the vagina in the form of capsules, tablets and suppositories).

    In hormone replacement therapy need only those women whose menopause occurs in severe form. This condition is due to serious adverse reactions to this treatment: an increase in the risk of cancer of the body of the uterus and breast, vein thrombosis and stroke. Therefore, before the start of HRT is required to carefully weigh the benefits from it and the possible risk.

    Antidepressants. To reduce or eliminate hot flashes, antidepressants may be prescribed: Sertralin (Zoloft), Paroxetine, Venlafaxine, and Fluoxetine. With the same purpose using anticonvulsants - hypotensive clonidine (clophelin) and gabapentin.

    Vitamins. For the prevention of osteoporosis, it is advisable to take calcium up to 1.5 g per day and vitamin D at a dose of 800 units. In addition, to prevent the development of osteoporosis, you can use drugs from the group of bisphosphonates (Bonefos, Alendra, Bonviva, etc.).

    Sedatives. For psycho-emotional disorders, effective tranquilizers (Tazepam), neurometabolic stimulants (Nootropil, Aminalon, etc.), neuroleptics (Frenolon), herbal remedies (Deprim). In addition, designate Belloid, Cinnarizin, Bellatamininal.

    Menopause prevention

    Prevent early extinction of reproductive function will help a healthy lifestyle:

    • hardening of the body,
    • weight control,
    • balanced and rational nutrition (eating foods rich in fats, proteins, vitamins and minerals),
    • moderate exercise
    • compliance with the regimen of hormonal drugs,
    • regular visits to the gynecologist (at least 2 times a year),
    • elimination of excessive psycho-emotional stress
    • smoking cessation and alcohol abuse
    • timely treatment of colds and inflammatory diseases.

    If you have any symptoms of menopausal syndrome do not despair. Menopause does not negate sexuality and femininity. However, in the case of pronounced manifestations of this process, it is necessary to urgently consult with your gynecologist. The sooner treatment is started, the better the result will be.

    The phases of menopausal syndrome

    The period of menopause in a woman's life is not a disease, but a physiological norm, due to age-related hormonal changes. Between the ages of 45-55 years, there is a restructuring of the work of the higher parts of the central nervous system of the female body, associated with a genetically incorporated mechanism for the termination of reproductive function. The result of these changes is a decrease in the synthesis of gonadotropic hormones that ensure the insufficiency of the functions of the sex glands.

    The processes occurring in a woman’s body during menopause develop gradually. Climacteric syndrome is related to hormonal changes complications and failures in the work of various systems and organs. Pathologies appear with varying degrees of intensity, depending on the climacteric phase:

    1. Premenopausal. It precedes the cessation of the menstrual cycle, lasts for 2-5 years. Pathological syndromes occur in 30-35% of women.
    2. Menopausal. Menstruation stops completely (you can talk about it after a year of their continuous absence). Symptoms of menopausal syndrome are recorded in 50-70% of women.
    3. Postmenopausal. The final restructuring of the reproductive and related systems, characterized by a deficiency of estrogen and an increase in the level of gonadotropic hormones. Lasts about 2 years, the pathological phenomena normally stop.

    Climacteric is called the early menopausal syndrome, which gradually develops from the onset of premenopausal disease, and is fading away by the time hormonal changes are completed. On average, this condition lasts for 3-7 years, reaches its peak in menopause, gradually disappears. In the acute stage, the symptoms manifest themselves intensively, the woman needs the support of others, and often in drug therapy.

    Causes

    Climacteric syndrome in women is provoked by changes in the structures of the hypothalamus - the gland, which mainly regulates the menstrual cycle. It is responsible for the synthesis of GnRH - neurohormone, under the action of which the adenohypophysis produces gonadotropic (follicle-stimulating and luteinizing) hormones. These substances ensure the maturation of the follicles and corpus luteum in the ovaries.

    The system of the hypothalamus-pituitary-ovaries during menopause undergoes functional changes, due to which, to maintain its balance, the pituitary gland stimulates the secretion of an increasing number of gonadotropic hormones. The result of this process is the failure of ovarian function. The cyclical nature of the products and the quality of the sex hormones estrogen (estradiol, estriol, and estrone) deteriorate, provoking a further imbalance of the reproductive system.

    Under the combined influence of these factors, ovulation ceases, and the reproductive period of a woman’s life ends there. Due to the fact that the pituitary and hypothalamic parts of the brain are connected with its cortex and other endocrine glands, against the background of changes in the functioning of the hypothalamus-pituitary-ovary system, the functions of the associated brain systems change. This causes the development of the following main climacteric pathological manifestations:

    • violations of the regulation of the cardiovascular system,
    • failures of the central and peripheral nervous systems,
    • changes in metabolic processes,
    • osteoporosis, etc.

    In some women, lack of ovarian function is compensated by increased function of the adrenal cortex. In this case, the pathological syndrome does not develop and its symptoms practically do not manifest themselves, the menopausal period proceeds gently, without complications. Violations of the physiological course of menopause occur under the influence of the following factors:

    • Intensive work, accompanied by mental, physical and emotional fatigue.
    • A disorder of the functions of the central nervous and endocrine systems, which developed before the onset of hormonal restructuring, under the influence of stressful situations or due to dysfunction of the organs of these systems.
    • Difficult pregnancies, childbirth or complications in the postpartum period in history.
    • Inflammatory processes in the pelvic organs.
    • Disorders of the menstrual cycle throughout the reproductive period.
    • Surgical interventions.
    • Overweight.
    • Bad habits (smoking, alcohol abuse).

