Severe menopausal syndrome treatment. Premenopausal period (syndrome)

Description:

Climacteric syndrome is a symptom complex that develops during the period of age-related decline in the function of the reproductive system and is characterized by neurovegetative, metabolic-endocrine and psycho-emotional disorders of varying degrees of intensity and duration. Clinical manifestations of menopausal syndrome are often interrelated and may be due to various diseases of adolescence. The overall incidence of menopausal syndrome varies from 40% to 80%.

Climacteric syndrome can manifest itself in relation to the time of cessation of menstruation (menopause) with different frequencies: in the premenopausal period in 36% - 40% of patients, immediately with the onset of menopause - from 39% to 85%, within 1 year after menopause - in 26% , 2–5 years after menopause - in 3%.

Symptoms:

Clinical manifestations of climacteric syndrome can be conditionally divided into three groups: neurovegetative, metabolic-endocrine and psycho-emotional. In most cases, the first signs of menopausal syndrome occur in direct connection with the cessation of menstruation (menopause) or in the first year after menopause. Often the onset of the disease is preceded by stressful situations of a different nature. The phenomena of the climacteric syndrome often have a wavy and seasonal character in the spring (February-March) or autumn (September-October) time.

The most typical (90% - 98%) for the clinical picture of the climacteric syndrome are hot flashes to the face, head and upper half of the body, which last from 30 seconds to 1-2 minutes. Increased sweating accompanies hot flashes in more than 80% of cases. These phenomena can be provoked by any irritants, including emotional stress, changes in weather conditions, etc. peripheral vessels, increased heart rate up to 130 beats / min or more.

Despite the variety of individual clinical manifestations of menopausal syndrome, neurovegetative manifestations occupy the main place in the clinical picture of the disease.

For many patients with menopausal syndrome, the following autonomic disorders are characteristic: the appearance of red spots on the neck and chest (“vascular necklace”); frequent bouts of severe; decrease or increase in blood pressure (BP); crisis course; cardiopalmus; seizures with a pronounced psycho-emotional coloring.

In 66% of women after the first 0.5 - 2 years after menopause, episodes of acute increase in blood pressure are observed, which occur both at rest and in an active state, and sometimes provoked by emotional arousal. In the intervals between these episodes, blood pressure indicators remain within normal limits. In some cases, fluctuations in blood pressure in patients with climacteric syndrome, which go beyond the normal range, are the first clinical manifestations of previously secretive hypertension.

Among the complaints presented by patients with menopausal syndrome, a special place belongs to cardiovascular symptoms, and therefore it often becomes necessary to exclude myocardial infarction. The appearance of pain in the region of the heart in menopausal syndrome is due to the increased sensitivity of the cardiovascular system to common stimuli due to metabolic disorders in the heart muscle. In almost 1/3 of observations, climacteric cardiopathy is combined with the initial stages.

As a result of a change in immunological reactivity after menopause, the clinic of menopausal syndrome can manifest itself in the form of:, on the face, vasomotor, intolerance to a number of foods, seizures that are not amenable to traditional therapy.

In the occurrence of metabolic and endocrine disorders, both general changes in metabolic processes and an increased reaction of some organs and tissues to an age-related decrease in estrogen levels play an important role.

Urogenital symptoms include: dystrophic changes in the vulva, inflammation of the walls of the vagina, cystalgia. Atrophic changes in the genitourinary tract are observed in 80% of women 4–5 years after menopause. In urogenital disorders, itching or dyspareunia, recurrent vaginal infections, painful and involuntary urination, etc. are noted. Loss of tone of the supporting ligaments and muscles can lead to prolapse and prolapse of the vagina and uterus.

Estrogen-dependent tissues include not only the genitourinary system, but also the mammary glands, skin, hair and nails. All of them are susceptible due to a decrease in the content of collagen during menopause. Along with this, the thickness of the skin decreases, its elasticity decreases and blood circulation in the skin capillaries slows down due to estrogen deficiency. In 15% of patients with menopausal syndrome with the onset of menopause, there are: "dry" conjunctivitis, laryngitis, dry mouth. Often there are problems with the use of contact lenses. Some women with menopause may experience facial hair growth and a deepening of the voice. In the menopause, certain changes in body weight are also observed: a decrease in 16%; an increase in 40%; no change in body weight in 44%.
in the postmenopausal period is also a consequence of estrogen deficiency. In some cases, patients with menopausal syndrome are also concerned: night pains in the limbs are sometimes accompanied by a feeling of cold; lesions of the spinal column by type with degeneration phenomena; skin .

In menopause, there is a tendency to increase the activity of the blood coagulation system. Due to this, the risk of developing thromboembolic complications against the background of various provoking factors (injuries, surgical interventions, infections, etc.) increases.

Among the psycho-emotional disorders in patients with menopausal syndrome, there are: emotional and mental disorders; decreased memory and attention; deterioration in performance; irritability; emotional instability. There are several options for the form of behavior in menopausal syndrome: indifferent behavior; fixture; active overcoming; neurotic behavior. In 13% of patients, neurotic disorders are noted, which are manifested by tearfulness, an attack of irritability, a feeling of fear, intolerance to sound and olfactory stimuli. At the same time, a woman's behavior is significantly influenced by her perception of menopause as a sign of aging, the end of a specific biological function of the female body. In 10% of patients, it is observed, which is one of the most severe and difficult to treat symptoms that occur in menopausal syndrome.

Causes of occurrence:

Climacteric syndrome occurs as a result of age-related fluctuations in estrogen levels, but not their absolute deficiency. On the other hand, climacteric syndrome is the result of the consistent development of age-related changes in certain centers of the hypothalamus.

