Content

Upon reaching a certain age, the body of every woman undergoes dramatic changes, the nature and duration of which depend on many factors. Menopause is a normal decrease in fertility (ability to reproduce), accompanied by endocrine, physiological, psycho-emotional changes. According to statistics, about 80% of women suffer from menopause symptoms, so emotional and physical preparation for the onset of menopause is very important.

What is a climax

Menopause (menopause, menopause) is a natural aging process, characterized by the extinction of the reproductive function. As a rule, the first signs of menopause in women appear at the age of 45-50. Nothing abnormal happens during menopause - this is an absolutely normal phase of the human life cycle. In men, this stage also occurs at a certain point, but it begins later and is characterized by a milder course.

There are natural menopause (45-55 years), artificial (with violations of the proper functioning of the ovaries and uterus) and premature (30-35 years). The age of menopause and its accompanying signs depend on genetic heredity, lifestyle, the presence of bad habits (especially smoking), and individual characteristics of the organism. Artificial menopause can be caused by irradiation of the pelvic region, early operations and courses of treatment with strong drugs.

Menopause can develop over a long period - several years pass from the onset of the first manifestations to the onset of menopause. During this time, single follicles can be found in the ovaries, but with age they atrophy and disappear. Menopause includes three stages - premenopause, menopause and postmenopause.

Beginning of menopause (premenopause)

The average age of onset of premenopause is 45-50 years. In rare cases, amenorrhea (absence of menstruation) occurs abruptly, but more often the stage is characterized by a gradual long course (from 2 to 10 years). During premenopause, the development of a climacteric syndrome is possible, since the ongoing changes are observed not only in the reproductive organs - the bone tissue, nervous and cardiovascular systems are completely rebuilt. The onset of menopause is characterized by the following features:

• Menstruation becomes irregular, at this time the probability of uterine bleeding is high.
• The number of follicles decreases, which reduces the likelihood of conception, but there is still the possibility of becoming pregnant during this period.
• Due to the unstable content of estrogen (the main female hormone) in the blood, hypersensitivity of the mammary glands can be observed.

Menopause

You can talk about the onset of menopause a year after the last menstruation. For most women, this occurs between the ages of 49-55. After the cessation of menstruation, a woman cannot become pregnant naturally. This period is accompanied by the following manifestations:

• There is a decrease, deformation of the ovaries, eggs are absent or their maturation is impossible.
• Due to a decrease in the production of progesterone and estrogen, an imbalance occurs between the hormones of the thyroid gland, adrenal glands and pituitary gland. For this reason, a woman suffers from regular hot flashes, headaches, insomnia, and emotional swings.
• Due to hormonal disruptions, the likelihood of developing various concomitant pathologies increases - osteoporosis, coronary heart disease, atherosclerosis, etc.

Postmenopause

The last stage begins at 54-56 years, its duration is 5-6 years. Postmenopause ends with a complete stop of the ovaries. The consequences of menopause, which can be expected during this period:

• The amount of pubic hair is reduced.
• The large labia are deformed, the small ones gradually disappear completely.
• The synthesis of hormones by the ovaries is completely stopped, the level of estrogen is kept at a consistently low level.
• Vaginal protective lubrication disappears, which contributes to the development of inflammation and infections.
• Deep wrinkles appear, body weight increases, hair on the head thins and turns gray.
• Attention, memory, vision worsens.

What changes occur in the body of a woman in the premenopausal period

Premenopause is the most important phase of menopause, since at this time cardinal age-related changes begin, the nature of which determines the quality of the next 30-40 years of life. A woman needs to take a responsible attitude to the state of her health, change her lifestyle, if necessary, undergo a course of drug treatment in order to avoid a sharp withering of the ovaries, the inevitable consequence of which is the general aging of the body.

Decrease in blood estrogen

At the beginning of premenopause, there is a decrease in the duration of the follicular phase (menstruation becomes shorter). At this time, the concentration of estrogen and progesterone in the blood decreases significantly. It is noteworthy that the synthesis of male hormones (androgens) remains at the same level, since during menopause a significant part of estrogen is synthesized from male hormones, which are predominantly in adipose tissue. Androgen production is influenced by FSH (follicle-stimulating hormone) produced by the pituitary gland, the synthesis of which increases at the onset of menopause.

To determine the hormonal background, the doctor must refer the patient to conduct mandatory blood tests, the results of which can be used to judge estrogen deficiency. For a complete clinical picture, the patient is recommended to do an ultrasound of the uterus and appendages, mammography. If necessary and strictly under the supervision of a gynecologist, it is possible to adjust the concentration of female hormones with the help of drug therapy.

Circulatory disorders

With age, the vascular walls become thinner and lose their natural elasticity, the heart muscle wears out and "gets tired" - these and other reasons lead to drops in blood pressure, the occurrence of cardiac arrhythmia. Due to the aging of the body and the ongoing hormonal changes, blood circulation in all organs is disturbed, which leads to the occurrence of pathologies.

As a rule, premenopause is accompanied by tachycardia (increased heart rate). In addition, a woman may feel tingling in the limbs, dizziness, a feeling of pressure in the chest, suffer from migraines and weakness. Experts say that patients with cardiovascular diseases (especially hypertension) are more difficult to tolerate the onset of menopause.

Anxiety and mood swings

Hormonal disruptions and reactions of the nervous system to them lead to anxiety and irritability. In addition, there may be problems with memory, a decrease in concentration, the appearance of sudden mood swings. In rare cases, neurotic states characterized by obsessions may develop. It is noteworthy that even restrained and calm women react to the onset of menopause with resentment, tearfulness, even hysteria, but in the later period of menopause, love for life and joy not only return, but also become stronger than at a young age.

The first signs of menopause

The main signs of the onset of menopause in a woman depend on the work of the pituitary gland, which ensures the onset of ovulation and the synthesis of estrogen. The action of the latter extends not only to the reproductive function - estrogen affects the regulation of metabolism, strengthening the muscle corset and bone tissue, the psychological state of the woman, the functioning of the uterus; therefore, recognizing the onset of menopause is not a problem - the first symptoms of menopause are directly dependent on estrogen deficiency.

Menstrual irregularities

At the beginning of premenopause, there is a decrease in the duration, frequency and amount of menstrual flow. Normally, the time between periods should increase from 30 to 90 days. Periods may disappear abruptly, or may stop after prolonged amenorrhea (absence of menstruation). In some cases, the resumption of discharge is observed even after a long break. If the restoration of the menstrual cycle occurred after 6 months of delay, there is a possibility of uterine bleeding - in this case, a consultation with a gynecologist is necessary.

Scanty or very profuse discharge

In most women, the amount of monthly discharge at the beginning of the menopause gradually decreases, which indicates the cessation of steroid secretion by the ovaries. In rare cases, an increase in the amount of menstruation is possible, which is associated with a violation of ovulation. As a rule, abundant discharge appears after a long delay.

Hot flashes and night sweats

The imbalance of female hormones leads to disruption of the autonomic nervous system. Essentially, hot flashes and excessive sweating are neuronal responses to hormonal surges that occur at the onset of physiological aging. Hot flashes are characterized by the appearance of heat in the neck, chest, face. In this case, reddening of the skin, an increase in body temperature, pronounced hyperhidrosis (sweating) are observed.

The hot flashes last no longer than a minute, but at the same time they cause significant discomfort - the body temperature can rise to 38 degrees, the pulse quickens, perspiration appears. Such attacks happen unexpectedly, with an unpredictable frequency (from 10 to 60 times per day). To reduce discomfort after hot flashes, doctors advise patients to wear several thin layers of clothing in order to remove the wet bottom layer if necessary.

Insomnia

Sleep disturbance is a common complaint at the beginning of menopause. Insomnia is caused by anxiety, which is a side effect of decreased female hormone production. In addition, hot flashes and excessive sweating often disturb a woman at night. In addition, palpitations, together with impaired thermoregulation (chills), are the causes of difficult falling asleep.

Weight gain

In 60% of women during menopause, there is a metabolic disorder, accompanied by excessive deposition of adipose tissue. This happens due to a decrease in the concentration of estrogen in the blood - this is how the body tries to make up for the lack of the female hormone. The main place of deposition of subcutaneous fat is the waist and hips. A woman needs to carefully monitor her weight, eat right, since it can be difficult to get rid of extra pounds gained at the beginning of menopause. In addition, metabolic disorders can lead to the development of diabetes, oncology.

Decreased libido or increased sex drive

A decrease in sexual desire is an inevitable sign of menopause, which occurs due to hormonal disruptions, psychological causes, or medical problems (urinary incontinence, uterine prolapse). A woman stops feeling young and sexy, gets hung up on problems. In addition, dryness and loss of elasticity of the vagina affect the occurrence of pain during sex. In rare cases, there is an increase in libido. This is due to the fact that a woman no longer fears getting pregnant and does not suffer from monthly discharge.

