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Menopause. Menopause in women: age of onset, symptoms and treatment

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The climacteric period (menopause, menopause) is the physiological period of a woman's life, during which, against the background of age-related changes in the body, involutional processes in the reproductive system dominate.

Climacteric syndrome (CS) is a pathological condition that occurs in some women in menopause and is characterized by neuropsychic, vegetative-vascular and metabolic-trophic disorders.

Epidemiology

Menopause occurs at an average age of 50 years.

Early menopause is called the cessation of menstruation at 40-44 years. Premature menopause - the cessation of menstruation at 37-39 years.

60-80% of peri- or postmenopausal women experience CS.

Classification

In the menopause, the following phases are distinguished:

■ premenopause - the period from the appearance of the first menopausal symptoms to the last independent menstruation;

■ menopause - the last independent menstruation due to ovarian function (the date is set retrospectively, namely after 12 months of absence of menstruation);

■ postmenopause begins with menopause and ends at age 65-69;

■ perimenopause - the period that combines premenopause and the first 2 years after menopause.

The time parameters of the phases of the menopause are to some extent conditional and individual, but they reflect morphological and functional changes in various parts of the reproductive system. Isolation of these phases is more important for clinical practice.

Etiology and pathogenesis

During the reproductive period, lasting 30-35 years, a woman's body functions under the conditions of cyclic exposure to various concentrations of female sex hormones, which affect various organs and tissues, and are involved in metabolic processes. There are reproductive and non-reproductive target organs for sex hormones.

Reproductive target organs:

■ genital tract;

■ hypothalamus and pituitary gland;

■ mammary glands. Non-reproductive target organs:

■ brain;

■ cardiovascular system;

■ musculoskeletal system;

■ urethra and bladder;

■ skin and hair;

■ large intestine;

■ liver: lipid metabolism, regulation of SHBG synthesis, conjugation of metabolites.

The climacteric period is characterized by a gradual decrease and “turning off” of ovarian function (in the first 2-3 years of postmenopause, only single follicles are found in the ovaries, later they completely disappear). The resulting state of hypergonadotropic hypogonadism (primarily estrogen deficiency) may be accompanied by a change in the function of the limbic system, impaired secretion of neurohormones, and damage to target organs.

Clinical signs and symptoms

In premenopause, menstrual cycles can vary from regular ovulatory cycles to long delays in menstruation and/or menorrhagia.

In perimenopause, fluctuations in blood estrogen levels are still possible, which can be clinically manifested by premenstrual-like sensations (breast engorgement, heaviness in the lower abdomen, lower back, etc.) and / or hot flashes and other symptoms of CS.

According to the nature and time of occurrence, menopausal disorders are divided into:

■ early;

■ delayed (2-3 years after menopause);

■ late (more than 5 years of menopause). Early symptoms of CS include:

■ vasomotor:

Flushes of heat;

increased sweating;

Headache;

Arterial hypo- or hypertension;

Cardiopalmus;

■ emotional-vegetative:

Irritability;

Drowsiness;

Weakness;

Anxiety;

Depression;

Forgetfulness;

inattention;

Decreased libido.

2-3 years after menopause, the following symptoms may occur:

■ urogenital disorders (see the chapter "Urogenital disorders in menopause");

■ damage to the skin and its appendages (dryness, brittle nails, wrinkles, dryness and hair loss).

Late manifestations of CS include metabolic disorders:

■ cardiovascular diseases (atherosclerosis, coronary heart disease);

■ postmenopausal osteoporosis (see the chapter "Osteoporosis in postmenopause");

■ Alzheimer's disease.

Postmenopause is characterized by the following hormonal changes:

■ low serum estradiol levels (less than 30 ng/ml);

■ high serum FSH, LH/FSH index< 1;

■ estradiol/estrone index< 1; возможна относительная гиперандрогения;

■ low serum SHBG;

■ low serum levels of inhibin, especially inhibin B.

The diagnosis of CS can be established on the basis of the symptom complex characteristic of estrogen-deficient conditions.