Treatment:

For treatment appoint:

Stages of treatment of patients with menopausal syndrome 1) non-drug therapy, 2) special drug non-hormonal therapy 3) hormonal therapy. 1) non-drug therapy (outpatient stage) Psychoprophylactic preparation of every woman for the transition period is important. It is advisable to use special complexes of physiotherapy exercises. General massage, walks before going to bed also help to improve the well-being of patients. In adolescence, systematic monitoring of body weight is especially necessary. The diet should be dominated by fruits and vegetables, vegetable fats. You should limit your intake of carbohydrates. In the process of regulating the diet, it is recommended to include vitamin preparations in the diet. The natural deficiency of vitamins during menopause can be covered by the periodic appointment of special vitamin complexes. The use of vitamins "A", "E" and "C" is especially advisable. To regulate the hormonal balance, replenish the deficiency of vitamins and minerals in the periods of pre- and postmenopause, preparations containing a complex of vitamins, macro- and microelements are specially proposed: Menopace. For the prevention and treatment of osteoporosis in menopausal syndrome, calcium preparations and mineral complexes - Osteokea are recommended. 2) special drug non-hormonal therapy (outpatient stage).

Climacteric syndrome is a symptom complex that develops during the period of age-related decline in the function of a woman's reproductive system and is characterized by neurovegetative, metabolic-endocrine and psycho-emotional disorders of varying degrees of intensity and duration.

Etiology and pathogenesis

The main regulating link of the menstrual cycle is the hypothalamus. It produces releasing hormones. Currently, it is believed that the hypothalamic regulation of the production of FSH and LH by the adenohypophysis is carried out by one hormone - gonadoliberin, produced by the hypothalamus. For many years, the hypothalamus-pituitary-ovarian system has been functioning as a self-regulating system based on the feedback principle. However, with age, involutive changes in the hypothalamus occur, which is manifested by an increase in its sensitivity threshold to the action of estrogens and increased production of gonadotropic hormones, primarily follitropin. The cyclicity of their selection is also violated. Due to the ever-increasing stimulation of the ovaries from the hypothalamus, they secrete into the blood a large amount of not only the working hormones of estrogens, but also the intermediate products of their synthesis. However, from a certain point on, the amount of hormones produced by the ovaries is insufficient to inhibit the excited hypothalamic activity and high production of follitropin. There is no decrease in follitropin release, and therefore ovulation does not occur. With the cessation of ovulation, the corpus luteum does not develop, reproductive function stops. With age, there is a progressive decrease in the number of primordial follicles, although a small number of them can be found in postmenopausal ovaries. The most characteristic of this period is the resistance of such follicles to the action of FSH and LH, an increase in the level of which in the blood serum always occurs during menopause. Menopause is characterized by impaired secretion of many hormones, primarily gonadotropic and sex hormones. Despite the almost complete cessation of the hormonal function of the ovaries, the level of estrogen in the blood serum does not reflect this condition. This is due to the fact that an additional source of estrogens, mainly in the form of estrone, in general, and especially in menopause, is androstenedione, which is converted to estrone in peripheral tissues. A decrease in the level of classical estrogen in the body contributes to the development of osteoporosis. Estrogen deficiency accelerates the development of atherosclerosis. An increase in the concentration of gonadotropins probably contributes to the development of ovarian cancer. A decrease in the content of dopamine in the hypothalamus leads to vegetovascular reactions, which is manifested by hot flashes, autonomic crises, and an increase in blood pressure. The sensation of heat is a consequence of paroxysmal vegetative sympathicotonic manifestations. Characteristic sensations arise due to central hyperthermia and appear 30-50 minutes after the spastic state of the capillaries and the development of venous stasis. In the pathogenesis of climacteric syndrome, changes in the functional state of the hypothalamus are important. At birth, a girl has primordial follicles from 300 to 500 thousand. But gradually the number of primordial follicles decreases and by the age of 40 they remain from 5 to 10 thousand. Accordingly, fertility decreases, estrogen secretion changes, which decreases. In addition, the qualitative composition of the produced estrogen changes. The main active fractions of estrogen are estrone, estradiol, estriol. In menopause, the most active estriol. At an older age, the reticular zone of the adrenal cortex produces part of the sex hormones, and some women go through menopause very calmly, and some women do not have any sensations and manifestations of the menopause (since these women suffer the least from the adrenal glands during their lives). The adrenal glands take over the function of the ovaries when the function of the latter fades. In addition, the content of gonadotropin changes. If estrogens decrease, then the feedback mechanism of gonadotropins increases (more than 10 times). The ratio of luteinizing hormone and FSH changes. In the reproductive age, this ratio is equal to one, in the menopause more FSH is released (ratio 0.43). The modern concept of the pathogenesis of climacteric syndrome attaches great importance to age-related changes in the hypothalamic structures.