Acceleration of skin aging processes and dry mucous membranes

One of the main signs of approaching aging is the progressive dryness of the skin and mucous membranes, in connection with which new wrinkles appear on the skin and old ones deepen, and the mucous membranes lose their natural protective lubricant. In relation to the genital organs, the onset of menopause is accompanied by itching, pain, and swelling. Then the tissues of the labia lose their elasticity, acquire a brown color, the skin resembles parchment. Next, tissue atrophy occurs, accompanied by scarring and narrowing of the entrance to the vagina.

To alleviate this condition, it is recommended to follow the rules of personal hygiene, wear underwear made from natural fabrics, wash with a decoction of calendula, chamomile, and a solution of baking soda. Ointments based on anesthesin and diphenhydramine, vaginal suppositories, which include the necessary hormones, help to significantly stop the symptoms of dryness (these agents should be used only as directed by a doctor).

How to relieve the symptoms of menopause in women

Treatment of diseases accompanying menopause, improving the quality of life in adulthood is the task of obstetrician-gynecologists. Currently, older women often turn to therapists, neuropathologists with problems that gynecologists would help them solve, since during menopause the state of the body largely depends on the lack of estrogen.

To reduce the manifestations of menopausal syndrome, strengthen immunity, alleviate the general condition of the patient and improve the psycho-emotional background, therapy is recommended under the supervision of a specialist. At the beginning of menopause, non-drug therapy should be carried out, then - drug treatment. In some cases, in the absence of effect, hormone replacement therapy is prescribed. Patients suffering from a severe form of menopausal syndrome may need to carry out the entire complex of therapeutic measures.

Medical therapy

The characteristic signs of the onset of menopause in women will help overcome the use of medications. It should be remembered that the relief of symptoms does not mean recovery - with age, the amount of estrogen will decrease, which will inevitably lead to the progression of menopause. All medicines (including homeopathic ones) must be taken strictly according to the doctor's prescription in order to avoid serious hormonal and metabolic disorders.

Combined oral contraceptives

Contraceptive pills (for example, Regulon, Logest, Marvelon, Novinet) are prescribed during menopause, not only to avoid an unplanned pregnancy, but also to relieve symptoms. The scheme of treatment with oral contraceptives in most cases is the same - 1 tablet daily for 3 weeks, then a break of 7 days. Some oral contraceptives must be taken continuously.

Phytopreparations

Medicines based on natural ingredients containing phytoestrogens are more easily accepted by the body and have a relatively small list of side effects. To relieve symptoms at home, you can prepare a mixture of motherwort, valerian and hawthorn, the regular intake of which strengthens the nervous system and normalizes sleep. Treatment with official homeopathic remedies is more effective than the use of traditional medicine recipes. Characteristics of some popular tools:

Name of the drug	Indications for use	Dosage, course
Klimadinon	Vegetative-vascular disorders, menopause	1-2 tablets (or 30 drops) per day, as directed by the physician
	Menstrual disorders, climacteric syndrome	1 tablet (or 10 drops) up to 3 times a day, course 6 months
	climacteric syndrome	1 capsule/day, course 3 months
Climaxan	climacteric syndrome	1-2 tablets (or 5-10 granules) per day, course 1-2 months

Hormonal drugs

Hormone replacement therapy is one of the most effective treatments for menopausal disorders, but also the most dangerous because of the risk of complications. Contraindications for treatment with hormonal drugs are endometrial and breast cancer, hepatic pathologies, thrombophlebitis (inflammation of a vein with the formation of a blood clot). To prescribe such treatment, a comprehensive study of the patient's history, lifestyle, and family diseases is necessary. Comparative characteristics of popular drugs:

Name of the drug	Indications for use	Dosage, course
Proginova	Climacteric disorders	1 tablet/day, course 21 days or continuously
Premarin	Estrogen deficiency, climacteric syndrome
	Postmenopause	1 tablet/day, continuously
	climacteric syndrome	1 tablet/day, course 21 days, break 7 days
	Postmenopause	1 tablet/day, continuously

Vitamin and mineral complexes

Numerous studies have shown that taking vitamins and minerals greatly alleviates unpleasant menopausal manifestations and helps strengthen immunity. For example, vitamin C has a positive effect on the walls of blood vessels and relieves swelling, vitamin E has a beneficial effect on the functioning of the sex glands, improves blood circulation. Mineral preparations are important for maintaining metabolism and cell repair. Calcium plays a special role in this sense - it not only strengthens bone tissue, but also participates in brain function.

Regular physical activity

Physical activity is the key to successfully overcoming the symptoms of menopause. Fitness, which strengthens the heart muscle and increases endurance, and yoga, which can help increase the flexibility of the body, will help to survive the restructuring of the body. In addition, practicing such a sport as Pilates has a beneficial effect on the muscular corset, which is especially important for protecting bone tissue. Additionally, a visit to the pool is recommended to relieve the symptoms of dystonia, relax and improve sleep.

Active lifestyle

In addition to regular physical activity, a woman needs to walk every day in the fresh air to improve blood circulation, prevent the appearance of excess weight, strengthen the muscular corset and the musculoskeletal system. In addition, walking, especially in good weather, helps to improve mood, relieve psychological stress.

Diet adjustment

During the changes that accompany the onset of menopause, it is necessary to adhere to a healthy diet in order to avoid gaining unwanted weight and to strengthen the body as a whole. It is recommended to increase the consumption of fruits, vegetables, while flour products, fatty foods, hot spices should be abandoned. It will be useful to add seafood and lean fish to the diet.

Hi girls! The first sign of menopause in women is noted after 45 years in the form of general vegetative symptoms. Within 10 years, the symptoms progress and gradually the menstrual cycle ends first, and then slowly, against the general background of changes in the body, the ovaries stop their hormonal function. In the article, we will analyze the periods of menopause, find out the early signs and causes of the cessation of reproductive function. And also what to do, how to treat.

The fertile period is divided into 4 stages - puberty, maturity, menopause and old age. With age, there is a gradual fading of the reproductive function. With a decrease in hormone levels and the cessation of the activity of the genital organs, namely the production of estrogen and progesterone.

Each of the fair sex suffers this stage of extinction in different ways. Someone does not feel any changes, and someone is going through a menopause with a pathological course. Approximately half of all women have neurological, endocrine, and vascular disorders during menopause. Performance may decrease, quality of life deteriorates.

In fact, the climax is divided into 3 periods:

1. Premenopausal - usually occurs after 45 years. Menstrual bleeding still persists. but become irregular and meager due to a decrease in the secretion of progesterone and estrogen. This moment is the very first bell about changes in the body.
2. Menopause - the cessation of regular menstruation (about 50 years), but the possibility of unexpected bleeding still persists, the ability to conceive during this period of conception is almost absent.
3. Postmenopausal - up to 70 years. Complete cessation of the synthesis of progesterone and estrogen.

The age criteria for the stages are rather conditional. Therefore, it is important to know the first signs of menopause in women, in order to pick up in time and to support the whole body.

early signs

Many ladies are not even aware of the onset of menopause. They visit therapists with complaints of high blood pressure, pain in the heart, as well as with neurosis and depression.

The period of the first early manifestations usually lasts the entire premenopausal stage and a couple of years postmenopausal. Then unpleasant symptoms turn into more serious metabolic disorders.

At the initial stages, there are:

• "Hot flashes" are sudden bouts of heat that are not related to the ambient temperature. You may also suddenly feel chills.
• Headaches and migraines.
• Increase in sweating.
• Jumps in blood pressure.
• Increased heart rate, rhythm disturbance.
• Decreased bone mineralization, which leads to development.

Changes affect not only the general condition of the body, but also affect the psycho-emotional sphere. A woman may experience memory disorders, fatigue and drowsiness appear, and sexual desire decreases. The upcoming menopause also affects mood - irritability increases, depression may develop.

How menopause begins in women - symptoms

How menopause will proceed depends on many factors. The severity determines the hormonal background, general condition, heredity.

Hot flashes accompany almost all ladies, their intensity can vary.

1. A mild feeling of "heat" can be felt 1 to 10 times during the day.
2. Medium - up to 20.
3. Severe hot flashes may be accompanied by more than 20 times a day.

Interesting: the state of sudden heat is explained by vasomotor (vascular) disorders. This dilates the capillaries, causing blood flow to the head, neck, and body. Rise can be observed from 2 to 5 degrees Celsius.

The fever often starts at night, causing insomnia, sweating, and increased heart rate. Hot flashes are often accompanied by dizziness and weakness.

Watch a very helpful video.

About 20 percent of women are prone to neurotic disorders in the early period - a sharp change in mood, aggression, irritability, tearfulness.

These signs are the most common, but there are also atypical manifestations:

• Arterial hypertension, accompanied by migraines, increased urination (the reverse process is also possible - urinary retention).
• Intense heart pain without manifestation of changes in the cardiogram and not stopped by standard therapies.
• Exacerbation of the immunological status - skin rashes, urticaria, allergic rhinitis and lacrimation are observed. In rare cases, a sudden intolerance to medicines or certain types of products (which the woman had calmly consumed before) manifests itself.

Unfortunately, mild premenopausal symptoms are rare. Only 1/6 of women experience a period of extinction with little or no discomfort. Usually these are the fair sex without chronic diseases and leading a healthy and active lifestyle.