Necessary examination methods in outpatient practice:

■ scoring of CS symptoms using the Kupperman index (Table 48.1). The severity of other symptoms is assessed on the basis of the subjective complaints of the patient. Next, the scores for all indicators are summarized;

Table 48.1. Menopausal index Kuppermann

■ cytological examination of smears from the cervix (Pap smear);

■ determination of the level of LH, PRL, TSH, FSH, testosterone in the blood;

■ biochemical blood test (creatinine, ALT, AST, alkaline phosphatase, glucose, bilirubin, cholesterol, triglycerides);

■ blood lipid spectrum (HDL-C, LDL-C, VLDL-C, lipoprotein (a), atherogenic index);

■ coagulogram;

■ measurement of blood pressure and heart rate;

■ mammography;

■ transvaginal ultrasound (the criterion for the absence of pathology in the endometrium in postmenopausal women is the width of the M-echo 4-5 mm);

■ osteodensitometry.

Differential Diagnosis

Menopause is the physiological period of a woman's life, so differential diagnosis is not required.

Since most diseases in the menopause occur as a result of a deficiency of sex hormones, the appointment of HRT is pathogenetically justified, the purpose of which is to replace the hormonal function of the ovaries in women who are deficient in sex hormones. It is important to achieve such levels of hormones in the blood that would actually improve the general condition, ensure the prevention of late metabolic disorders and do not cause side effects.

Indications for the use of HRT in perimenopause:

■ early and premature menopause (under age 40);

■ artificial menopause (surgical, radiotherapy);

■ primary amenorrhea;

■ secondary amenorrhea (more than 1 year) in reproductive age;

■ early vasomotor symptoms of CS in premenopause;

■ urogenital disorders (UGR);

■ the presence of risk factors for osteoporosis (see the chapter "Osteoporosis in postmenopause").

In postmenopausal women, HRT is prescribed for therapeutic and prophylactic purposes: for therapeutic purposes - for the correction of neurovegetative, cosmetic, psychological disorders, UGR; with prophylactic - to prevent osteoporosis.

Currently, there are no reliable data on the effectiveness of HRT for the prevention of cardiovascular diseases.

Basic principles of HRT:

■ Only natural estrogens and their analogues are used. The dose of estrogens is small and corresponds to that in the early and middle phase of proliferation in young women;

■ mandatory combination of estrogens with progestogens (with preserved uterus) prevents the development of endometrial hyperplasia;

■ All women should be informed about the possible impact of short-term and long-term estrogen deficiency on the body. Women should also be informed about the positive effects of HRT, contraindications and side effects of HRT;

■ To ensure optimal clinical effect with minimal adverse reactions, it is extremely important to determine the most acceptable optimal doses, types and routes of administration of hormonal drugs.

There are 3 main modes of HRT:

■ monotherapy with estrogens or gestagens;

■ combination therapy (estrogen-progestin drugs) in a cyclic mode;

■ combination therapy (estrogen-progestin drugs) in monophasic continuous mode.

For therapeutic purposes, HRT is prescribed for up to 5 years. With longer-term use in each case, the effectiveness (for example, reduced risk of fracture of the femoral neck due to osteoporosis) and safety (risk of developing breast cancer) of this therapy should be commensurate.

Monotherapy with estrogens and gestagens

Estrogens can also be administered transdermally:

Estradiol, gel, apply on the skin of the abdomen or buttocks 0.5-1 mg 1 r / day, permanently, or patch, stick on the skin 0.05-0.1 mg 1 r / week, permanently.

Indications for transdermal estrogen administration:

■ insensitivity to oral drugs;

■ diseases of the liver, pancreas, malabsorption syndrome;

■ disorders in the hemostasis system, high risk of venous thrombosis;

■ hypertriglyceridemia that developed before oral administration of estrogen (especially conjugated) or against its background;

■ hyperinsulinemia;

■ arterial hypertension;

■ increased risk of formation of stones in the biliary tract;

■ smoking;

■ migraine;

■ to reduce insulin resistance and improve glucose tolerance;

■ for a more complete implementation of the HRT regimen by patients.