The most traditional classification is the division of menopausal syndromeby the number of tides: mild form - a disease with up to 10 hot flashes per day; medium form - a disease with 10-20 hot flashes per day and with other characteristic symptoms; a severe form - a disease with more than 20 hot flashes per day and other symptoms, in which a woman almost completely loses her ability to work Forms of climacteric syndrome: typical - uncomplicated complicated - in combination with ischemic, hypertension, diabetes mellitus, arthropathy, osteoporosis atypical - symptoms prevail, indicating primary disorders in the hypothalamus, which is manifested by hypothalamic syndrome (most often with early menopause in young women)

Clinical picture General picture of the disease. In the early stages, symptoms of disorders associated with a violation of the nervous regulation of vascular tone appear - the so-called hot flashes and sweating. These symptoms are accompanied by significant disturbances in higher nervous functions: sleep disorders, increased irritability and excitability, and depression. In the future, there are symptoms associated with a decrease in the level of female sex hormones. Atrophy of the skin occurs (slow recovery of skin cells, its withering), as well as the mucous membrane of the vagina, which is manifested not only by unpleasant subjective sensations (primarily dryness and itching), but is also fraught with the addition of urinary tract infections. There is insufficiency of the sphincters of the bladder, which is manifested by involuntary urination (urinary incontinence). The clinic is diverse and manifests itself in neuropsychic, vegetative-vascular and metabolic disorders and is similar to diencephalic syndrome: neuropsychic manifestations: irritability, depression, tearfulness, aggressiveness, insomnia, headache, dizziness, nausea and vomiting, itching, vegetative vascular manifestations: sweating, heart pain, tachycardia (may be paroxysmal), arterial pressure lability; endocrine-metabolic disorders - decreased diuresis, thirst, edema, painful breast engorgement, flatulence, etc.

Diagnostics Complaints should be sorted into three groups: neurovegetative - hot flashes, sweating, dizziness, paresthesia, tingling in the heart area, tachycardia. All this, as a rule, happens at the time of high tide. psycho-neurotic - impaired memory, sleep, bad mood up to depression. somatic - atherosclerosis, systemic osteoporosis, atrophic changes in the internal organs During the first days of the examination, general analysis of blood, urine, TSH, the study of the level of potassium, sodium in the blood plasma, electrocardiography with physical activity (according to indications), X-ray examination of the chest. In pathological menopause, the electrocardiogram is normal or is characterized by the pathology of the T wave in the form of its decrease, smoothing and transition to a negative one, a shift in the S T interval, especially in the right (V1 Vz), less often in the left (V5 V6) chest leads, without dynamic changes (in contrast to from changes caused by ischemia), including after exercise. A test with nitroglycerin not only does not improve, but sometimes even worsens the ECG parameters and the well-being of patients.

Treatment Allocate drug, non-drug and hormonal treatment of menopausal syndrome.

The first stage is non-drug therapy: morning exercises physiotherapy exercises general massage proper nutrition (vegetables, fruits, vegetable fats should prevail in the diet) physiotherapy (collar with novocaine according to Shcherbak, galvanization of the brain, electroanalgesia. procedures 7-8 times spa treatment - hydrotherapy, balneotherapy , radon baths The second stage - drug non-hormonal therapy: vitamins A, C, E - improve the condition of the diencephalon and help well when the first symptoms appear; neuroleptic drugs - phenothiazine series drugs - meterazin, etaperazine, triftazin, frenolon; act at the level of the interstitial brain, affect the subcortical structures, and the Moscow school believes that they have a pathogenetic effect; start with small doses, and evaluate the effect after 2 weeks; tranquilizers - diazepam, elenium, if menopausal syndrome is combined with hypertension, then reserpine has a good effect in this case - pressure decreases, and gives a neuroleptic effect;

The third stage - hormone therapy Currently, the following main provisions on the use of hormone replacement therapy have been developed: the use of only analogues of natural hormones the appointment of low doses of estrogens, corresponding to the level of endogenous estradiol in the early phase of proliferation in young women, the combination of estrogens with progestogens, which makes it possible to exclude hyperplastic processes in the endometrium with a removed uterus, estrogen monotherapy can be prescribed; the duration of hormone prophylaxis and hormone therapy is at least 5- 7 years for the prevention of osteoporosis and myocardial infarction

With the extinction of the reproductive system of a woman, various changes occur in the body. This period is called the climax. But it does not come immediately, but only after a while. The period is divided into 3 stages, the initial of which is premenopause. It is necessary to know the main signs of the premenopausal period in order to alleviate the condition.

The onset of menopause depends on many factors.

Menopause occurs due to a decrease in the production of sex hormones and the cessation of ovulation. As a result, the menstrual cycle changes, its abundance gradually decreases. In the absence of menstruation, the reproductive function of a woman ends.

Climax is divided into 3 stages:

1. Premenopause. It starts with menstruation and continues until it stops completely. At the initial stage, the presence of various symptoms that may interfere with the woman is allowed. Most often, the period begins at 45 - 47 years.
2. Menopause. Complete cessation of menstrual flow due to the extinction of the reproductive system. The phase appears over 50 years of age.
3. Postmenopause. The period continues until the end of the patient's life. All signs that a woman had during 2 phases decrease or disappear completely. But if the negative effects have managed to harm the body, they will manifest themselves until the end of life.

The premenopausal period occurs with a decrease in the production of sex hormones.

This applies more to estrogen, because it is responsible for many important processes in the female body. Namely:

• stability of the menstrual cycle;
• metabolic control;

• the formation of a woman's figure;
• attraction to a partner;
• maintaining the mucous membranes of the genital organs in a normal state;
• stability of the emotional state;
• normal absorption of trace elements (calcium);
• youth of the body;
• normalization of memory and concentration.

Premenopause is of particular importance in the life of every woman, because it is the initial period before the onset of menopause itself. The stage lasts about 4 years, but this period is individual for everyone. With the onset of premenopause, you need to pay special attention to your body.

What are the first symptoms of change

The onset of menopause can be identified by the appearance of the following symptoms:

• hot flashes;
• change in the menstrual cycle;
• increased sensitivity of the breast;
• hormonal changes;
• nervousness;
• problems with concentration;
• lack of sexual desire;
• a feeling of discomfort in the vaginal area, because due to a decrease in natural lubrication, the mucous membrane becomes dry;
• insomnia;
• increased anxiety;
• exacerbation of premenstrual syndrome;
• pain in the head, resembling a migraine.