Almost all women with chronic pathologies experience a difficult menopause. Also, risk factors include endocrine and hormonal disorders, irregular menstruation. Early onset of menopause (up to 40 years), lack of pregnancy and childbirth.

early menopause

This pathological condition begins at the age of 35-40 years. This is usually associated with a burdened gynecological history (urogenital diseases, frequent miscarriages and abortions), autoimmune diseases, surgery and ovarian tumors.

The first sign of this process is a change in the monthly cycle. First, the intervals between bleedings lengthen, reaching 1 cycle within six months. Due to a decrease in estrogen production, hot flashes, sweating, and shortness of breath begin. During physical exertion, heart pain and dizziness are observed.

Due to the slowdown in lipid metabolism, body weight increases, and the fat mass is deposited in the abdomen according to the "male" type. Also, weight gain contributes to the state of depression and depression.

Hair growth increases - “antennae” appear above the upper lip and hair on the chin.

The main danger of the early onset of menopause is an increase in the frequency of intrauterine bleeding, primary infertility, problems with the thyroid gland and an increase in the likelihood of developing cancerous processes.

For the differential diagnosis of the onset of menopause from amenorrhea after 35 years, a blood test for hormones, ultrasound to assess the endometrium and colposcopy are prescribed. It is important to separate the onset of ovarian failure from pituitary tumors, thyroid and adrenal pathologies.

How to help

First of all, at the first signs of menopause, a woman should contact her attending gynecologist. He will be able to assess the severity of the manifestations and prescribe both hormone replacement and symptomatic therapy. You should also undergo an examination on a chair with a cytological sample of the cervix, an ultrasound of the pelvic organs and a mammogram.

The main problem with menopause symptoms is its negative reaction to standard treatments. The doctor can eliminate the signs with the help of non-hormonal agents, as well as with the introduction of estrogens.

The most effective treatment is hormonal, which helps to remove almost all unpleasant symptoms. Usually, small doses of natural estrogens are used, which are combined with progesterone for prophylactic purposes (it helps to avoid hyperplasia of uterine tissues). Hormones help reduce the likelihood of developing osteoporotic changes, strokes and heart attacks. It is obligatory to visit the gynecologist 2 times a year, and even more often.

However, this treatment has its contraindications:

• Uterine bleeding of unknown etiology.
• Cancer of the genital organs.
• Violation of blood clotting.
• Renal or liver failure.
• Thrombosis.

As a symptomatic treatment, antidepressants, drugs for the prevention of osteoporosis (biophosphonates) are usually used.

Non-drug therapy is used, this is an integral treatment for the rest of life. Banal physical therapy every day helps to cope with the restructuring of the body.

Balneotherapy is a method of treatment using mineral and radon baths in natural climatic conditions in spring or autumn (very hot in summer).

The first sign in a woman with menopause begins with meager periods and there may also be mild hot flashes. This is a natural process of the physiological period, the transition from puberty to the period of cessation of reproductive function. Proper lifestyle and rational therapy will make it easier to endure unpleasant symptoms, as well as reduce the risk of complications.

You can write a lot of articles about menopause, a lot of different examples and situations, in my case the first sign was those very light showers of heat and then cold. Now they are more pronounced, because the second period of menopause is still underway. To weaken them, I am looking for my remedy, described.

Hold on girls, let's break through! Take care of yourself and your loved ones!

At a time when women gave birth in a haystack, the problem of menopause did not exist - most simply did not live up to this time due to hard work, the lack of normal medicine and the low level of social and living conditions.

Menopause in a woman begins at about 45-50 years old, now many at this age remain socially active and do not consider themselves "aging" at all. And it is right.

But the transition period knocks out of the usual rhythm of life, increases the number of "sores" that you never had to think about before. Are there ways to get rid of discomfort and discomfort?

Menopause periods

Menopause doesn't happen overnight. This process can take several years.

Three types of estrogens circulate in the body of a woman of reproductive age:

1. 1 Estrone;
2. 2 17-β-estradiol;
3. 3 Estriol.

The most pronounced activity has 17-β-estradiol. The decrease in its level normally begins about 5 years before the end.

The solo role remains for estrone, but it cannot have the same effects on target organs as 17-β-estradiol. Therefore, all the "side effects" of the transitional stage develop.

1. 1 premenopause- the period from the moment the first signs appear to the last menstruation.
2. 2 Menopause- The most recent independent menstruation.
3. 3 Postmenopause- the time from the last menstruation to 65-69 years.

The date of menopause is set only retrospectively (that is, after the end of menstruation). Every woman should keep a calendar, which marks the beginning and end of menstruation.

If menstruation has stopped, then this will fix this date, so that after a year it can be said with certainty that the postmenopausal period has begun.

In Russia, the average age of menopause is 45-50 years. But for every woman this time is different.

If menstruation stops before the age of 45, then this is considered early menopause. Premature menopause is said to occur when menstruation ends before the age of 40.

60-80% of women with early or premature menopause suffer from unwanted manifestations.

2. How to understand that menopause begins?

If you do not delve into special studies, then you can understand that the menopause has begun, you can change your condition and the appearance of some symptoms that were not noticeable before.

The onset of menopause can be compared to a domino effect: hormonal changes affect the functioning of the nervous system, disrupt metabolic processes, and together this leads to immunological changes.

The first thing a woman can pay attention to is a change in the menstrual cycle.

Fluctuations in estrogen levels make themselves felt. Reducing their concentration activates the pituitary gland, which tries to "stimulate" the ovaries and increases the secretion of LH and FSH.

But this cannot significantly affect the gradual extinction of the function of the sex glands.

Menstruation can come regularly, but sometimes the cycle goes astray, the gap between them is significantly shortened or lengthened.

The discharge itself can also change (from daubing to heavy bleeding).

The severity of the changes depends on the accumulated baggage of gynecological problems.

Fibroids, endometrial hyperplasia, endometriosis in themselves lead to menstrual irregularities, by the time of menopause, these symptoms become more pronounced.

Manifestations of menopause are divided into three groups according to the time of their appearance:

1. 1 Early- These are vasomotor, vegetative and emotional-psychological manifestations.
2. 2 Delayed- appear 1-3 years after menopause - urogenital disorders (,), aging of the skin and its appendages.
3. 3 Late- these are symptoms that develop no earlier than 2-5 years after menopause, they include osteoporosis, atherosclerosis, heart disease, hypertension, insulin resistance, as well as memory, vision and hearing loss.

It is the early signs that attract attention. They force women to see a doctor, unfortunately, not always a gynecologist.

3. Signs of the onset of perimenopause

Before menstruation stops, a woman may experience the following symptoms:

1. 1 , excessive sweating, low or high blood pressure, headache.
2. 2 Emotional-vegetative: irritability, weakness, drowsiness, feeling of depression, decreased libido.
3. 3 Other disorders: osteoporosis and vascular damage - do not belong to the initial signs of menopause. They appear a few years after the cessation of menstruation.

They are among the most typical signs of premenopause. This is a vascular reaction, which consists in the appearance of a feeling of heat in the upper body, reddening of the face. Sweating and palpitations are observed.

Tides are seasonal. Very often, the first signs appear in autumn (September-October) or spring (February-March).

Usually they occur in the evening and at night, for some - in the morning after waking up.

Hormones and the autonomic nervous system are to blame for feeling unwell. The neurotransmitters dopamine and norepinephrine are involved in the regulation of body temperature and vascular tone. A sharp increase in their production leads to the expansion of skin vessels and the appearance of discomfort.

Palpitations are also a consequence of hypersensitivity to catecholamines. Similarly, the propensity to jumps in blood pressure is explained.

It should be remembered that many arterial hypertension appears even before menopause.

You can establish a connection between hypertension and menopause based on anamnesis. It is only necessary to clarify which symptoms arose earlier.

Estrogens act on the brain directly, through neurons, and also indirectly by regulating the blood supply to its areas responsible for memory and emotions.

This can indirectly explain the deterioration of cognitive functions and emotional lability.

Any diseases that a woman acquired before the onset of menopause signs only worsen the situation.

4. How to respond to the first symptoms?

Passing, they gradually fade away, or their severity decreases to a minimum. Some women have to wait for this moment for about five years, and this is not easy.

No need to try to get rid of unpleasant sensations on your own, with the help of traditional medicine, "cleansing" the body. If you consult a doctor in time, the treatment will not take much time and money.

4.1. Lifestyle

The nervous system is influenced by the external environment. The correct mode of the day, sufficient time for a night's rest will allow you to adjust the rhythm and production of hormones.

Physical activity is also important. During the week, it is enough to do two or three workouts of medium intensity, lasting 30 minutes each.

Too active exercises will tire, and moderate training will keep the body in good shape.

For those who have not yet given up bad habits, it's time to do it. Smoking, drinking alcohol worsen the entry into a new phase of life.

Should be regular. But we must not forget about contraception: the menstrual cycle can proceed without ovulation, but age does not completely exclude it.

Therefore, in maternity hospitals there are often women who decided to become a mother at the age of 50.

