MENOPAUSE

Menopause (syn .: menopause) in women is caused by functional changes in the hypothalamus - pituitary - ovary and is expressed in the gradual cessation of menstruation, followed by almost complete extinction of ovarian hormonal activity within the context of age-related changes.

The first phase (premenopausal) is characterized by rhythm disturbances of menstruation and menstrual cycle length. Most women are gradually increasing the intervals between periods and decreases the intensity of bleeding. Less commonly observed shortening intervals and increased bleeding. Premenopausal usually occurs at age 45 and later, lasts about 5 years before complete cessation of menstruation (menopause). The duration of the second phase of menopause (postmenopausal), characterized by ovarian hormonal activity after the cessation of menses, is quite difficult to establish, but sometimes for 3 - 5 years (or more) after menopause may appear bloody menstrualnopodobnye selection. After menopause hormonal ovarian activity almost stops and comes the so-called physiological dormancy of the reproductive system.

Premature menopause (before 40 - 43 years) seen in women under unfavorable conditions of work and life, after frequent childbirth and abortion, massive blood loss during childbirth, chronic infectious diseases. Later, the extinction of menstrual function (after 53 - 55 years) observed in uterine fibroids, hypertension. Women puberty sudden cessation of menstruation can contribute to severe mental trauma, prolonged emotional stress.

The menopause often have dysfunctional uterine bleeding - prolonged irregular bleeding of varying duration and intensity. A number of patients having bleeding after menstruation. In clarifying the causes of uterine bleeding is important to separate diagnostic scraping the mucous membrane of the cervix and uterine body channel. The histological study scraping possible to identify the nature of endometrial changes, and most importantly - to exclude the presence of cancer.

In dysfunctional uterine bleeding produced before treatment diagnostic curettage endometrial provides both a therapeutic effect. When recurrent uterine bleeding, as well as hyperplastic processes of the endometrium in women aged 45 years and older spend on prescription hormone therapy (progestins, androgens) in a cyclic or continuous mode.

At menopause there are specific disorders. These include: 1) vasomotor disturbances - hot flushes, sweating, blood pressure fluctuations, palpitations; 2) emotional and mental - irritability, tearfulness, sleep disturbances, susceptibility to depression ; 3) Urogenital - typical of menopause dryness of the vulva and vaginal mucosa (senile colpites), frequent urination.

All these violations occur against the background of the female sex hormone deficiency and occur with varying intensity. Vasomotor and emotional and mental disturbances are called climacteric syndrome.

Its severity is determined by the frequency of hot flushes. Mild - up to 10 hot flashes per day; of average weight - up to 20 hot flashes, accompanied by dizziness, palpitations; severe - more than 20 hot flashes a sharp fluctuations in blood pressure, heart attacks, weakness and disability.

Treatment. In milder forms of climacteric syndrome used sedatives, antihypertensives, beta-blockers. Recommended light exercise (gymnastics in the morning), a balanced diet with restriction of the content in the diet of carbohydrates and fats, light water treatments (showers, douches), smoking cessation. They are also used specially developed for the treatment of menopausal disorders estrogen and progestogen drugs. Contraindication to hormone therapy are: uterine bleeding of unknown etiology; tumors of the uterus, ovaries, breast, thrombophlebitis a history of liver disease, kidney; hypertension (blood pressure above 150/90 mm Hg. Art.), severe diabetes. For the treatment of age-related kolpitov used topically ointment containing estrogen drug - estriol. If frequent urination is effective tableted product estriol.