How does the menstrual cycle change?

During premenopause, menstruation can change in duration, for example, if a woman used to have them regularly, then in the premenopausal period there is a possibility of a delay. The abundance of secretions also changes. Menstruation becomes scanty, and then may return to its normal state.

Menstruation should not be delayed for a long period. In addition, the discharge cannot be plentiful (change of hygiene products every 1 to 2 hours) and last longer than 7 days. In this case, it is necessary to consult a gynecologist, because the symptoms are a sign of various diseases:

• myoma;
• polyps;
• tumor;
• disrupted endocrine system.

We should not forget that in the premenopausal period, although menstruation is disturbed, ovulation is possible. Therefore, the possibility of conception is not excluded.

But it will not be easy to bear a child due to a decrease in the level of progesterone, which is the main hormone that ensures the normal course of pregnancy. Since the hormonal background is unstable, there is a risk of egg attachment outside the uterus.

What are the signs of changes in the work of internal organs

At the first stage of menopause, the work of many organs changes. Symptoms of premenopause are presented in the table.

How to relieve the condition with the help of drugs

It is forbidden to choose your own medicines to alleviate the condition, as you can aggravate the situation. It is recommended to consult a gynecologist. First, the specialist conducts an examination and asks various questions that relate to complaints. The patient is then sent for examination. For this, the following procedures are used:

• blood and urine analysis;
• consultation of doctors of other specializations (therapist, mammologist);
• ultrasound diagnostics;

After receiving the results of the examination, the doctor writes a prescription for the necessary drug.

For the treatment of premenopause, a specialist may prescribe hormonal drugs to a woman. Indications for use:

• hot flashes;
• unstable emotional state;
• incontinence;
• dryness of the mucous membrane of the genital organs;
• for the prevention of osteoporosis.

Hormone therapy has contraindications:

• malignant tumor;
• high risk of thrombosis;
• high blood pressure;
• acute heart disease;
• allergic reaction.

In addition, hormone preparations must be used with caution in myoma, migraine, epilepsy, gallstones. Since these medicines have a large number of contraindications and side effects, they are often replaced with phytoestrogens.

Phytopreparations help to normalize the work of many internal organs, namely:

• reduce the risk of developing hypertension;
• stabilize the nervous system, reduce nervousness and irritability;
• allow the body to better absorb calcium;
• normalize the condition of the skin.

The most popular drugs from the group of phytoestrogens are Cyclim, Estrovel, Klimadinon. Medicines will only be effective if the symptoms are severe, when the symptoms prevent the woman from performing her natural functions. If the symptoms of premenopause are mild, there is no need to take medication, it is enough to change your diet and eliminate bad habits.

How to change your lifestyle and diet

To reduce the symptoms of premenopause, it is recommended to follow the rules of a healthy diet. It is necessary to reduce the consumption of sugar, fatty varieties of meat products. In addition, it is better to exclude fried, salty, smoked, harmful. The diet should consist of a large number of vegetables and fruits, low-fat products.

With the abuse of alcohol and smoking, there is a high probability of developing oncology, thyroid diseases, and other disorders.

What is the prevention of premenopause

Prevention of premenopause has a particular advantage. In a woman's body, menopause is just beginning, so you can influence its dynamics by following various rules. Premenopausal syndrome requires preparation for it. Yes, the manifestation to some extent depends on heredity, but the patient's lifestyle also affects the symptoms. This is why pre-climax preparation is so important.

Preventive actions:

1. Completely rest. This point is one of the most important in prevention. With lack of sleep or insufficient rest, a woman will be depressed and nervous. All this negatively affects health.
2. Do physical exercises. In the absence of sports in the body, muscle tone decreases, and there is a possibility of developing diseases. Therefore, it is better to devote time to physical activity. The event not only helps to maintain the body in a normal state, but also reduces the likelihood of cardiovascular disease.
3. Reduce stress. A woman needs to control her emotions, as the work of the nervous system is disrupted from overexertion. If it is impossible to eliminate stress, it is necessary to relate to life situations in a different way.
4. Have sex. Sexual intercourse affects the production of hormones. In addition, the process helps to improve blood circulation in the pelvic organs and eliminate congestion.
5. Visit a gynecologist annually. It is necessary to undergo a complete examination once a year to exclude various diseases.

Menopause is a natural process for the body, which should not be feared. It is divided into 3 phases. The initial stage is premenopause. To alleviate the condition, you need to know the symptoms and methods of treatment. If the symptoms are not strong, it is recommended to change the diet and exclude smoking, alcohol. But when the onset of menopause manifests itself strongly and interferes with a woman, you can resort to taking medications.

In this video you will find menopause symptoms that you should pay attention to:

It is forbidden to prescribe medications on your own without consulting a doctor, as this will harm the body even more. The specialist will conduct the necessary examination and, based on its results, write a prescription for the necessary drug.

The body of a woman, in particular, her reproductive system, is distinguished by a number of features. Upon reaching the fair sex of 45-50 years, there is a gradual loss of childbearing function. This is a natural process that develops against the background of the restructuring of the work of the gonads and the central nervous system. All women experience menopause differently. Changes in the sexual cycle are gradual. After 55 years, the reproductive structures completely lose their natural function, physiological amenorrhea occurs.

In some cases, such restructuring is accompanied by unpleasant symptoms, which are combined into a climacteric syndrome. The natural transformations taking place in the body cause serious discomfort to patients. In addition to changes in the normal mental and emotional state, vegetative disorders also occur, as well as malfunctions in the cardiovascular and endocrine systems. Similar problems are diagnosed in 30-50% of women in menopause. It is important to distinguish normal clinical signs of menopause from pathological manifestations. To do this, you will need to visit a doctor and undergo a comprehensive examination.

