Menopause: treatment and prevention
Cessation of menstruation in women indicates the beginning of menopause and the physiological cessation of female reproductive organs. The process starts a year later from the moment of the past month. The last menstruation in a woman’s life is called menopause.
Menopause normal is observed in women 45 to 50 years of age. However, there are early menopause on the background of gynecological diseases and iatrogenic (after surgical removal of gonads in women).
How is menopause?
Regardless of the beginning of the process in a woman’s body happen the same changes:
- Hormonal changes (increase in blood concentration of FSH and LH hormones; reduced estrogen levels).
- Termination of maturation of oocytes in the ovaries.
Menopause is manifested in all the patients differently and change begins in the eligibility period. The final relief of all signs of the syndrome occurs in postmenopausal period. Duration of menopause in women vary individually from 3 years to 10 or more. Have 50% of patients the duration of symptoms from 3 to 7 years.
There is an alternative point of view is confirmed by research, according to which 80 % of patients in postmenopause all the symptoms is completely.
Climacteric syndrome of various intensity and clinical symptoms. Rare lucky women can boast of easy menopause. The majority of women go to the doctor with the following complaints:
- hot flashes, sweating;
- the feeling of heat;
- sleep disorders;
- nervousness, depression;
- the development of hypertension and hypertensive crises;
- disruptions of the heart;
- chest pain;
- pain in the bones;
- heightened emotional sensitivity.
How is menopause?
For menopausal syndrome are divided into complicated and uncomplicated. The first option appears multiple symptoms that do not disturb the habitual way of life and the health of women.
The symptomatic manifestation
Clinical features of menopausal syndrome divided into two groups:
- The VASO-vegetative symptoms (disorders of the cardiovascular system, increase or decrease the pressure of pain of different localization, hot flashes, sweating, a sense of begonia gave me goose bumps).
- Disorders of the emotional-mental sphere (frequent mood swings, depression, constant fatigue, desire to sleep, insomnia, reduced performance, loss of memory, inability to concentrate, decrease in sexual activity).
- Changes in the genitourinary system and disease condition (thrush, failure of function production of protective mucus in the genital tract, pain during intercourse, frequent urination, leakage of urine during physical exertion, weakening of the ligamentous apparatus of the uterus and vagina, pain when urinating, incontinence).
- Fading of the skin, change of hair, nails (the appearance of new wrinkles and deepening of existing, thinning and hair loss, delamination, and the wringing of the nails).
- Change of metabolism (a tendency to obesity, atherosclerosis, osteoporosis, cardiovascular disease and Alzheimer’s disease).
The main cause of all pathological changes in a woman’s body is a decrease and then cessation of synthesis of estrogens. Such clinical diversity of symptoms associated with the presence of receptors for the female hormones in all tissues and organs.
In order of the first displays tides. Characteristic suddenness. The patient feels a sudden heat in the face, neck and then throughout the body. The rush is accompanied by hyperemia (redness of skin), difficulty breathing, rapid heart rate, sometimes chest pain, and sweating, and found this symptom in 90% of cases. The period of display of the tides varies from six months to 10 years.
The severity of the clinical picture is determined by the frequency of symptoms:
- mild (1 — 10 times a day);
- moderate (11 — 20 times per day);
- severe (more than 20 times per day).
The patient noted the manifestation of symptoms mostly at night, in summer, in a well-heated room, when the use of intoxicating drinks, spicy food, tea, coffee.
Variations of the menstrual cycle
The next symptom of menopause — the change cycle. After reaching 40 years of age monthly cycle is shortened or lengthened, the discharge becomes less abundant. Strengthening the menstrual discharge is an alarming symptom and evidence of the development of the pathological process in the female genital area.
The urinary system
The main manifestation of inflammatory diseases of the genital tract on the background of atrophy of the mucosa (vulvovaginitis, vaginitis) are dryness, burning and itching in the vagina, dyspareunia (pain during sex). Atrophy of secondary sexual characteristics.
Degenerative processes of the urinary tract lead to the leakage of urine during physical exertion, pain in the bladder (cystalgia), dysuria. The lack of adequate treatment leads to the progression of all symptoms.
The change in the elasticity of the ligamentous apparatus leads to a prolapse and prolapsed uterus, rectum.
Other symptoms of menopause
A decrease in the synthesis of estrogen results in a decrease in the number of collagen fibers in the skin, resulting in and deepening fine lines and wrinkles. The skin itself becomes thinner, loses its elasticity and dries up mostly on the face and hands.
In postmenopausal period in women with cardiovascular pathology is equivalent to that in men.