Monotherapy with gestagens is prescribed in premenopausal women with uterine myoma and adenomyosis, in which surgical treatment is not required, with dysfunctional uterine bleeding:

Dydrogesterone inside 5-10 mg 1 r / day

from the 5th to the 25th day or from the 11th to

25th day of the menstrual cycle or Levonorgestrel, intrauterine

system1, insert into the uterine cavity,

single dose or medroxyprogesterone 10 mg orally

1 r / day from the 5th to the 25th day or from

11th to 25th day of the menstrual cycle or

Oral progesterone 100 mcg once daily from days 5 to 25 or from days 11 to 25 of the menstrual cycle or into the vagina 100 mcg once daily from days 5 to 25 or from day 11 to the 25th day of the menstrual cycle. With irregular cycles, gestagens can be prescribed only from the 11th to the 25th day of the menstrual cycle (for its regulation); with regular, both schemes for the use of drugs are suitable.

Combination therapy with two- or three-phase estrogen-progestin drugs in a cyclic or continuous mode

Such therapy is indicated for perimenopausal women with preserved uterus.

The use of biphasic estrogen-progestin drugs in a cyclic mode

Estradiol valerate orally 2 mg 1 r / day, 9 days

Estradiol valerate/levonorgestrel orally 2 mg/0.15 mg 1 r/day, 12 days, then break 7 days or

Estradiol valerate orally 2 mg, 11 days +

Estradiol valerate/medroxyprogesterone orally 2 mg/10 mg 1 r/day, 10 days, then break for 7 days, or

Estradiol valerate orally 2 mg

1 r / day, 11 days

Estradiol valerate / cyproterone inside 2 mg / 1 mg 1 r / day, 10 days, then a break of 7 days.

The use of biphasic estrogen-gestagenic drugs in continuous mode

Estradiol inside 2 mg 1 r / day, 14 days

Estradiol / dydrogesterone by mouth

2 mg / 10 mg 1 r / day, 14 days or

Estrogens conjugated orally 0.625 mg 1 r / day, 14 days

Conjugated estrogens / medroxyprogesterone orally 0.625 mg / 5 mg 1 r / day, 14 days.

The use of biphasic estrogen-progestin drugs with a prolonged estrogenic phase in continuous mode

Estradiol valerate inside 2 mg 1 r / day, 70 days

Estradiol valerate / medroxyprogesterone inside 2 mg / 20 mg 1 r / day, 14 days

The use of three-phase estrogen-gestagenic drugs in continuous mode

Estradiol inside 2 mg 1 r / day, 12 days +

Estradiol / norethisterone inside 2 mg / 1 mg 1 r / day, 10 days

Estradiol inside 1 mg 1 r / day, 6 days.

Therapy with combined monophasic estrogen-gestagen drugs in continuous mode

Indicated for postmenopausal women with preserved uterus. This HRT regimen is also recommended for women who have undergone hysterectomy for adenomyosis or cancer of the internal genital organs (uterus, cervix, ovaries) no earlier than 1-2 years after the operation (the appointment will be agreed with oncologists). Indications - severe CS after treatment of the initial stages of endometrial cancer and malignant ovarian tumors (cured cancer of the cervix, vulva and vagina is not considered a contraindication to the use of monophasic estrogen-progestin drugs):

Estradiol valerate/dienogest

15-04-2019

Menopause- the physiological transition of the body from puberty to the cessation of the generative (menstrual and hormonal) function of the ovaries, characterized by the reverse development (involution) of the reproductive system, occurring against the background of general age-related changes in the body.

Menopause occurs at different ages, it is individual. Some experts call the numbers 48-52, others - 50-53 years. The rate of development of signs and symptoms of menopause is largely determined by genetics..

But the time of onset, the duration and characteristics of the course of different phases of the menopause are also influenced by such moments as, for example, how healthy a woman is, what her diet, lifestyle, climate, and much more.