Symptoms of the climacteric syndrome

The appearance of the restructuring of the work of the genital organs is accompanied by some features. All patients are prone to mood swings during this difficult period, which is associated with the influence of hormones on the psyche. However, not only the intensity of symptoms is important, but also their combination with vegetative manifestations. The clinical signs of menopausal syndrome in women include:

1. Sleep disorders, as well as cognitive problems, accompanied by memory impairment.
2. Anxiety, depression and the appearance of constant self-doubt.
3. Significant mood swings that are not associated with the phase of the cycle, exposure to stress and other environmental factors.
4. Fatigue, dizziness and migraines.
5. Changes in the genital organs are provided by the restructuring of the hormonal background. Frequent complaints of dryness of the mucous membranes of the vagina, itching and discomfort during intercourse.

Vegetative manifestations of pathology are considered the most significant and alarming. Premenopausal syndrome, that is, failures that occur at an early stage of restructuring, rarely lead to the appearance of such symptoms. Violations of the work of internal organs indicate a serious failure in the regulation of their activity by the central nervous system. The clinical picture in such cases includes:

1. The formation of vegetovascular dystonia (VVD), which is accompanied by pressure drops and unexplained pain in the chest.
2. Intense sweating and constant hot flashes. This sign also accompanies the normal course of menopause in some women, however, with pathological expression, it brings significant inconvenience.
3. Numbness of the fingers, a change in the nature of tactile sensations, convulsive contractions, which most often affect the muscles of the legs, and at night.

A peculiar classification of manifestations of VVD in case of illness has been adopted. It allows you to differentiate the severity of the pathological menopausal syndrome. The frequency of "hot flashes" in women per day is taken as the basis:

1. With a mild form, no more than 10 “attacks” are noted during the day. Half of women with this disease face a similar problem.
2. The second degree of severity is characterized by a greater intensity of clinical manifestations. There are from 10 to 20 "tides" within 24 hours. This form occurs in 30% of patients.
3. Severe menopausal syndrome is diagnosed in only 17% of women. It is accompanied by a high intensity of symptoms. The frequency of hot flashes reaches 20 per day.

Causes

The pathogenesis of the disease is associated with the development of hormonal changes in the body of a woman. The function of the sex glands is controlled by the hypothalamus - a special part of the brain that affects the pituitary gland. The latter produces protein compounds that stimulate the gonads. The ovaries normally respond by releasing hormones. In the process of aging, the work of the genital organs is restructured. At the same time, the hypothalamus is still trying to stimulate their natural function. The ovaries cannot produce the proper amount of biological compounds, which leads to the absence of menstruation and the loss of a woman's ability to bear children. However, in many cases, the onset of menopause occurs in a mild form. The following adverse factors contribute to the development of menopausal syndrome:

1. Constant exposure to stress negatively affects the functioning of the whole organism, including the function of the ovaries and the central nervous system.
2. Heavy physical activity also does not contribute to the reproductive health of women.
3. Endocrine disorders, such as diseases of the thyroid or pancreas, affect metabolic processes. This creates favorable conditions for further failures.
4. Inflammatory diseases of the pelvic organs in history. Pre-menopausal problems that affect the uterus, oviducts, or directly the gonads also contribute to the formation of menopausal syndrome.
5. Abuse of alcohol-containing drinks and smoking negatively affect many organs, including the genitals.

Diagnostic methods

As a rule, confirmation of the disease is not difficult. However, for correct treatment, a doctor's consultation is required. Diagnosis is carried out in a complex, on the basis of the collected anamnesis. Important parameters are the regularity of the sexual cycle, as well as the presence and frequency of menstrual bleeding. Confirmation of menopausal syndrome in women requires the exclusion of ailments similar in symptoms. This will require an examination of the patient, bacteriological tests and blood tests. Hormonal studies are most revealing in this case. Of great importance is the consultation of a psychotherapist, who will help to cope with possible cognitive impairment and sleep disorders.

Treatment of pathology

Since menopause is a natural process, therapy is limited to alleviating this condition and correcting symptoms. Changing the lifestyle of a woman is of great importance. Clinical recommendations include, first of all, the rejection of bad habits. Alcohol and cigarettes lead to an even greater imbalance in the work of the genital organs and the central nervous system. Moderate physical activity has a positive effect. They help prevent the development of complications associated with malfunctions of the cardiovascular system.

Recommendations for menopausal syndrome also apply to diet. The diet is required to include foods rich in fiber. This is due to their normalizing effect on the gastrointestinal tract. There is a direct link between the balance of microflora in the digestive system and the reproductive system. This is due to the peculiarities of their anatomical location in the fair sex. Exclusion from the menu of fatty, fried and salty foods will also have a beneficial effect on the course of menopause.

Medical support for women in this difficult period is reduced to the use of drugs based on estrogens and progestogens. They allow you to deal with the vegetative-vascular manifestations of menopausal syndrome, which are associated with hormonal changes. The use of these funds is possible only when prescribed by a doctor, since only patients with a severe degree of the disease need to use medications. As a symptomatic therapy, various tranquilizers and antipsychotics are used, which help to improve the general condition of patients.

Alternative methods of treating menopausal syndrome are reduced mainly to the use of decoctions based on herbs that have a sedative effect. These include motherwort, valerian and mint. These plants allow you to deal with anxiety and stress, which women suffer during menopause.