4.2. Diet

In women, as in men, basal metabolism decreases with age. Therefore, you need to take care of reducing the calorie content of the diet.

This is done by reducing the proportion of simple carbohydrates and animal fats. Sweet, floury, high-calorie foods and salt should be excluded or limited.

The basis of the diet should be:

1. 1 Cereals.
2. 2 Vegetables.
3. 3 Fruit.
4. 4 Dairy products.
5. 5 Lean meat.
6. 6 Fish.

No need to completely abandon foods containing cholesterol (eggs, butter). It is the basis for the synthesis of steroid hormones and is necessary for the body. It is enough to maintain a balance and not abuse such food.

4.3. Hormone Replacement Therapy

Lack of estrogen leads to the appearance of unpleasant signs of aging. Therefore, it is logical that it is possible to support the body and improve the quality of life if this deficiency is compensated.

You need to understand that they are not an elixir of youth, they are not used for the prevention of menopause.

Treatment is prescribed only according to indications:

1. 1 The onset of menopausal disorders (hot flashes, tachycardia, nervousness, insomnia, etc.).
2. 2 Urogenital disorders.
3. 3 Prevention of osteoporosis.

Under the influence of drugs, vegetative disorders disappear, the severity of hot flashes decreases, the emotional background is restored, and the taste for life returns. They relieve pain in the joints and muscles, eliminate problems with sleep.

In women with premature menopause, menopause is much more difficult, this is due to the fact that the body was not yet ready for such a deficiency of estrogen.

Those who have menopause before the age of 40 should heed the doctor's recommendations and, in the absence of contraindications, prefer hormone therapy to folk remedies with unproven effectiveness.

Preparations for HRT belong to different groups:

1. 1 Pure estrogens.
2. 2 The combination of estrogens + progestogens in different modes.
3. 3 Estrogens + androgens.
4. 4 Progestogen monotherapy (very rarely used).

Medicines can be produced in different forms: tablets must be taken orally, depot forms are administered subcutaneously. Local funds are produced in the form of a cream, patch.

What form and dosage the doctor prefers depends on the nature of the manifestations and their severity.

For example, with urogenital disorders (dryness, discomfort, pain during sex, etc.), it is enough to use creams with estrogens (Ovestin).

The average duration of replacement therapy ranges from 2 to 3 years. With early menopause, it is usually increased until a woman reaches the age of 50 years.

There is a risk of complications of hormone replacement therapy. It increases the risk of breast cancer, endometrial cancer, and the risk of venous thrombosis.

However, if you follow the rules, proper examination and regular monitoring, you can go through perimenopause without harm to your health and exacerbation of concomitant diseases.

Menopause and menopausal syndrome: what happens in a woman's body? Harbingers, hot flashes, symptoms and manifestations, diagnosis of menopause (menopause). Diseases associated with menopause (uterine fibroids, endometrial hyperplasia, and others)

Thanks

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Climax- this is the depletion of the female sex glands - the ovaries, which every woman inevitably experiences. And although menopause is a completely physiological process, and not a pathology, every woman feels different symptoms, requires observation by her gynecologist and treatment.

All the rich symptoms of menopause are the result of a deficiency of female sex hormones, which play a huge role in a woman's life. There is probably not a single organ in the female body that does not involve sex hormones. Therefore, during menopause, changes affect the entire body as a whole, including appearance, psycho-emotional state and sexual life.

What happens in a woman's body?

Ovaries with menopause

The ovaries undergo irreversible changes during menopause. As it has already become clear, at all stages of menopause there is a change in their functions. The activity of the ovaries decreases premenopausal and stops completely postmenopausal.

In addition to functions, the ovaries change their shape, size and structure. At the initial stages, the ovaries slightly decrease in size; a small number of follicles can still be found in them. After the onset of menopause, they seem to wrinkle, their size decreases several times, follicles are not defined in them, and the ovarian tissue is gradually replaced by connective tissue - that is, tissue devoid of any function.

Changes in the uterus and endometrium with menopause

The uterus also responds to hormonal imbalances. During a normal menstrual cycle, physiological changes constantly occur in it, necessary to prepare for the fixation of the fetal egg. Particular changes occur in the inner layer of the uterus - the endometrium, it is updated monthly, rejected during menstruation and thickened after ovulation. And all this under the influence of estrogens and progesterone.

Involution in the uterus and in the fallopian tubes with menopause:

• Premenopausal the uterus increases somewhat in size, but becomes less dense.
• After menopause the uterus decreases in size several times.
• Myometrium , or the muscular layer of the uterus gradually atrophies, in postmenopause it is replaced by connective tissue - that is, it loses contractile functions.
• Even at the beginning of the climax uterine endometrium , or its inner layer gradually becomes thinner, by menopause it is also replaced by connective tissue - the inner cavity of the uterus overgrows.
• Cervix is also shortened, the cervical canal connecting the uterus with the vagina is significantly narrowed or completely overgrown. It also disrupts the functioning of the mucous glands located on the neck, which reduces the amount of vaginal mucus, or "lubrication".
• The fallopian tubes gradually atrophy, their patency disappears, they also overgrow with connective tissue over time.
• Weakened ligaments and muscles that support the uterus with appendages in the pelvis. As a result, the risk of prolapse of the vagina and uterus increases.

How does menopause affect the vagina and vulva?

Female hormones are responsible for the elasticity, firmness and moisture of the vagina, which is necessary for a normal sexual life and fertilization. With the extinction of the ovaries and estrogen deficiency, changes also occur in the vagina that bring women unpleasant discomfort.

Changes in the vagina with menopause:

• Gradual loss of elasticity and firmness of the vagina, thinning of its walls, as a result - it narrows and stretches poorly during sexual intercourse, bringing pain to the woman.
• Decreased secretion of vaginal secretions, or "lubrication". The vagina becomes dry, poorly lubricated during sexual arousal.
• The acidity of the vaginal mucus changes, which reduces local immunity, leads to a violation of the microflora (dysbiosis, thrush) and increases the risk of infection with sexually transmitted diseases.
• Fragility of the vessels that feed the vaginal wall is noted, which can be manifested by spotting.

With menopause, the appearance of the external genitalia also changes:

• the labia majora become flabby due to the loss of adipose tissue in them;
• labia minora gradually atrophy;
• thinning pubic hair.

Processes in the mammary glands

The condition of the mammary glands directly depends on female sex hormones. They constantly undergo changes associated with the menstrual cycle and lactation. With menopause, as in the genitals, changes also occur in the mammary glands (involution, or reverse development), because there are few sex hormones, there is no menstrual cycle, and breastfeeding is no longer useful.

Physiological involution of the mammary glands with menopause:
1. Fat involution - replacement of the glandular component of the mammary glands with adipose tissue, which does not carry specific functions.
2. fibrous involution - replacement of glandular tissue with connective tissue. In this form, the reverse development of the mammary glands can be complicated by the formation of tumors and cysts, which are usually benign in nature, but always have a risk of malignancy. This process is called "fibrocystic involution".
3. Fibrofat involution The mammary gland is made up of fat and connective tissue.

What does the mammary gland look like after menopause?

• In premenopause, the mammary glands may thicken, swell, and slightly increase in size.
• After menopause, the mammary glands become soft, sag, change their size, in overweight women they increase in size due to excess fat, and in lean women, on the contrary, they decrease, they can completely atrophy.
• The nipple also changes, it sags, decreases in size, turns pale.

Skin in menopause. What does a woman look like after menopause?

Female hormones are the beauty of a woman, beautiful skin, hair, toned face and figure, attractiveness. And the saddest thing that happens during menopause is the appearance of age-related changes, that is, aging. Of course, the pace of aging is different for every woman. Everything is very individual. Some girls are already covered with wrinkles at 30, while other ladies at 50 even look very young. But with the onset of menopause, everything becomes very noticeable, because changes in the skin cannot be avoided.

What changes in appearance can appear in women after menopause?

1. Wrinkles, skin laxity. In the skin, the processes of formation of its own collagen, elastin and hyaluronic acid worsen, that is, the skin frame becomes loose and flabby. As a result - wrinkles, dry skin, sagging of the contours of the face and body.
2. Tired appearance, morning swelling. Under the influence of a lack of hormones and cardiovascular problems, the microcirculation of the skin is disturbed, which worsens the metabolic processes in it. The skin suffers from a lack of oxygen and nutrients, harmful compounds accumulate in it. Subsequently, the skin fades, turns pale, has a tired look. Red spots may appear associated with dilated blood vessels (rosacea). Morning swelling on the face and limbs is also associated with poor circulation.
3. Skin inflammation. Sex hormones regulate the work of the sebaceous and sweat glands, which protect the skin from negative environmental factors. Therefore, with a deficiency of female hormones, the skin becomes sensitive, easily irritated, various inflammatory dermatological problems appear. Seborrheic dermatitis may appear, as well as blackheads and acne, with which we are accustomed to associate adolescence.
4. Age age spots are more embarrassing for many than wrinkles and sagging skin. They cover not only the body, but also the face.
Causes of age spots after menopause:

• Violation of pigment metabolism, which probably involves sex hormones. In this case, the extra pigment melanin is not "utilized", but accumulates in the skin.
• The protective layer of the skin is weakened, so it is more susceptible to sunlight, which stimulates the production of excess melanin.
• By menopausal age, problems often appear with the liver, which is also involved in the exchange of pigments.
• Many experts believe that age spots are manifestations of atherosclerosis, and since this pathology often progresses with menopause, there are more and more spots.