Scientists have found that females who smoke more than 40 cigarettes a day, menopause occurs on average 2 years earlier than non-smokers.

The beginning of the menopause begins with a significant decrease in the production of female sex hormones. The fact is that over the years, the function of the ovaries gradually fades away, and may even stop altogether. This process can last from eight to ten years, and it is called menopause in women.

But do not forget what exactly during the premenopausal period, a woman is at risk for unwanted pregnancy. Pregnancy during menopause is very common, and therefore the number of abortions in this age category is very high.

The main signs of menopause

Changes in the emotional sphere. Often a woman suffers from astheno-neurotic syndrome. She constantly wants to cry, irritability rises, the woman is afraid of everything, she cannot stand sounds, smells. Some women behave provocatively. They begin to color brightly.

The manifestation of clinical signs of menopause is individual. In some cases, it is not difficult to tolerate, in other cases, the symptoms are pronounced and torment a person for about five years. Climacteric symptoms disappear after the body adapts to new physiological conditions..

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

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

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

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

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

Women's problems in postmenopause

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

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

Typical problems that await a woman in 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. Significantly slow metabolism affects the increase in cholesterol, which forms blood clots. The latter, in turn, can lead to ischemic diseases, angina pectoris, and cardiac arrhythmia.
Vision is deteriorating, hearing is getting worse.
Thought processes slow down, memory worsens.
Unstable emotional state, nervousness, tantrums.
. May be bothered by itching. Warts appear and hairiness on the face and body increases.
A reduced amount of secretion secreted by the genitals affects their microflora. In conditions of insufficient amount of protective mucus, it is easier to get sick with sexual infections or inflammatory diseases. Colpitis (vaginitis, inflammation of the vaginal mucosa) and cystitis are frequent companions of women at this time.
The presence at the final stage is a very alarming sign. They indicate a high level of estrogen in the body, which is considered an anomaly at this age. The most common cause of this phenomenon is the development of breast, cervical or ovarian cancer. Danger is also any opaque discharge with a smell.
Urinary incontinence, which occurs for two reasons: prolapse of the pelvic organs and rapid weight gain.

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

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

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

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

"Climax" in Greek means "ladder". At some point, a woman, due to the reverse development of the reproductive organs, has to overcome this stage, leading to the extinction of the reproductive function. Hormonal changes that occur during menopause are a natural process, you do not need to be afraid of it.

Stages of menopause

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

There are three stages of menopause in women:

premenopause. It starts a few years before the full end of menstruation. The duration of the stage is from 1 to 3 years. The functions of the ovaries gradually begin to fade, ovulation ends, the process of conception becomes problematic. There are irregular periods. The interval between them increases, and the duration gradually decreases. The stage drags on.
Menopause. The period when a woman does not have menstruation during the year. At this time, a woman can gain a lot of weight, heart problems arise, and diabetes can develop. Menopause most often develops between the ages of 45 and 50. The cessation of menstruation before the age of 45 is considered early menopause, and before the age of 40 - premature.
Postmenopause. Time from the end of menopause to 69-70 years.

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

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

Symptoms

The table shows the main signs of an impending menopause.