To date, hormonal therapy for the manifestations of menopausal syndrome is the main option in the fight against the problem. Moreover, with a mild clinical picture, local remedies are used. For example, the use of vaginal suppositories and ointments to reduce the manifestations of atrophic changes in the mucous membrane shows good results. Such drugs do not have as many contraindications and side effects as systemic drugs.

However, despite all the benefits of hormone replacement therapy, there are alternative treatments for menopausal syndrome. They are often used as an adjunct to medical support. For example, red clover extract, which contains a large amount of isoflavones, is used as a source of estrogen. Soy has a similar therapeutic effect. Despite the widespread use of such methods, they have not been proven effective, although some women report relief of vaginal symptoms. If there are contraindications to the use of hormonal drugs to combat the vasomotor manifestations of menopause, agents from the group of serotonin reuptake inhibitors, such as Fluoxetine, are used.

Possible Complications

The unpleasant consequences of the disease most often include both significant damage to the genital organs and cognitive impairment. If the symptoms are ignored, women suffer from chronic insomnia, depression and severe stress, which only aggravates the course of menopause.

Prevention

Preventing the development of unpleasant symptoms comes down to following the principles of a healthy lifestyle. Regular visits to the gynecologist also contribute to the easy flow of menopause. Early detection of problems favors their faster and smoother flow. Self-medication is dangerous, therefore, if unpleasant symptoms appear, you should consult a doctor.

Content

The onset of menopause involves significant hormonal changes in the female body. Such transformations can cause discomfort of varying severity. The phenomenon occurs in all the fair sex, but the pathological course of the process is typical only for some patients. The development of the syndrome can cause severe manifestations from the psycho-emotional, endocrine and vegetative spheres, finding which you need to immediately contact a gynecologist.

What is climacteric syndrome in women

Menopause is the physiological state of the female body, genetically determined, consisting in age-related changes in the higher parts of the central nervous system. This phenomenon is not regarded by specialists as a disease. Climax occurs in 3 phases:

• Premenopausal - there are signs of extinction of hormonal function. The phase lasts until the last menstruation, on average 4-5 years. Premenopause is expressed by a violation of the cycle, a change in the volume, duration of discharge. Spontaneous ovulation may occur, in which childbearing function is preserved. The probability of developing a pathological course in this phase is 35%.
• Menopausal - characterized by the absence of any bleeding. It starts from the moment of the last menstruation and lasts about a year. The pathological course in this phase develops in 70% of cases.
• Postmenopausal - is determined by the lack of ovarian production of estrogens, an increase in the level of gonadotropic hormones, and the restructuring of the female reproductive system.

The climacteric syndrome is a set of symptoms that are observed during the pathological course of menopause. The condition is characterized by disorders of the psycho-emotional, adaptogenic, neurovegetative, metabolic-endocrine, cardiovascular spheres of the female body. Pathology develops in 30-60% of the fair sex at the age of 45-55 years. The duration of the syndrome is on average 2-3 years. In some cases, its duration increases to 10-15 years.

Causes of pathology

The main reason for the development of pathological menopause are changes in the structure of the hypothalamus, which are age-related. This gland regulates the cycle of the menstrual function of the female body. In the hypothalamus, the synthesis of the neurohormone gonadoliberin occurs, under the influence of which luteinizing, follicle-stimulating hormones are produced. Substances affect the process of maturation, the functioning of the corpus luteum of the ovary, follicles.

Changes in the work of the hypothalamus lead to a decrease in estrogen levels, an increase in the concentration of gonadotropic hormones. As a result, the functioning of the ovaries, the cessation of ovulation, and the reproductive ability of a woman occur. The pituitary and hypothalamus are strongly connected with the cerebral cortex and other endocrine glands, therefore, under the influence of negative age-related changes, the work of the cardiovascular, peripheral nervous systems, metabolic processes is disrupted, and osteoporosis develops.

The pathological course of menopause is not typical for all the fair sex. The causes of the syndrome are the following factors:

• hereditary predisposition;
• professional activity - work involving constant intellectual, physical overwork, exposure to harmful substances on the body;
• pathological changes in the functioning of the endocrine, central nervous system, internal organs that occurred before the onset of menopause;
• inflammation of the pelvic organs, disruptions in the cycle of menstruation, serious surgical interventions;
• moderately or excessively increased body weight;
• complications arising during pregnancy, childbirth, in the postpartum period;
• the presence of infectious diseases, diseases accompanied by prolonged pain syndromes.

Clinical manifestations of climacteric syndrome

The symptomatology of the syndrome is characterized by a variety of manifestations that can cause serious discomfort to a woman. The course of the pathological process depends on the physical and emotional state of the patient, the degree of hormonal imbalance, the influence of external factors, and the presence of chronic diseases. All clinical manifestations of the syndrome can be divided into 3 groups:

• vasovegetative;
• psychoneurotic;
• endocrine (somatic).

Vasovegetative

The most common clinical symptom of this group is hot flashes to the head, face, upper body. Their duration varies from 30 to 120 seconds. Vasovegetative manifestations of menopausal syndrome are expressed in excessive sweating, which accompanies hot flashes. Hot flashes can occur under the influence of irritants: weather changes, stress and other adverse conditions. During hot flashes, there is an increase in body temperature, expansion of peripheral vessels, and increased heart rate.

To vegetative clinical manifestations, experts include the occurrence of redness in the form of a necklace on the neck and chest, paroxysmal headache, vasomotor rhinitis, hypertensive crises, changes in blood pressure. Some women report swelling, numbness, leg cramps, irritability, drowsiness, dry skin. Vasovegetative manifestations of a climacteric pathological condition can provoke an increase in the sensitivity of the nervous system, pain in various organs.

