Climacteric syndrome (cc)
a complex condition with polymorphic vegetative-vascular, metabolic-endocrinia and psychopathological symptoms, in particular for menopausal pathologies. The cause of this condition is, firstly, the lack of estrogen (sex hormones) due to age-related endocrine adjustment in the woman's body. It should be noted that menopause (the last uterine bleeding caused by ovarian function) occurs in all women, but not all of them suffer from menopausal syndrome. It occurs in the case of a decrease in the adaptation systems of the body, depending, in turn, on many factors. The probability of its occurrence increases in women with heredity, aggravated pathology of menopause, cardiovascular diseases. The occurrence and further course of menopausal syndrome are adversely affected by such factors as the presence of pathological personality traits, gynecological diseases, especially uterine fibroids and endometriosis, premenstrual syndrome before menopause. Of great importance are also the factors of social status: lack of family life, dissatisfaction with sexual relations; suffering from infertility and loneliness: lack of job satisfaction. The mental state is aggravated in the presence of psychogenic situations, such as severe illness and death of children, parents, husband, conflicts in the family and at work.
Symptoms and course:The typical manifestations of kpimaktericheskogo syndrome include sticky heat and sweating. The severity and frequency of tides varies from single to 30 per day. In addition to these symptoms, there has been an increase in blood pressure, vegetatypical-spissy crises. Mental disorders are present in virtually all patients with CS. Their nature and severity depend on the severity of the vegetative manifestations and personal characteristics. In the difficult situation of menopause, there is weakness, fatigue, irritability. Sleep is disturbed, patients awaken at night due to strong tides and sweating. There can be depressive simmatika: low mood with anxiety over one's health or the fear of death (especially during severe crises with palpitations, suffocation). Fixing one's health with a pessimistic assessment of the present and the future can become a leading disease in the clinical field, especially in individuals with anxious and suspicious character.
In the period of menopause, women may have ideas of jealousy, especially among those who, in their youth, were distinguished by their jealous nature, as well as by people inclined to logical constructions, touchy, stuck, punctual. The ideas of jealousy can so seize the patient that her behavior and actions become dangerous towards her husband, his “mistress” and herself. In such cases, hospitalization is required to avoid unpredictable consequences.
The ideas of jealousy usually occur in women who do not receive sexual satisfaction. The fact is that during the period of preklimaksa (before menopause), many women have increased sexual desire, which for various reasons (impotence in her husband, sexual illiteracy, rare sexual relations for objective reasons) is not always satisfied. In cases where rare marital relations are not associated with sexual disorders in her husband, suspicion and thoughts of possible betrayal may arise, which are reinforced by incorrect interpretation of the real facts. In addition to the ideas of jealousy, sexual dissatisfaction (with increased sexual desire) contributes to the appearance of psychosomatic (see Psychosomatic diseases) and neurotic disorders (fears, emotional instability, hysterics, etc.). After the onset of menopause, in some women, on the contrary, sexual desire decreases due to atrophic vaginitis (vaginal dryness), which leads to a decrease in interest in sex life and ultimately leads to disharmony in the marital relationship.
Climacteric symptoms in most women appear long-term menopause, and only a small part - after the onset of menopause. Therefore, the period of menopause is often stretched for several years. The duration of a CS course depends to a certain extent on personal characteristics that determine the ability to deal with difficulties, including diseases, and to adapt in any situation, as well as due to the additional influence of socio-cultural and psychogenic factors.
Treatment:Hormone therapy should be prescribed only to patients without pronounced mental disorders and with the exception of mental illness. It is advisable to conduct replacement therapy with natural estrogens in order to eliminate estrogen-dependent symptoms (hot flashes, sweating, vaginal dryness) and prevent the long-term effects of estrogen deficiency (cardiovascular diseases, osteoprosis - rarefaction of the bone tissue, accompanied by its fragility and fragility). Estrogens not only help to reduce the tides, but also increase the tone and improve overall health. Progestogens (progesterone and others) themselves can reduce mood, and in the presence of mental disorders exacerbate the condition, so gynecologists in such cases prescribe them after consulting a psychiatrist. In practice, often use a combination of estrogen-progestin drugs in order to avoid the side effects of pure estrogen. However, the long-term and sometimes unsystematic and uncontrolled use of various hormonal agents leads, firstly, to the preservation of cyclical fluctuations of the state of the type of premenstrual syndrome (pseudo-pre-menstrual syndrome) and the formation of psychological and physical hormonal dependence and hypochondriacal development of the personality. The climacteric period in such cases extends over many years.
Mental disorders are corrected with the help of psychotropic drugs (tranquilizers; antidepressants; antipsychotics in small doses such as frenolone, sonapaks, epotarazine, nootropics) in combination with various types of psychotherapy. Psychotropic drugs can be combined with hormones. The purpose of treatment in each case is carried out individually, taking into account the nature and severity of psychopathological symptoms, somatic disorders, hormonal adjustment stage (before or after menopause).
In principle, menopausal syndrome is a transient, temporary phenomenon caused by a period of age-related neuro-hormonal adjustment in a woman’s body. Therefore, the overall outlook is favorable. However, the effectiveness of therapy depends on the influence of many factors. The shorter the duration of the illness and the earlier the treatment started, the fewer different external influences (psychosocial factors, somatic diseases, mental trauma), the better the treatment results.