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Climacteric Syndrome (CS)


complex condition with polymorphic vegechativno-vascular, metabolic and endocrine and psychopathology, vochnikayuschee the pathological course of menopause. The cause of this state is, firstly, estrogen deficiency (sex hormones) due to endocrine age adjustment in women. It should be noted that menopause (the last uterine bleeding due to ovarian function) occurs in all women, but not every one of them is suffering climacteric syndrome. It occurs in the case of reducing the body's adaptation systems, depending, in turn, on many factors. The probability of its occurrence is increased in women with a family history, pathology burdened menopause, cardiovascular disease. The occurrence and the further course of the climacteric syndrome are adversely affected by factors such as the presence of pathological character traits, gynecological diseases, especially uterine fibroids and endometriosis, premenstrual syndrome to menopause. Are of great importance and gkyahosotsialnye factors: disruption of family life, dissatisfaction with sexual relations; sufferings associated with infertility and loneliness: the lack of satisfaction in the work. Mental state is aggravated by the presence of psychogenic situations, such as serious illness and death of children, parents, husband, conflicts in the family and at work.
Symptoms and over:
Typical manifestations of the syndrome are stuck kpimaktericheskogo heat and sweating. Intensity and frequency of the tides is different from single to 30 per day. In addition to these symptoms, there is an increase in blood pressure, vegetatipno-spsutsistye crises. Mental disorders are represented in almost all patients with CS and nature of their severity depend on the severity of autonomic symptoms and personality characteristics. When the plight of menopause there is weakness, fatigue, irritability. Disturbed sleep, patients wake up during the night because of the strong tides and sweating. Maybe depressive simmatika: depressed mood with concern for their health, or the fear of death (especially in crises with severe palpitation, dyspnea). Commit to your health with a pessimistic assessment of the present and the future can become a leader in clinical kartdne disease, especially in people with anxiety and doubtful character.
During menopause women may experience jealousy ideas, especially those who in his youth differed a jealous nature, as well as in those who are prone to logical constructions, resentful, stuck, punctual. Ideas can be so jealous master patient that her behavior and actions become dangerous in relation to her husband, his "mistress" and to itself. In such cases, hospitalization is required in order to avoid unintended consequences.
jealousy ideas usually occur in women who are not receiving sexual gratification. The fact is that during preklimaksa (before menopause) many women have increased sexual desire, which for various reasons (impotence in man, sexual ignorance, occasional sexual relationships to objective reasons) is not always satisfied. In cases where the rare conjugal relations are not related to sexual disorders in man, and can arise suspicions and thoughts about possible changes, which are supported by an 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 illness) and neurotic disorders (fear, emotional instability, tantrums, etc.). After menopause in some women, on the contrary, decreased sex drive, due to atrophic vaginitis (vaginal dryness), which entails a reduction of interest in sexual activity, and ultimately leads to disharmony marriage.
Climacteric symptoms in most women appear zadolgodo menopause and only a small proportion - after menopause. Therefore, the period of menopause often extends over several years. The duration of current COP depends to some extent on the personal characteristics that determine the ability to deal with difficulties, including disease and adapt to any situation, and is due to additional exposure to sociocultural factors, and psychogenic.
Treatment:
Hormone therapy should be administered only to patients without obvious mental disorders, and the exclusion of mental illness. It is advisable to carry out the natural estrogen replacement therapy for the elimination of estrogen-dependent symptoms (hot flushes, sweating, vaginal dryness) and prevent long-term consequences of estrogen deficiency (cardiovascular disease, osteopoproz - bone loss, accompanied by its fragility and brittleness). Estrogens contribute not only to a decrease in hot flashes, but also improve the tone and improve overall health. Progestins (progesterone, etc..) Alone can reduce mood, and in the presence of mental disorders aggravate the condition, so in such cases, gynecologists prescribe them after consultation with a psychiatrist. In practice, often use the combined estrogen-progestin drugs to avoid side effects of pure estrogen. However, prolonged and sometimes haphazard and uncontrolled, the use of different hormonal agents leads, first, to preserve the state of cyclic fluctuations such as premenstrual syndrome (psevdopredmenstrualny syndrome) and the formation of the psychological and physical dependence and hormone hypochondriacal personality development. Menopause in such cases, extends over many years.
Mental disorders are corrected with the help of psychotropic drugs (tranquilizers, antidepressants, neuroleptics in small doses, such as frenolona, ​​sonapaksa, etaperazina; nootropics) in combination with different types of psychotherapy. Psychotropic drugs can be combined with hormones. Purpose of treatment in each case carried out individually, taking into account the nature and severity of psychiatric symptoms, somatic disorders, hormonal changes phase (before or after menopause).
In principle, menopausal syndrome - a phenomenon transient, temporary, due to the period of the age of neuro-hormonal changes in a woman's body. Therefore, in general, favorable prognosis. However, the effectiveness of therapy depends on many factors influence. The lower the duration of illness and the sooner treatment is started, the smaller the various external factors (psychosocial factors, somatic illness, trauma), the results of treatment are better.