    Manifestations of menopausal syndrome

    All the symptoms of a complicated menopause are conditionally divided into somatic, psychoneurotic, and vasic-vegetative manifestations of menopausal syndrome.In the early stages of development of abnormalities that coincide in time with the onset of failures in the menstrual cycle, vascular dystonia develops with characteristic clinical signs, complicated by neuropsychiatric disorders. Later, somatic signs appear that are associated with age-related changes and the body's response to the changed hormonal background.

    Neurovegetative

    Neuropsychiatric disorders and vegetative manifestations of menopausal syndrome combined with the onset of hormonal changes in the body are accompanied by the following neurovegetative symptoms:

    • "Hot flashes" - a feeling of influx of heat to the head, face, upper body,
    • redness of the skin on the neck, face, chest,
    • paroxysmal severe sweating, more intense at night,
    • dizziness
    • numbness of fingers
    • paresthesias,
    • goosebumps
    • muscle contractions,
    • tingling, pain in the heart,
    • lack of air, choking attacks,
    • heart palpitations and heart rate malfunctions, not arising from physical exertion,
    • differential blood pressure.

    Psychoneurotic

    During menopause, the mental state of a woman is under serious strain. In addition to hormonal adjustment, there is awareness of the onset of aging and wilting of the body, which is difficult to cope with on the background of disorders of the nervous system. The most common psychoneurotic disorders during the menopausal syndrome are:

    • increased anxiety, obsessive thoughts and states,
    • sleep disorders
    • short-term memory disorders
    • feeling of depression
    • diffidence,
    • high emotional lability - instability of mood, irritability, tearfulness,
    • reduced performance
    • increased fatigue
    • headaches,
    • concentration disorders
    • depressive syndrome
    • worsening or increasing appetite
    • weakening or increasing libido.

    Somatic

    Not only the reproductive, endocrine and nervous systems react to the changes in the hormonal background. Reactions from other systems are referred to as somatic symptoms, the most common are:

    • changing the condition of hair, nails, mammary glands,
    • weight gain (almost 50% of women)
    • dystrophic changes of the vaginal walls,
    • frequent urination,
    • reduced skin elasticity, wrinkles,
    • due to the leaching of calcium, the synthesis of vitamin D decreases, which provokes fractures, osteoporosis, and spinal diseases.

    Traditional methods of treatment

    To eliminate the symptoms of hot flashes help folk remedies based on medicinal herbs. In the absence of contraindications, you can use one of the following methods:

    • Sage tea. 400 ml of boiling water requires 1 tbsp. l valerian root, 3 tbsp. l sage, 1 tbsp. l horsetail. Mixture pour boiling water, insist half an hour. Take 100 ml twice a day.
    • Soothing decoction. 1 st. l dry motherwort, lemon balm, hawthorn, peppermint. Mixture pour 0.5 liters of boiling water, hold on low heat for 10-15 minutes. Take 100 ml before the main meals, courses of 14-20 days.
    • Beet juice with honey. 2 tbsp. l Spoons of beet juice mixed with 1 tsp. honey, dilute 1-2 tsp. water. Take 3 times a day, before meals, gradually move to the undiluted product (without water).
    • Tincture on hopy cones. For 250 ml of vodka or alcohol, 20 g of cones are required. Means insist two weeks in a glass container in a dark place. Take 30 drops, diluted with water, at the beginning of the attack of the tide.

    How does menopausal syndrome manifest and how to facilitate its flow?

    Symptoms of menopausal syndrome are observed within a few months after the first failure of the menstrual cycle. At the first stage, vegetative and psychoemotional disorders predominate, which include:

    • Sleep disturbances
    • Headaches,
    • Anxiety and apathy,
    • Unreasonable change of mood
    • Weakening of sexual desire
    • Flushing and sweating
    • Heart palpitations and jumps in blood pressure,
    • Pain in the heart,
    • Numbness of the limbs and cramps.
    • Climacteric depression.

    In accordance with the severity and intensity of symptoms, doctors distinguish three forms of the climacteric syndrome:

    1. Easy form: mild menopausal syndrome is considered to be the occurrence of hot flashes up to 11 times a day. This form is observed in 48% of patients and does not require special treatment.
    2. Moderate form: moderate climacteric syndrome is considered to be a condition when hot flashes occur 11 to 21 times a day. This deviation is observed in 34% of patients.
    3. Heavy form: The diagnosis of pathological climacteric syndrome is made to the patient if she develop hot flashes more than 21 times a day. This condition requires mandatory hormonal correction.

    To alleviate the climacteric syndrome can be a variety of methods. With mild and moderate flow, it is often enough just to change lifestyles, adjust nutrition and normalize work and rest schedules. Severe menopausal syndrome requires medical treatment. For therapy can be used both hormonal and non-hormonal drugs, depending on the overall clinical picture and the health of the woman.

    Important! Any medications to relieve menopausal manifestations should be prescribed by a doctor. Self-treatment even with folk remedies can result in the development of dangerous diseases.

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