The reduction of calcium in bones leads to osteoporosis. This condition decreases bone strength and the slightest injuries cause fractures that have important social value. The disease is asymptomatic for a long period of time and manifests itself directly in case of injuries. Typical locations of fractures: femoral neck, vertebral bodies and bones of the forearm in a typical place (the bottom third).
Alzheimer’s disease the menopause can occur from lesions of the nervous system. In this nosology atrophy of the cortex of the brain, killing neurons of cortex and subcortical structures. Clinically gradual progressive deterioration of memory and mental development of dementia.
To prevent the development of all significant and unwanted consequences for the health of the patient by using replacement therapy (estrogen and progesterone).
Diagnosis of menopausal syndrome
The diagnosis of “menopause” is based primarily on clinical data. Laboratory confirmation is the study of hormonal background of the patient (follicle-stimulating hormone and estrogens, thyroid hormones).
All women in postmenopausal period should undergo an annual examination by a gynecologist. The appearance of pathological bleeding on underwear during the premenopausal, the changing nature of menstruation must guard against malignant diseases of the female genital organs. Absence of menstruation during this period, in rare cases, it may be a sign of pregnancy.
Nonpharmaceutical treatment of climacteric syndrome
Remember that any change in the body is a way of life. Menopause is no exception. Early referral for specialized care provides a greater chance for the prevention of diseases and prevention of health effects.
First of all, change the habitual way of life:
- Maintain fitness or yoga — physical activity reduces the risk of heart disease and blood vessels, obesity, diabetes. Bike ride or imitation is a great way to strengthen the muscular system of the pelvic floor.
- Drink more water, reduce the intake of carbohydrates. Enrich your diet with foods rich in fiber.
- Take your multivitamin.
- If possible, give up or reduce consumption of coffee and alcoholic drinks.
- Get enough sleep (normal sleep duration adult 8 hours).
- Start walking before bedtime.
- After consulting the physiotherapist go through restorative therapies.
In case of severity of symptoms of climacteric syndrome, your doctor will prescribe drug therapy.
Hormones in the treatment of menopause
Replacement therapy by the complex of estrogen with progesterone improves mood, eliminates the manifestation of vegetative-vascular reactions, stabilizes emotional and mental state and eliminates the symptoms of inflammatory and atrophic diseases of the genitourinary system.
Hormone replacement therapy shown in patients with severe menopause.
The risk of breast cancer and uterus, disorders of cerebral circulation and thrombosis of the veins of the unwanted effects of hormone replacement therapy.
The decision to use hormonal preparations taken by the doctor after a full examination, the weighing of risks and detailed information of the patient.
The set of tests before prescribing estrogen and progesterone include:
- a detailed medical history;
- study of cellular composition of smears;
- ultrasound examination of the reproductive system and mammary glands;
- densitometry of bones;
- the study of coagulation and biochemical blood analysis.
The number and composition of agents that are assigned to the woman, influence of surgical intervention on the organs of the reproductive system. For example, patients after hysterectomy are reserved exclusively for estrogens. A progestogen with estrogen in menopausal period are recommended to patients with preserved all organs, with the aim of preventing malignant diseases.
Ways of intake of medicines
Methods of administration of hormonal drugs is varied and you can choose the option optimal for the patient: injection, skin patches and gels, vaginal — candles, pills and capsules).
Symptoms of atrophic vulvovaginitis it is possible to adjust vnutrivlagalischnye the introduction of estrogen (cream, tablet, vaginal ring).
Prevention of diseases of other organ systems
The flow of estrogen in the woman’s body slows the process of disintegration of the collagen fibers and thus prevents atrophy of the skin.
Treatment and prevention of osteoporosis in menopausal syndrome is medication calcium, vitamin D, bisphosphonates and, more recently, a prohormone is a synthetic steroid that has estrogenic, progestogenic, and androgenic effect.
Correction changes the emotional-mental sphere is carried out with tranquilizers, antidepressants, sedatives.
For the normalization of the lipid spectrum of the prescribed statins, obesity — drugs affecting the metabolism, diuretic. The pressure change in the patient requires antihypertensive medication.
When a progressive deterioration of memory is recommended to consult a neurologist and an MRI of the brain with the aim of timely detection of Alzheimer’s disease.
Topical application of homeopathic medicines or use herbal teas, tinctures and decoctions of herbs (upland uterus, chamomile, red brush, etc.).
Timely diagnosis, correction and prevention of climacteric syndrome helps to preserve a woman’s health and quality of life. Medication (hormonal therapy) should be applied on the strict condition that is prescribed by your doctor.