	signs
Menstrual irregularity	With the extinction of the hormonal function of the ovaries, the duration of menstruation changes. They run irregularly and poorly. There can be an interval of one to three months between periods, and sometimes more. After a certain time, menstruation stops completely.
tides	At such moments, the woman is thrown into a fever that spreads to the face, neck, chest and arms. At this moment, the temperature rises, sweating and lack of air occur. The skin becomes red or blotchy. These symptoms may be accompanied by dizziness, nausea and tachycardia. Hot flashes last from 30 seconds to 3 minutes.
Mood change	In the premenopausal period, women experience disturbances in the psycho-emotional state. They are expressed in aggressiveness, irritability, tearfulness, anxiety, restlessness. For most women, such changes in mood appear before menstruation.
Change in appearance	Hormonal imbalance in the body leads to skin laxity, hair loss. Nail plates become brittle, dry, begin to exfoliate.
Weight gain	Being overweight is not always a sign of menopause. Fatty high-calorie foods also affect weight gain. Insulin resistance may develop. With age, the muscles decrease, and the layers of fat increase.
Nocturnal hyperhidrosis	Manifested in heavy sweating during sleep.
Vaginal dryness	With the slowdown of metabolic processes in the body, there is a decrease in elasticity, moisture content of tissues. become loose, cracks appear. The pelvic organs may droop and prolapse.
Insomnia	Restful sleep depends on the balance of estrogen and progesterone. The lack of the first leads to sweating, the second - to insomnia.
Decreased libido	The first reason for a decrease in sexual desire is the discomfort that occurs during 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	The most dangerous symptom. There are changes in the bone tissue, characterized by its rarefaction and increased fragility. Increased risk of bone fractures. The woman feels increased fatigue, weakness.
Urinary incontinence	Deficiency of female hormones weakens the muscles of the pelvis and leads to relaxation of the sphincter of the bladder
Muscle and headaches	During menopause, the tone of the blood vessels changes, resulting in headaches. Muscle pain appears when calcium metabolism is disturbed.
Memory problems	The reason is low estrogen levels. With the normalization of the hormonal background, the problem disappears.
Gynecological diseases	Influence the appearance of early menopause (primarily ovarian tumors).
Allergy	Its appearance is influenced by the connection of the endocrine and immune systems. With hormonal changes, allergic rhinitis, asthma, and dermatitis can occur.

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

Complications of the menopause

Not in all cases, there is a normal course of menopause in women. Possible complications of this period:

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

Due to the large number of possible complications, regular preventive visits to the gynecologist are necessary.

climacteric syndrome

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

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

In combination, these symptoms significantly worsen the quality of life of a woman, lead to a decrease in working capacity.

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

Causes of early menopause

Early menopause is called hormonal changes that began earlier than 45 years. This can be caused by a number of reasons:

ovarian depletion associated with a genetic anomaly (defect of the X chromosome);
inherited diseases (galactosemia, amenorrhea, blepharophimosis);
the consequences of surgical intervention - removal of fibroids along with the uterus, oophorectomy;
the effect of radiation and chemotherapy prescribed in the treatment of malignant neoplasms;
decrease in immunity.

A woman should know which doctor to contact with early menopause. A professional gynecologist-endocrinologist will consult and prescribe treatment.

How to delay the onset of menopause?

Specialists have developed several methods to remove menopause. period most suitable for the application of deferral 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 a long-term intake of phytoestrogens - plant substances similar in mechanism of action to natural estrogen. These drugs include Feminal, Estrovel, Femiwell, etc.
Phytotherapy - the use of decoctions and infusions of some medicinal plants (thyme, lungwort, sage, horsetail and many others). Effective for postponing menopause and Monastic tea.
In addition, for an effective result, you must adhere to the following rules:

do not eat fatty, sweet foods; the diet should be dominated by fruits, vegetables, dairy products;
play sports, thereby stimulating the production of biological substances that prolong youth;
take care of women's health and regularly visit a gynecologist;
avoid stressful situations;
to refuse from 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, 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, mammography is performed.

Ways to eliminate the symptoms of menopause

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

Hormonal drugs (estrogen) are indicated for severe menopause.
Phytoestrogens are a mild option for the treatment of menopausal disorders.
Physiotherapy - massage, physiotherapy exercises.
Folk treatment.

By what means is the treatment of female menopause, 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.

Menopause is the next stage of physiological changes in a woman's body, associated with the extinction of reproductive function. The greatest probability of its onset falls on the age of 45-52 years. Depending on the characteristics of the organism, past diseases, living conditions, menopause may occur earlier or later. The ongoing hormonal changes gradually lead to the aging of a woman. If she leads an active lifestyle, pays the necessary attention to her appearance, takes care of her health, then the aging of the body slows down.