Psychoneurotic

This group of symptoms is expressed by a decrease in attention, memory, a constant feeling of fatigue, irritability, instability of the emotional sphere. In some patients, neurotic disorders are accompanied by a feeling of anxiety, fear, tearfulness, intolerance to certain sounds, smells. A considerable part of women suffer from persistent depression caused by the perception of menopause as a sign of old age. Experts attribute this phenomenon to severe psychoneurotic disorders that are difficult to treat.

Endocrine

Somatic (endocrine) symptoms of menopause may occur due to changes in metabolic processes characteristic of a certain age, or a high degree of body response to a decrease in estrogen. Patients have inflammation in the walls of the vagina, bleeding, itching, dystrophy of the vulva, painful, involuntary urination. Weakening of muscle tone leads to prolapse of the uterus. With a further deterioration in the condition of the muscles, prolapse of the reproductive organ is possible.

The lack of estrogen affects not only the reproductive system, but also the mammary glands, skin, hair, nails. These areas of the body undergo atrophy caused by collagen deficiency. Wrinkles appear in women, weight increases, the synthesis of vitamin D decreases, which disrupts the absorption of calcium, leading to its increased leaching from the bones. The skeleton gradually begins to collapse, osteoporosis appears, pain in the limbs at night, pathology of the spine. Some women develop thyroid disorders.

Classification of pathology

Menopausal syndrome is classified according to severity. There are 3 forms:

1. Light - there are 7-10 hot flashes per day, there are practically no changes in the working capacity and condition of the patient. This form is diagnosed in 16% of women.
2. Medium - characterized by an increase in the frequency of hot flashes (10-20 per day). The fair sex has pronounced signs of the syndrome: dizziness, headaches, memory impairment, general well-being, sleep disturbances. This form of menopausal pathology occurs in 33% of patients.
3. Severe is the most common type of syndrome. There is a sharp deterioration in well-being, loss of working capacity. If the pathology was formed at the age of 38-43, it is characterized by a long, especially severe course. In this case, serious violations of psychosocial adaptation are possible.

There is a classification of menopausal pathology depending on the clinical manifestations. There are the following forms:

1. Uncomplicated (typical) - manifested only by excessive sweating (hyperhidrosis) and hot flashes. It occurs under the influence of excessive mental or physical stress in a healthy woman. The typical form is characterized by the classic signs of menopause, which will disappear after 1-2 years, the timely onset of menopause. The general well-being of a woman practically does not change. In patients with an uncomplicated form of the syndrome, slight deposits of subcutaneous fat and a decrease in skin elasticity are detected. All changes are age appropriate.
2. Complicated - develops against the background of diseases of the cardiovascular system, digestive organs, dysfunction of the thyroid gland, diabetes mellitus. The form of pathology occurs in the fair sex over 45 years old. The complicated course of the syndrome is characterized by an increase in the frequency and severity of hot flashes, the presence of an increased heartbeat, sleep disturbance, attention, and memory. Feelings of fading and pain in the region of the heart may occur. Women suffering from hypertension are at risk of developing a complicated form of the syndrome.
3. Atypical - occurs in patients who have undergone surgery, mental or physical trauma, severe illness, worked for a long time in adverse conditions. This form is characterized by failures in the menstrual cycle, subsequently transforming into a complete cessation of menstruation. After some time, typical menopausal symptoms occur: tearfulness, memory loss, sleep disturbance, deterioration in performance. External manifestations of the atypical form of the syndrome are expressed in fragility and hair loss, dry skin, age spots on the surface of the chest, arms, head. Characteristic signs are itching of the extremities, in the genital area, increased urination, swelling, weight gain, joint pain. The condition of a patient suffering from an atypical form of the syndrome deteriorates rapidly, panic attacks, osteoporosis, hypoglycemia, osteochondrosis, and asthma may develop.

Complications

Untimely or incorrect therapy of a pathological syndrome can cause adverse consequences. Some complications are likely:

• pathological changes in the urogenital area, expressed as urinary incontinence;
• increased risk of atherosclerosis, thrombosis, stroke, ischemia, diabetes;
• development in the mammary glands, reproductive organs of neoplasms of a benign or malignant nature;
• increased risk of osteoporosis, the likelihood of chronic fractures;
• deterioration in the quality of life, the level of working capacity of women.

Diagnostics

If a woman has symptoms of a pathological menopause, she should immediately contact a gynecologist. In addition, it is required to be examined by a therapist, a rheumatologist. Women in adulthood are advised to consult a psychotherapist, ophthalmologist, endocrinologist. To diagnose menopausal syndrome, research is needed:

• Collection of anamnesis in order to identify hereditary, gynecological factors for the appearance of menopause, chronic diseases, analysis of the patient's complaints.
• Questioning a doctor about the menstrual functionality of the body. The gynecologist must find out the age when the first menstruation began, their regularity, frequency and duration at the moment. If the function is absent, you need to find out the date of the last menstruation.
• Gynecological examination to determine the correct development of the reproductive organs, their size, localization of pain. For this, the doctor uses a two-handed examination of the vaginal cavity.
• Breast examination - to detect the presence of pathological changes in the structure of the mammary glands.
• The study of the state of the body as a whole. A diagnostic measure is necessary to detect pathologies associated with the syndrome that are not related to diseases of the reproductive system. It requires an assessment of the performance of the cardiovascular system, measurement of blood pressure, the study of the condition of the skin, nails, hair, body weight.
• Blood tests to determine the level of hormones, the degree of clotting, for a biopsy. A cytology smear is also taken.
• Mammography - to detect serious pathologies of the mammary glands through x-rays.
• Ultrasound examination (ultrasound) of the pelvic organs.
• Densitometry - the method is designed to identify the state of the skeleton (vertebral column, forearms, hips). The results help determine the presence of osteoporosis.