Age spots on the skin can be in the form of ordinary dark spots that merge with each other (chloasma), freckles, which are more located on the hands, and also in the form of plaques (keratoma, xanthelasma), which are dangerous for the risk of malignancy.
5. Increased hair loss - they thin, become drier, stiffer, brittle, devoid of shine and natural color. Who has not yet turned gray before, gray hair appears. Thinning eyelashes and eyebrows.
6. May be noted hair growth in unwanted places , for example, antennae, individual hairs on the cheeks, back.
7. Shape changes associated with weight gain, sagging skin, redistribution of fat throughout the body. In addition, over time after menopause, posture changes and even a person’s height decreases, which is associated with age-related changes in the bones.

Why is menopause dangerous for bones?

Throughout life, there is a constant renewal of bone tissue, or, as experts call this process - remodeling. In this case, the bone tissue is partially absorbed and a new one (osteogenesis) is formed in its place. Remodeling is planned at the genetic level and is regulated by many metabolic processes and hormones, including sexual ones, this is a very complex process. Without a sufficient amount of estrogen during menopause, bone formation is disrupted, while the bone is gradually destroyed. Also, as a result of menopause, the absorption of calcium and phosphorus, minerals that are responsible for bone strength, is disrupted.

Such changes in the skeletal system lead to the slow destruction of bone tissue, or osteoporosis, to increased bone fragility and various degenerative processes in them.

Menopause, heart and blood pressure

Estrogens in childbearing age protect a woman from the development of cardiovascular diseases. But as soon as their level drops, the risk of developing atherosclerosis, arterial hypertension with all the consequences increases several times.

How does a deficiency of sex hormones affect blood vessels?

• With menopause, the metabolism of fats is disturbed. Excess fat, namely cholesterol, is deposited not only on the sides, but also on the walls of blood vessels, that is, atherosclerosis develops. Atherosclerotic plaques gradually increase and narrow the lumen of blood vessels, which leads to impaired blood circulation, increasing the risk of heart attack and stroke.
• Climax affects the processes of narrowing and dilation of blood vessels. These processes are necessary for the adaptation of the body during physical or emotional stress. Normally, vascular tone is regulated by the autonomic nervous system, and with a lack of estrogen, this regulation is disrupted, which leads to spontaneous vascular spasms or, conversely, to a decrease in vascular tone. This is manifested by jumps in blood pressure, the development of arterial hypertension, aggravation of atherosclerosis, the development of arrhythmias and coronary heart disease.
• Increases blood clotting. Estrogens thin the blood, and when they are deficient, the blood becomes thick, prone to the formation of blood clots and atherosclerotic plaques. As a result, an aggravation of the course of atherosclerosis, circulatory disorders and an increased risk of heart attacks, strokes and thromboembolism.

Menopause and thyroid gland

Thyroid and ovarian hormones are always interconnected. As with thyroid diseases, the reproductive function of a woman is disrupted, and with menopause, malfunctions in the thyroid gland can occur.

It's all about the hormones of the central nervous system that regulate the function of these organs, namely follicle-stimulating and luteinizing hormone (FSH and LH) and thyroid-stimulating hormone (TSH). They are very similar in their chemical structure. During the restructuring of the body at the beginning of menopause, the level of FSH and LH increases, they react to the lack of sex hormones and try to “spur” the ovaries to produce them. And with stress, which occurs during menopause, the thyroid gland may begin to perceive FSH and LH instead of TSH, which is more often manifested by an increase in its functions and the release of a large amount of hormones. This imbalance of thyroid hormones leads to metabolic disorders and requires urgent specific treatment.

Climax and nervous system

The nervous system during menopause suffers the most. In addition to the fact that female hormones are involved in various "nervous processes", menopause and aging for a woman is always stress, both somatic (bodily) and psycho-emotional. This is what exacerbates the development of nervous disorders.

What happens in the nervous system with the onset of menopause?

• Sex hormones affect the autonomic nervous system , which is responsible for the work of all internal organs, blood vessels and the adaptation of the body to various environmental factors, that is, to all internal processes. With an imbalance of estrogens and progesterone, the work of the autonomic nervous system is disrupted, as a result, a rich symptomatology of menopause: these are hot flashes, and a violation of vascular tone, the work of the heart and other organs.
• Influence of female hormones on the central nervous system. In the brain, the processes of excitation and inhibition of the nervous system are disturbed, this is manifested by increased emotionality, depression, emotional outbursts, sleep disturbance and other mental disorders. In addition, the lack of sex hormones affects brain structures such as the pituitary and hypothalamus, which are responsible for the production of many hormones, including serotonin, norepinephrine and endorphins - hormones of happiness.
• Mental disorders exacerbated by depression into which the woman "drives" herself. She realizes that she is getting old, it seems to her that she has become ugly, that she did not have time, did not achieve much. Besides, suffers and sex life , which, as you know, is an integral part of inner peace and satisfaction. Yes, and survive hot flashes and other unpleasant symptoms of menopause is also difficult.

Symptoms and manifestations of menopause in women

Deficiency of sex hormones during menopause affects many systems, organs and processes in the body. All these violations cannot pass without a trace, therefore, with the onset of menopause, various symptoms appear that bring discomfort and some women are driven to despair.

Symptoms and manifestations of menopause are very individual. We are all unique, every fifth woman does not feel any changes in her health at all. Menopause is more easily tolerated by people who lead a healthy lifestyle, have interesting hobbies, are in demand in the family and are ready to adequately meet their interesting mature age.

Harbingers

Experts believe that the harbingers of menopause appear already at the age of 30-40 years or even earlier, long before the onset of premenopause, and these are:

• problems with conceiving and bearing a child or reduced fertility after 30 years;
• hormone-dependent gynecological diseases, for example, endometriosis, ovarian cysts;
• diseases of the mammary glands, mastopathy;
• menstrual irregularities, heavy or scanty periods, menstrual cycles without ovulation.

All these conditions are associated with an imbalance of female sex hormones and require mandatory treatment by a gynecologist-endocrinologist.

The onset and first signs of menopause, menstrual irregularities

Beginning menopause is always characterized by menstrual irregularities. Against the background of a failure of menstruation, other symptoms associated with a lack of estrogen gradually develop. All these manifestations are combined in climacteric syndrome, which each woman manifests very individually. Usually, one of the first symptoms of menopause are hot flashes and impaired psycho-emotional state.

The menstrual cycle is completely dependent on the hormones that are produced by the ovaries and the central nervous system (releasing hormones, LH and FSH). At the very beginning of menopause, the female cycle does not stop yet, but obvious failures are already noticeable, menstruation becomes irregular and completely unpredictable. Also, most menstruation passes without ovulation, that is, without the maturation of the egg.

In what form, and with what regularity menstruation will go, traditionally depends on individual characteristics. But it is possible to define some options for menstrual irregularities in premenopause:

1. Cycle lengthening (more than 30 days), scanty menstruation . This is the most common type of menstrual irregularity before menopause. In this case, the period between menstruation can be several months, and after 2-3 years menopause occurs, that is, the complete cessation of menstruation.

2. Abrupt cessation of menstruation one can say in one day. It doesn't happen very often. In this case, the development of two variants of the course of menopause is possible: a woman crosses this stage in her life almost without any discomfort, or menopause is more difficult, which is due to the fact that the body does not have time to adapt to a sharp change in hormonal levels.

Why do hot flashes appear during menopause?

The mechanism of tidal development is so complex and multicomponent that it has not yet been fully studied. But many experts believe that the main mechanism for the development of hot flashes is the “suffering” of the central and autonomic nervous system from a lack of sex hormones.

Modern research has proven that the main trigger in the development of hot flashes is the hypothalamus, a structure in the brain whose main function is to regulate the production of most hormones and control thermoregulation, that is, to maintain normal body temperature under the influence of various environmental factors. With menopause, in addition to the ovaries, the hypothalamus is also rebuilt, because it disrupts the production of releasing hormones that stimulate the pituitary gland and then the ovaries. As a result, thermoregulation is also disturbed as a side effect.

In addition, menopause affects the functioning of the autonomic nervous system, sweat glands and the cardiovascular system. Obviously, the complex of all these reactions of the body to the lack of sex glands manifests itself in the form of attacks of hot flashes.

What are the symptoms of hot flashes during menopause?

