Menopausal Syndrome (cs)
a complex condition with polymorphic vegetative-vascular, metabolic-endocrinia and psychopathological symptoms, which is associated with the pathological course of menopause. The reason for this condition is, firstly, a deficiency of estrogens (sex hormones) due to age-related endocrine restructuring in the body of a woman. It should be noted that menopause (the last uterine bleeding due to 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 adaptive systems of the body, which, in turn, depend on many factors. The likelihood of its occurrence increases in women with heredity, weighed down by the pathology of the menopause, cardiovascular diseases. Factors such as the presence of pathological traits of character, gynecological diseases, especially uterine fibroids and endometriosis, premenstrual syndrome before menopause, have an adverse effect on the onset and further course of menopause. Gkiahosotsialnye factors are also of great importance: unsettled family life, dissatisfaction with sexual relations; suffering associated with infertility and loneliness: lack of satisfaction at work. The mental state is aggravated by 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:Typical manifestations of kpimaktericheskoy syndrome include hot flashes and sweating. The severity and frequency of tides is different, from single to 30 per day. In addition to these symptoms, there is an increase in blood pressure, vegetatively-spsucistye crises. Mental disorders are present in almost all patients with CS. Their nature and severity depend on the severity of autonomic manifestations and personality traits. In a difficult situation, menopause is observed weakness, fatigue, irritability. Sleep is disturbed, patients wake up at night due to strong tides and sweating. There may be depressive sympathy: a lowered mood with anxiety for one's health or fear of death (especially with severe crises with a heartbeat, suffocation). Fixation on one’s health with a pessimistic assessment of the present and the future can become a leading factor in the clinical map of the disease, especially in people with an anxious-suspicious character.
During menopause, women may have ideas of jealousy, especially those who in their youth had a jealous character, as well as people who are prone to logical constructions, touchy, stuck, punctual. The ideas of jealousy can become so possessed by the patient that her behavior and actions become dangerous in relation to her husband, his "mistress" and herself. In such cases, hospitalization is required to avoid unpredictable consequences.
Ideas of jealousy usually arise in women who do not receive sexual satisfaction. The fact is that during the pre-menopausal period (before menopause), many women have increased sexual desire, which for various reasons (impotence in a husband, sexual illiteracy, rare sexual relationships for objective reasons) is not always satisfied. In cases where rare marital relations are not associated with sexual violations in the husband, and suspicion and thoughts about a possible betrayal may arise, which are supported by an incorrect interpretation of 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 imbalance, tantrums, etc.). After menopause, in some women, on the contrary, sexual desire decreases due to atrophic vaginitis (vaginal dryness), which entails a decrease in interest in sexual life and ultimately leads to disharmony in marital relations.
Menopausal symptoms in most women appear long after menopause and only in a small part after menopause. Therefore, the menopause period often stretches for several years. The duration of the course of CS depends to a certain extent on personality traits that determine the ability to deal with difficulties, including diseases, and adapt in any situation, and is also determined by the additional influence of sociocultural and psychogenic factors.
Treatment:Hormone therapy should be prescribed only to patients without severe mental disorders and with the exception of mental illness. It is advisable to carry out replacement therapy with natural estrogens in order to eliminate estrogen-dependent symptoms (hot flashes, sweating, dry vagina) and prevent the long-term effects of estrogen deficiency (cardiovascular disease, osteopoprosis - a rarefaction of bone tissue, accompanied by its fragility and fragility). Estrogens contribute not only to reducing hot flashes, but also to increasing tone and improving overall well-being. Progestogens (progesterone, etc.) by 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, they often use combined estrogen-progestogen drugs to avoid the side effects of pure estrogens. However, the prolonged, and sometimes unsystematic and uncontrolled, use of various hormonal agents leads, first, to the preservation of cyclic fluctuations in a state such as premenstrual syndrome (pseudo-premenstrual syndrome) and the formation of psychological and physical hormonal dependence and hypochondriacal personality development. The climacteric period in such cases stretches for many years.
Mental disorders are corrected using psychotropic drugs (tranquilizers; antidepressants; low-dose antipsychotics such as frenolone, sonapax, etaperazine; 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, the stage of hormonal adjustment (before menopause or after).
In principle, menopausal syndrome is a transient, temporary phenomenon, caused by a period of age-related neuro-hormonal changes in the body of a woman. Therefore, in general, the forecast is favorable. However, the effectiveness of therapy depends on the influence of many factors. The shorter the duration of the disease and the earlier treatment is started, the less various external influences (psychosocial factors, somatic diseases, mental injuries), the better the treatment results.