There are 3 stages of menopause:

Premenopause - the beginning of hormonal changes, in which the level of estrogen begins to decline, menstruation becomes irregular. The chance of conception is reduced.
Menopause is a period of 12 months from the start of the last menstrual period. If in the previous period a woman can still doubt the cause of menstrual cycle failures, then the absence of menstruation during the year is an accurate sign of the onset of menopause.
Postmenopause - the period after the end of menopause, is about 3-5 years. The level of estrogen reaches a minimum.

Video: Menopause and its types

Types of menopause and age of their onset

Symptoms of menopause in women depend on age. Treatment is also prescribed in accordance with the age of menopause, which depends on the characteristics of physiology, general health, conditions and lifestyle. There are several types of climax:

premature (after 30 and before 40 years);
early (from 41 years to 45 years);
timely, considered the norm (45-55 years);
late (after 55 years).

Premature and late menopause are usually a pathology. After examination and finding out the causes of deviations from the norm, treatment is prescribed. With the timely onset of menopause, in some cases, only the relief of accompanying symptoms is required.

Causes and effects of premature menopause

The onset of menopause at an early age is possible for several reasons. First of all, this is due to diseases of the ovaries, their removal or treatment with hormonal drugs. Sometimes premature menopause is caused by congenital genetic disorders. In this case, insufficient production of eggs occurs. This pathology is inherited.

One of the reasons is too early puberty of the girl. The usual age of the onset of the first menstruation is considered to be 13-14 years. But sometimes menstruation appears as early as 10-11 years.

Menopause comes too early for those who have had diseases of the thyroid gland, reproductive organs, immune system, liver. Radiation therapy in the treatment of tumors, chemotherapy can provoke the onset of menopause.

The emergence of early menopause is also facilitated by an unhealthy lifestyle and bad habits (smoking, alcohol abuse, drug addiction). The provoking factor is obesity, as well as passion for diets, prolonged fasting.

The onset of early menopause, as a rule, is associated with hormonal disorders in the body. A decrease in the level of female sex hormones leads to infertility and early aging. In addition, hormonal disorders increase the risk of tumors of the mammary glands, reproductive organs. It also increases the risk of heart attack, stroke and other cardiovascular diseases. Imbalance of hormones leads to diseases of the thyroid gland, the functioning of the genitourinary system is disturbed. Early menopause causes neurosis, depression.

When the first suspicions of a decrease in sexual activity of the body appear, you should consult a doctor. In case of doubt about the cause of the menstrual irregularity, an FSH (follicle-stimulating hormone) test is done. With menopause, its level rises and remains constantly high. If the disturbances are temporary, then the level of this hormone fluctuates.

Video: Hormone tests to determine the onset of menopause

Causes and complications of late menopause

As a rule, heredity is a factor in the onset of late menopause. If it does not occur before the age of 55, while there are no health problems, then late menopause plays only a positive role. The normal composition of bone and muscle tissue is preserved longer. Less problems with the work of the heart, blood vessels, brain.

However, in some cases, a serious gynecological disease or treatment with chemotherapy and radiation can be the cause of late menopause. In this case, a woman should be constantly under the supervision of a doctor, since an exacerbation or recurrence of diseases that caused a delay in menopause is possible. The irregular occurrence of bleeding of varying intensity sometimes masks the symptoms of diseases, including malignant tumors.

menopause symptoms

There are a number of signs by which you can determine that menopause has come.

tides- periodic sudden attacks, accompanied by a feeling of heat, as well as blood flow to the face. At the same time, the woman sweats a lot. After a few minutes, a state of chill sets in. Such hot flashes can last for years, appearing 20-50 times a day. In this case, the doctor will tell you how to reduce their number, alleviate the symptoms.

Headaches, dizziness usually appearing in the morning. A woman is forced to give up her usual activities, quickly gets tired. She experiences unreasonable anxiety, becomes irritable.

Sleep disorders. The tides that arise during the day and at night wake the woman. After that, it is difficult for her to sleep. Insomnia comes not only because of the hot flashes. The cause of sleep disorders can be neurosis, arising from the deterioration of the nervous system and brain. The inability to sleep normally deprives you of strength and causes even more anxiety and irritation.