1. Not all women feel the harbingers of the tides; many attacks are taken by surprise. Before the onset of the tide, tinnitus and headaches may appear - this is due to a spasm of the cerebral vessels.
2. Throws into the heat - many describe the abrupt onset of the tide, the head and upper body seem to be doused with boiling water, the skin becomes bright red, hot to the touch. At the same time, the body temperature rises above 38 o C, but it will soon return to normal.
3. There is increased sweating, drops of sweat immediately appear, which quickly flow down in streams. Many women describe that their hair and things become so wet that "at least wring it out."
4. General well-being is disturbed - heartbeat accelerates, headache, weakness appear. Against this background, nausea and dizziness may appear. Severe attacks of hot flashes can even lead to short-term fainting.
5. The feeling of heat is replaced by chills - due to the fact that the skin becomes wet with sweat and thermoregulation is disturbed, the woman freezes, muscle tremors begin, which can persist for some time. After an attack, muscles may ache due to muscle tremors.
6. Violation of the psycho-emotional state - during the tide, an acute attack of fear and panic occurs, a woman may begin to cry, may feel short of breath. After that, the woman feels devastated, oppressed, and a pronounced weakness develops. With frequent hot flashes, depression can develop.

It is these symptoms that are described by women who have experienced severe attacks of hot flashes. However, not everyone tolerates the menopause. Hot flashes can be short-term, lighter, without disturbing the general and psycho-emotional well-being. Often, ladies feel only increased sweating and heat. Some women experience nocturnal hot flashes in their sleep, and only a wet pillow indicates a past attack. Many experts believe that the severity of hot flashes directly depends on the psychological state of the woman, but there are a number of factors that often provoke the development of hot flashes.

Irritant factors that provoke hot flashes:

• Stuffiness: poorly ventilated area, large crowds, high humidity on a hot day.
• Heat: prolonged exposure to the sun, out-of-season clothing, space heating with fireplaces and other heat sources, bath or sauna.
• Anxiety: stress, emotional distress, nervous exhaustion, fatigue and lack of sleep.
• Food and drink: hot, spicy, sweet, too spicy food, hot and strong drinks, coffee, strong tea and overeating.
• Smoking, namely the very addiction to nicotine. Often the flush appears during a long break between cigarettes and with a strong desire to smoke.
• Poor quality clothes , poorly permeable to moisture and air, leads to overheating of the body, and wearing such things can provoke a rush.

In principle, if a woman avoids the effects of these factors, she can control hot flashes, and if good emotions are added to all this, then menopause will go much easier.

How long do hot flashes last during menopause?

The attacks of hot flashes themselves can last from a few seconds to several minutes, this is very individual. There may be no such attacks per day, or maybe several dozen.

Individually, and how much time they generally have to endure. Statistics show that almost all women experience hot flashes for at least 2 years (from 2 to 11 years). But some "lucky women" have to experience these hot flashes for many years after menopause and even for life. The duration and severity of hot flashes largely depend on when they began: with early menopause and a long period of premenopause, hot flashes last longer.

What do tides affect?

• Psycho-emotional state of a woman, self-confidence.
• Immunity - violation of thermoregulation reduces the body's ability to adequately respond to infections and other external factors.
• There may be fears of leaving the house so that people do not see her in this state.
• Prolonged depression against the background of severe hot flashes is not only a manifestation of psychological problems, but also increases the risk of developing other pathologies, such as psoriasis, diabetes, arterial hypertension, and many "mental" diseases.
• Some women have such a hard time with hot flashes that they even have to resort to emergency medical services.

It must be remembered that hot flashes and menopause itself are a normal reaction of the body, which is not any pathology, all the more something shameful and shameful. Moreover, many modern women are not only not shy about this, but are also ready to discuss it. It is important to prepare for menopause in advance, change your lifestyle, get everything from life, especially positive emotions, listen to your body. All this will not only alleviate the symptoms of menopause, but will also allow you to move on to a new stage of life with ease and dignity.

climacteric syndrome

As already mentioned, the climacteric syndrome in each woman proceeds differently. It represents a huge complex of symptoms and manifestations from various organs and systems. Many of these symptoms are still experienced by most women, to varying degrees and severity. Violation of the menstrual cycle and hot flashes are essential components of menopause. Other manifestations may be absent or unrecognized, often ladies associate poor health with fatigue or other diseases.

Symptoms depend on the phase of menopause. So, in premenopause, more vivid symptoms are observed, but after menopause, the risk of developing many diseases increases, which are often not associated with the manifestations of menopause.

Symptoms of the period of premenopause - from the first manifestations of menopause to 2 years of complete absence of menstruation

Symptoms	How do they appear?
tides	sudden feeling of heat; profuse sweating; skin redness; increase in body temperature; chills; severe weakness and disruption of the heart; psychoemotional disorders.
excessive sweating	may accompany hot flashes and be a separate manifestation of estrogen deficiency; often occurs at night; many women, because of this symptom, have to change clothes several times a day and use the most "powerful" antiperspirants.
Increased body temperature	fever may be associated with hot flashes or manifest as a separate symptom; during high tides, the temperature may exceed 38 o C; prolonged subfebrile condition or temperature up to 37 o C can be observed.
Discomfort in the mammary glands	swelling and puffiness; drawing pains in the chest; changes cease to depend on the phase of the menstrual cycle.
Insomnia and drowsiness	hard to sleep at night; during the day you constantly want to sleep; often women in menopause have bad dreams that are so vivid and realistic that they keep negativity for the whole day.
Headache	may be pronounced or aching; often develops for no apparent reason, at any time of the day, including in the morning and at night; often has the character of a migraine (acute pain in one half of the head); difficult to treat with conventional analgesics.
Weakness, increased fatigue	this symptom accompanies almost all women in menopause; often weakness and fatigue occurs already in the first half of the day, both after mental or physical exertion, and without it; working capacity decreases, memory, concentration and attention worsens, absent-mindedness appears.
Irritability , tearfulness, anxiety and a lump in the throat	even the most restrained women can break down on loved ones over trifles, often this symptom is accompanied by a fit of hysteria; ladies become touchy and impressionable, it seems to them that no one understands them; constant or sudden anxiety, many have bad "forebodings" of impending disaster, all this is accompanied by pathological fears; "pessimism" prevails over "optimism", and negative emotions over positive ones; a woman may stop enjoying life as much as before, but the interesting thing is that in the postmenopausal period, love and joy for life not only return, but also become much stronger than in her youth.
Depression, chronic stress	this is the result of not only a lack of hormones, but also an unwillingness to realize the fact of the onset of menopause; "fuel is added to the fire" nervous exhaustion due to fatigue, poor sleep, lack of sex, hot flashes and other manifestations of menopause.
Feeling the heartbeat	Most often, there is an increase in heart rate or tachycardia. Tachycardia usually occurs spontaneously and resolves on its own.
Urination disorder	increased risk of developing cystitis.
Sex, fertility and perimenopause	decreased sex drive (libido); there is a slight dryness in the vagina; sexual intercourse may become painful (dyspareunia); natural pregnancy is still possible.
Other manifestations	the first signs of skin aging: dryness, shallow wrinkles, decreased skin tone, etc.; fragility of hair and nails appears; blood cholesterol may increase; some women begin to gain weight.

Postmenopausal symptoms - 1 year after the last menstrual period and for the rest of life

Symptoms	How do they appear?
Hot flashes, sweating and psychoemotional disturbances	hot flashes usually become less frequent and easier, after a few years, most women have hot flashes completely; irritability, tearfulness, fatigue persist, but every month and year it becomes easier; insomnia and weakness persist for several more years, and some women do not get enough sleep for a long time.
Excess weight	many women gain weight, which is associated with a sedentary lifestyle, a slowdown in metabolism, and also with the fact that the body is trying to make up for the lack of estrogen by producing it with adipose tissue; the type of the figure also changes, there is a redistribution of fat in the abdomen and upper shoulder girdle, the skin sags, the posture changes.
muscle weakness	lack of hormones leads to weakening and flabbiness of muscle tissue, muscles sag, and their performance is significantly reduced; "Pumping muscle" with the help of sports becomes much harder than at a younger age.
Vaginal dryness	pain during intercourse; feeling of discomfort while wearing tight underwear and clothes; high risk of developing thrush and other inflammatory processes of the vagina.
Vaginal discharge, itching and burning	vaginal discharge is normal after menopause if it is: transparent, odorless and colorless, its amount is scarce and most importantly, it does not cause any discomfort and itching; the presence of itching, burning and unusual discharge indicate the presence of inflammatory and other problems, are not a normal condition, an appeal to a gynecologist is required; yellowish, odorless discharge, itching and discomfort during sexual intercourse indicate vaginal dysbiosis - the most common condition of the genital organs after the onset of menopause; cottage cheese discharge with a sour smell indicates vaginal candidiasis (thrush); secretions with a specific odor indicate the attachment of various pathogenic infections, including sexually transmitted ones; brown and bloody vaginal discharge may be associated with increased fragility of the vessels of the vaginal mucosa, in which case blood appears to a greater extent after intercourse, but also blood from the vagina can be a sign of tumors in the uterus and appendages, including malignant ones.
Urination disorder	the urge to urinate is significantly increased; a very high risk of developing urethritis and cystitis, as a result - the risk of developing inflammation of the kidneys (pyelonephritis); some women may experience urinary incontinence, especially when exercising, and the saying "you can stop laughing" is not so funny anymore.
Sex and fertility	libido continues to decline, although some women, on the contrary, have a special interest in sex, one that was not even in their youth; pain increases during sex due to vaginal dryness and poor elasticity of its walls; natural pregnancy is no longer possible.
Skin, hair and nails	there is a noticeable aging of the skin, it becomes dry, flabby, sags, deep age wrinkles appear, and not only on the face; the natural blush disappears, the skin of the face grows dull, looks tired, there are problems with acne, acne; often there are swelling of the eyelids; the hair splits, becomes thin, dull, turns gray, and there is also an increased loss of hair, over time the braid becomes much thinner; growing nails for a beautiful manicure is becoming increasingly difficult, they are brittle, often lose their color.
High risk of developing various diseases	osteoporosis - deformation of bone tissue; cardiovascular pathologies (arterial hypertension, atherosclerosis, arrhythmia, angina pectoris and others); diseases of the uterus and appendages (myoma, ovarian cysts, polyps, oncological diseases), prolapse of the vagina and uterus; pathologies of the mammary glands (mastopathy, cancer); diabetes mellitus, pathology of the thyroid gland and adrenal glands; diseases of the nervous system (vegetative-vascular dystonia, strokes, mental disorders and diseases); diseases of the digestive system (cholelithiasis, constipation, hemorrhoids); urinary tract infections and others.