Treatment of climacteric syndrome

Therapy of pathological menopause should be handled by a gynecologist or gynecologist-endocrinologist. If necessary, these specialists can refer the woman for a consultation with a therapist and an endocrinologist to obtain more complete information about her condition. An examination by a psychotherapist will be required if the patient has nervous disorders, depression, asthenia. For the prevention or treatment of diseases of the joints and bones, a consultation with a rheumatologist is necessary. The treatment regimen for vegetative manifestations should be prescribed by a neurologist.

There are two main strategies for the treatment of the syndrome: drug and non-drug. The second type of treatment includes diet, exercise, aromatherapy, massage and other treatments, folk remedies. Such therapy is provided for mild climacteric pathologies. Moderate and severe course of the syndrome involves the use of medications: hormonal, sedative drugs, antipsychotics, tranquilizers, vitamin complexes. Often, specialists prescribe a combination treatment.

Diet

The complex of non-drug therapy of the syndrome includes proper nutrition. The diet must be saturated with vegetables and fruits, vegetable fats. Especially useful food containing phytoestrogens. Natural hormones are found in linseed oil, nuts, soybeans, bran, cherries, apples, citrus fruits, spinach, garlic, broccoli, parsley.

With menopause, a woman should consume low-fat dairy products. Among drinks, preference should be given to herbal teas. It is required to limit the intake of caffeine, carbohydrate foods (chocolate, sweets, muffins, jams), alcohol, red meat, smoked, spicy foods. Seasonal lack of vitamins and minerals is replenished by complex preparations prescribed by a specialist.

Physiotherapy procedures

To maintain a woman's well-being during menopause, doctors often prescribe physiotherapy. The following procedures are recommended:

• Therapeutic gymnastics - it is necessary to start classes even in preparation for the menopause. Daily exercise helps to reduce the severity of psychoneurotic symptoms, reduce insulin levels, improve oxygen and carbohydrate metabolism. The type of physiotherapy exercises, the training program should be selected by the doctor based on the indications. Patients may be advised to study in groups or do gymnastics at home. In order to prevent prolapse of the uterus, Kegel, Bubnovsky, Yunusov exercises are prescribed.
• Acupuncture - helps to effectively cope with the symptoms that manifest pathological menopausal syndrome. The procedure has a beneficial effect on vascular tone, increases the activity of the immune, neurohumoral, endocrine systems. The advantage of acupuncture is safety, painlessness, almost complete absence of contraindications.
• Therapeutic massage - with menopausal changes in the body, it is recommended to carry out a general and point impact. Both types of procedures are prescribed as part of complex therapy, together with other physiotherapy methods, medications, and diet. Massage will help get rid of fatigue, mood swings, reduce the intensity and frequency of hot flashes. The procedure improves the tone of muscles and blood vessels, lymph circulation, activates metabolic processes, and has a relaxing effect on the nervous system.
• Hydrotherapy - can be carried out in a spa or at home. The procedure includes dousing, contrast showers, hot foot, coniferous, sage baths. The impact of water helps to reduce the frequency of hot flashes, improve the emotional state of the patient, increase vascular tone, and skin elasticity.
• Aromatherapy - essential oils of oregano, sage, orange, lavender, jasmine, inhaled through cold inhalations or aroma lamps, have a beneficial effect on the female body. Substances calm the nervous system, normalize heat transfer, relieve weakness, anxiety, tearfulness. Natural oils relax the body, preventing the appearance of depression, restore it after stress.

Medical therapy

Treatment of pathological menopause with medicines is used for moderate and severe forms of the disease. Depending on the indications, the following groups of drugs are prescribed:

1. Sedatives - are used to normalize the state of the nervous system, improve overall well-being. The means of this group include tinctures of motherwort herb, valerian root, fruits and flowers of hawthorn.
2. Antipsychotics (phenothiazine series) - are recommended for depression, hypochondriacal syndrome. Medications reduce psychomotor agitation, have a calming effect, inhibit feelings of anxiety, fear. The medicines of the group include Frenolon, Meterazin, Triftazin, Etaperazin.
3. Tranquilizers - are recommended for the development of asthenia, psycho-emotional disorders, mild menopausal neuroses. Drugs relieve fear, anxiety, anxiety, internal tension. Elenium, Diazepam are often prescribed.
4. Vitamins A, C, E - are prescribed to all patients. Means strengthen the body, improve the condition of the skin, hair, reduce the risk of formation and development of mastopathy, endometriosis, uterine fibroids, slow down the production of gonadotropic hormones, enhance the effect of progesterone and estrogen.
5. Hormonal drugs - used to treat severe forms of the syndrome. Medicines help to cope with hot flashes, discomfort in the vaginal area. The selection of drugs is carried out by the doctor individually, according to the indications. Popular medicines in this group are Norgestrel, Utrozhestan, Dydrogesterone.

Prevention of climacteric syndrome

To avoid exacerbation of the pathological symptoms of menopause, it is necessary to take preventive measures. Women should be guided by several aspects:

• lead a healthy lifestyle - eat right, fully eat, ensure control of body weight, apply moderate physical activity, form a daily routine, take time for rest;
• take hormonal drugs in strict accordance with the instructions, doctor's prescriptions;
• timely treat diseases, especially infections, inflammations;
• undergo a preventive examination by gynecologists at least once every six months.

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