Frequent mood swings. The woman becomes touchy, tearful. Cheerful mood is abruptly replaced by irritability and anger.

Lump in the throat. The reaction of the autonomic nervous system, in which there is a sensation of interference in the throat. There is a need to make swallowing movements. The woman does not experience pain or any discomfort. This condition usually resolves on its own. However, if the symptom does not disappear within a few months, pain appears, then it is necessary to consult an endocrinologist. Similar sensations occur in diseases of the thyroid gland.

Weakening of memory. During this period, most women complain of "sclerosis", absent-mindedness, inability to concentrate.

Dryness of the vagina. The symptom is usually accompanied by itching, is the cause of pain during intercourse. It occurs as a result of changes in the structure of the vaginal mucosa under the influence of hormones. At the same time, there is also a decrease in sexual desire.

Violation of the urinary organs. Violation of the composition of the vaginal environment makes the genitourinary system more vulnerable to infection. Often there are diseases of the kidneys, bladder, inflammatory diseases of the ovaries, uterus. Weakening of muscle tone leads to urinary incontinence.

Increased blood pressure, rapid heartbeat. This indicates changes in the structure of blood vessels and in the heart muscle. The risk of heart disease in women is significantly increased.

Joint diseases, bone fragility. This indicates a lack of calcium. With the onset of menopause, a woman's absorption of nutrients worsens. Insufficient calcium intake weakens the bones. In addition, nails become brittle, hair loss and deterioration of their structure are observed. Tooth enamel also becomes thinner, more often caries occurs.

Video: Symptoms of menopause, what determines their severity, how to treat them

Diagnosis in menopause. How to relieve symptoms

With the appearance of such signs as a violation of the menstrual cycle, a decrease or increase in the volume of secretions, a sharp change in body weight and other unexpected signs, a woman should definitely consult a doctor: a gynecologist, an endocrinologist, a mammologist. An examination using ultrasound, X-ray, as well as a biochemical blood test for hormones and tumor markers will allow timely detection of serious diseases that need to be treated urgently.

If a woman is healthy, unpleasant symptoms are associated with menopausal abnormalities, then she will be prescribed therapy to eliminate insomnia, taking sedatives and vitamins. Preparations containing calcium and silicon will help prevent osteoporosis. Means are used to enhance blood supply, eliminate high blood pressure.

The most effective method of getting rid of hot flashes and other symptoms of menopause is hormone therapy. Sometimes it is enough to choose suitable hormonal contraceptives with the help of a doctor. Candles containing hormonal preparations, special patches, intrauterine devices are also used. With the help of these funds, the level of estrogen increases, which allows you to slow down the onset of menopausal changes. Hormone replacement therapy is carried out for at least 1-2 years. To prevent osteoporosis, its use is sometimes required for several years after menopause.

Warning: Any hormonal drugs should be taken as prescribed by a doctor. Excess estrogen leads to weight gain, varicose veins in the legs, breast disease, uterine fibroids, and other serious health problems.

To gently reduce the symptoms of menopause, non-hormonal remedies based on herbal components are used, for example, the biologically active food supplement ESTROVEL® capsules - a complex of phytoestrogens, vitamins and microelements, the components of which act on the main manifestations of menopause.

Treatment with folk remedies for menopause

In the treatment of hot flashes, insomnia, headaches and other manifestations of menopause, traditional medicine is successfully used: decoctions of plants, herbal soothing baths. The lack of estrogens is replenished with the help of phytoestrogens, which include, for example, sage.

Infusion to eliminate sweating and relieve hot flashes

Mix sage, valerian root and horsetail in a ratio of 3:1:1. A glass of boiling water pour 1 tbsp. l. collection. This healing infusion is drunk every day in several doses.

Herbal infusion for high blood pressure, palpitations, sweating

1 st. l. mixtures of hawthorn, motherwort, cudweed, chamomile (4:4:4:1) insist in 1 cup of boiling water and drink the medicine 3-4 tablespoons several times a day.