Diseases with menopause

One of the manifestations of menopause after menopause is the risk of developing various diseases. This does not mean that all women in the period of menopause should suddenly begin to suffer from all diseases. Everything largely depends not so much on the level of hormones as on lifestyle, genetic predisposition and many environmental factors. In addition, many of these diseases can develop without menopause at a younger age. Yes, and men who are not so dependent on estrogens also suffer from these ailments. But many scientific studies have proven that it is the deficiency of sex hormones that is the trigger for the development of many of the "age-related" pathologies. Let's consider some of them.

Diseases associated with menopause:

Disease	Factors and causes that increase the risk of developing the disease	Main symptoms	What is dangerous?	How to reduce and prevent manifestations of the disease?
Osteoporosis- a decrease in bone density, a lack of calcium, phosphorus and other minerals in them, leads to the gradual destruction of bone tissue.	heredity; smoking; alcohol; sedentary lifestyle; excess weight; rare exposure to sunlight; unbalanced diet; diseases of the digestive and endocrine systems.	bone pain, especially "for the weather"; movement disorder in some joints; weakness, decrease in physical strength, sluggishness; spinal deformity, manifested by a violation of movements and posture, pain and a decrease in growth; deformation of the fingers and toes and other bones; fragility of nails, diseases of the teeth and hair loss.	Pathological bone fractures that can occur even with the slightest injury and simply unsuccessful movements. Fractures are difficult to grow together and can permanently chain a woman to a bed. Violation of cerebral circulation as a result of osteochondrosis of the cervical and / or thoracic spine.	Right way of life; food rich in calcium and phosphorus; moderate sunbathing; moderate physical activity, the correct mode of work and rest; fight against excess weight; avoid falls, injuries, awkward movements; hormone replacement therapy with sex hormones reduces the manifestations of osteoporosis; taking calcium supplements: Calcium D3, Ergocalciferol and many others.
Uterine fibroids is a benign tumor of the uterus associated with an imbalance of sex hormones. Myoma can be of different sizes, single or multiple. It often occurs against the background of menopause, and after the onset of menopause, small myomatous nodes are able to resolve on their own.	Abortions and operations on the uterus; lack of childbirth; endometriosis; irregular sex life; chronic stress; early menarche (first menstruation); excess weight; abuse of animal food; alcohol abuse; heredity; late pregnancy can exacerbate the growth of fibroids.	Prolonged, frequent and profuse menstruation; bleeding that is not associated with the monthly cycle; an increase in the volume of the abdomen; frequent urge to urinate; constipation; pain during intercourse.	Uterine bleeding, including massive. Pelvioperitonitis associated with torsion of the leg of the myoma node requires surgical intervention. Cancer is the malignancy of a tumor.	Replacement hormone therapy; healthy lifestyle; regular sex; prevention of venereal diseases; fight against excess weight; regular follow-up with a gynecologist.
ovarian cysts- benign cavity formations. With menopause, dermoid, endometrioid and other types of non-functional cysts often occur, as well as polycystic ovaries.	Endocrine diseases of the thyroid gland, adrenal glands, brain; abortions and operations; inflammatory diseases of the pelvic organs; sexually transmitted infections; genetic predisposition; taking contraceptives and hormone replacement therapy with sex hormones.	Pain in the abdomen, in the lower abdomen or in the lower back, aggravated by physical exertion and sexual intercourse; violation of urination and constipation; asymmetric enlargement of the abdomen; spotting spotting; painful menstruation in premenopause.	Cancer - non-functional cysts have a high risk of malignancy. Cyst rupture, ovarian rupture, and torsion of the cyst pedicle are conditions that require urgent surgical treatment.	Annual examination by a gynecologist and timely treatment of gynecological problems; if necessary, surgical treatment; prevention of venereal infections; healthy lifestyle and "no" to carcinogens.
Uterine bleeding- spotting from the vagina of a different nature, associated or not associated with menstruation.	In premenopause, bleeding is often associated with hormonal changes in menopause and menstrual irregularities; endometriosis; uterine fibroids; uterine polyposis; pathology of the cervix; polycystic and other ovarian cysts; spontaneous abortions.	Options for uterine bleeding in the premenopausal period: prolonged and heavy menstruation (more than 6 pads per day and more than 7 days); periodic spotting spotting, not associated with menstruation; the presence of large blood clots, lumps during or between periods; frequent periods (more than every 3 weeks); spotting that appears after intercourse; prolonged spotting of varying intensity (more than 1-3 months). After the onset of menopause, any spotting should alert.	Crayfish. Uterine bleeding can be a sign of serious illness, including cancer. Anemia - with prolonged and heavy bleeding, lead to loss of blood. Hemorrhagic shock - can develop with massive uterine bleeding, requires urgent resuscitation, surgery and transfusion of blood products.	Timely access to a doctor to determine the causes of bleeding and their correction; food rich in protein and iron; control over the amount of blood lost.
Mastopathy- a benign tumor of the mammary glands.	Involution of the mammary glands associated with hormonal changes; early onset of menstruation and early puberty; various diseases of the uterus and appendages, especially inflammatory ones; lack of lactation or a short period of breastfeeding; no pregnancy before the age of 30; abortions and miscarriages; stress; excess weight; taking contraceptives and other hormonal drugs in large doses; endocrine pathologies. heart attack; heart failure.	Proper lifestyle and nutrition; Regular physical activity; fight against excess weight; control of diabetes; regular intake of drugs containing aspirin; control of blood pressure; timely access to a doctor and compliance with his recommendations.

Diseases associated with menopause can be prevented not only by hormone replacement therapy, often recommended during severe menopause, but also by the right lifestyle and regular examinations by your gynecologist.

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Menopause diagnostics

Menopause is not a disease and, it would seem, why diagnose it, because everything is clear anyway - hot flashes, menstrual irregularities, the onset of menopause and the body getting used to living on small doses of sex hormones. But there are situations when it is simply necessary to know whether menopause has begun, and at what stage it is.

Why do we need menopause diagnostics?

• differential diagnosis of menopause and other diseases;
• identification of complications and diseases associated with menopause;
• examination before prescribing hormone replacement therapy and contraceptives.

What is included in the examination plan for menopause?

1. Analysis of life history and complaints (time of onset of menarche, presence of pregnancies, abortions, regularity of the menstrual cycle, etc.).
2. Examination by a gynecologist, taking swabs, bakposev from the vagina, cytological examination of smears from the cervix. Examination of the mammary glands.
3. Blood test for sex hormones.
4. Ultrasound of the uterus and appendages.
5. Breast ultrasound or mammography.
6. Osteodensitometry - measurement of bone density.
7. Electrocardiography (ECG)
8. Biochemical blood test: glucose, triglycerides, cholesterol, lipoproteins, blood clotting factors, calcium, phosphorus, etc.
9. Analysis for HIV and syphilis.

Sex hormones (estrogens, progesterone, FSH and LH) in a blood test with menopause:

Period of a woman's life	Indicators of the level of gomons in the blood, norm *
	Estradiol, pg/ml	Progesterone, nmol/l	FSH(follicle-stimulating hormone), honey/ml	LG(luteinizing hormone), honey/ml	LH/FSH index
Reproductive period before menopause: 1. Follicle maturation phase (1-14th day of the menstrual cycle).	less than 160	up to 2.2	to 10	less than 15	1,2-2,2
2. Ovulation (14-16th day).	over 120	to 10	6 – 17	22 – 57
3. Luteal phase (16-28th day).	30 – 240	over 10	up to 9	less than 16
premenopause	Female sex hormones gradually decrease**, menstrual cycles are observed without ovulation.		over 10	over 16	about 1
Postmenopause	5 – 30	less than 0.6	20 - 100 and above	16 - 53 and above	less than 1

* All normal values ​​are approximate. Each laboratory has its own reference (normal) values, which are usually indicated on the answer sheet. This is due to the various methods and test systems that are used in the process of laboratory research. Therefore, it is necessary to take into account those reference values ​​that the laboratory gives.

** Interestingly, at the beginning of premenopause, progesterone deficiency is especially pronounced, and not estrogen. And by the time of menopause, progesterone is formed in very low doses, and estrogen is only half as much as in childbearing age.

Hormonal background every woman is very susceptible to environmental factors, emotional state and various diseases, so the level of hormones varies in the same woman.

When to take a blood test for sex hormones?

An analysis for sex hormones during the premenopausal period, that is, with saved menstruation, must be taken at certain periods of the menstrual cycle, accurately indicating the day from its beginning. Usually, FSH and LH are recommended to be taken on the 3-5th day from the onset of menstruation, and estradiol and progesterone on the 21st day. After the onset of menopause, the analysis can be taken any day.

Preparing for a blood test for sex hormones:

• the analysis is given strictly in the morning on an empty stomach, in the evening a light dinner;
• before the analysis, you should stop taking alcohol, coffee and drugs, do not smoke;
• when taking contraceptives, the results are adjusted taking into account their doses;
• the day before blood donation, it is recommended to give up sex and heavy physical exertion;
• before donating blood, you must completely relax, sit quietly for at least 10 minutes.

With the help of a blood test for sex hormones, the doctor can detect the onset of menopause or the onset of menopause, whether pregnancy and its bearing are possible. Also, depending on the level of hormones and the severity of symptoms, you can determine the severity of menopause. Severe menopause is indicated by high FSH levels, as well as the LH / FSH ratio: the lower it is, the more difficult the woman’s body tolerates the lack of sex hormones and the more pronounced the symptoms and diseases associated with menopause.

Ultrasound examination for menopause

With the advent of menopause, women's health problems often come. These are, first of all, various tumor-like formations, both benign and malignant. It is for their detection and observation that ultrasound diagnostics of the pelvic organs is necessary, and annually. In addition, ultrasound helps to diagnose the onset of menopause and determines the possibility of late pregnancy.

Ultrasound signs of the upcoming menopause:

• Ultrasound can detect the presence or absence of follicles in the ovary and their number. The closer to menopause, the fewer follicles, and the less chance of getting pregnant. After menopause, the follicles in the ovaries are not determined.
• The ovaries gradually decrease in size , they lose their echogenicity. After menopause, they may not be detected at all.
• The uterus is shrinking , becomes denser, small fibroids can be observed, which after menopause most often resolve on their own. The location of the uterus in the small pelvis also changes, it shifts somewhat.
• Life after menopause - what is it like? Sex and sexual relations. Is it possible to get pregnant with menopause? Nutrition advice for women before and after menopause. Do men have menopause?

Menopause in women: symptoms and treatment

Introduction

Menopause (climacteric period) is not a disease, but a natural phase of life that every woman goes through at a certain age. However, menopause can cause symptoms that sometimes require treatment.

During menopause, a woman moves from the stage of puberty to the so-called aging. Most women go through menopause between 45 and 70 years of age. During menopause, a woman undergoes a restructuring of hormones (hormonal levels):

• during menopause, the body constantly loses estrogens (female sex hormones),
• as a result, menstrual bleeding is becoming increasingly rare,
• until, finally, the last climacteric period comes - the so-called menopause.

Estrogen deficiency can cause menopausal symptoms.

Typical symptoms of female menopause are hot flashes, sweating, and dizziness. However, most women do not need treatment: about a third of all women remain unaffected during menopause, only the remaining third of women over 50 develop any minor health problems.

It is only during the last menopause that very severe symptoms can be noticed that may require therapy.

Hormonal preparations with estrogens and/or progestins are primarily used to relieve severe menopausal symptoms: this so-called hormonal therapy (sometimes also called hormone replacement therapy) is the most effective method for treating menopausal symptoms in women.

However, in some cases, such therapy during menopause is out of the question, including with:

• breast cancer;
• uterine cancer;
• resistant (high blood pressure).

Hormone therapy can lead to side effects - so a woman should consult with her doctor to determine which procedure is best for treating her menopausal symptoms. During hormone therapy, regular gynecological examinations are recommended.

In the long term, the estrogen deficiency typical of menopause in women leads to changes in the body: first of all, the uterus, vagina, vulva and mammary glands suffer, they begin to weaken. In addition, during the menopause, the skin and mucous membranes suffer: the skin becomes thinner and less elastic. This can lead to pain during intercourse (dyspareunia).

Without treatment, about one in four women develops. However, hormonal therapy can at least partially compensate for these effects of menopause.

What is a climax?

The term menopause or menopause - refers to the entire transitional period from the end of full puberty to the so-called aging of a woman. This transitional phase begins a few years before the last menstrual period - the so-called menopause.

At what age does menopause begin and how long does it last?

On average, menopause occurs and lasts from 45 to 70 years.

Menopause

Menopause occurs at different times. Their designations indicate a temporal relationship with menopause. - “pre” (premenopause) means before the last menstrual period, “post” (postmenopause) - after it, “peri” (perimenopause) means the period during menopause:

• Premenopause: refers to the period of 2 to 7 years before menopause. Menstrual bleeding becomes irregular and mild menopausal symptoms can be detected.
• Menopause- this is the last menstrual period, spontaneously controlled by the ovaries, after which bleeding stops. This happens on average at age 51.
• Postmenopause is the period after menopause. Postmenopause lasts from 10 to 15 years, ending at age 70.
• Perimenopause: means a period of about 2 years before and after menopause, that is, usually between 49 and 53 years of age.

As a woman ages, estrogen and progesterone levels drop. During the onset of menopause, estrogen levels can vary greatly.

On average, the menopause lasts from 10 to 15 years. During the various transitional phases of menopause, the level of female sex hormones is constantly changing. This can lead to complaints that are summarized under the term climacteric syndrome.

Menopause: causes in hormones

Menopause in women occurs due to hormonal causes: with age, the level of hormones in a woman changes. Around age 40, ovarian function begins to decline, gradually reducing estrogen levels (female sex hormones).

At birth in girls, both ovaries contain several million follicles. During puberty, their number decreases to about 100,000-250,000, and then their number steadily decreases with each ovulation. Although only one egg is released from the ovaries in the month of ovulation, the ovary produces several new follicles in the same month, after ovulation they are again lost.

On average, at age 50, there are no more follicles in a woman's ovaries. Ovulation stops. Since the follicles produce estrogen, estrogen production also decreases. As a result, the last menstrual bleeding controlled by the ovaries occurs around menopause.

Menopause also changes the production of hormones in the brain: as the ovaries produce less and less estrogen during menopause, the brain secretes more hormones of the gonadotropin group - these are sex hormones that should stimulate the ovaries to produce hormones.

In particular, the so-called follicle-stimulating hormone (FSH, follitropin) is released: while, for example, the concentration of a specific estrogen called estradiol decreases to about one sixth during menopause, the concentration of FSH increases on average more than six times.

Such changes in the hormonal background during menopause can provoke various symptoms, such as fatigue, hot flashes or.

female sex hormones

During menopause, various female sex hormones are involved in hormonal changes: the concentration of some hormones drops, while the body produces more hormones, trying to somehow compensate for the loss. The most important group of female sex hormones are estrogens. Sex hormones also include gonadotropins and progestogens.

Estrogens

The follicles in the ovaries are primarily responsible for the production of estrogens, which is why estrogens are sometimes referred to as follicular hormones. These sex hormones, which are produced less and less during menopause, are responsible for many functions in the female body and play a role, among other things, in ovulation.

A group of follicular hormones is especially important for reproduction.

The most important natural estrogens include the hormones estradiol, estrone, and estriol. These three estrogens differ mainly in their activity. Estradiol is the most active estrogen, while estrogen contains only one third and estriol only one tenth of this activity.

Gonadotropins

During menopause, the brain begins to produce more gonadotropins, releasing them into the blood. These sex hormones include luteinizing hormone (LH, luteotropin) and follicle-stimulating hormone (FSH, follitropin).

• luteinizing hormone (LH): means from lat. luteum "yellow". The brain releases luteinizing hormone to stimulate ovulation. LH also contributes to the formation of the so-called corpus luteum, which is formed from the granulosa cells of the ovarian follicle.
• Follicle stimulating hormone (FSH): Follitropin stimulates the growth of follicles in the ovary and also helps them to mature.

Thus, both gonadotropins together contribute to the production of estrogen in the ovaries. During the menstrual cycle, the interaction of estrogens, LH and FSH leads to ovulation once a month. The ovaries then transfer one egg to the fallopian tube.

Progestogens

Progestogens (gestagens) are also known as corpus luteum hormones, as they are produced in the ovaries of the luteal body.

During menopause, the production of progestogen in the ovaries gradually stops. During a woman's puberty, progestogens act on the lining of the uterus and prepare it for eventual fertilization by an egg. If the fertilized egg is actually capable of implanting, pregnancy occurs.

After that, gestagens prevent further maturation of the follicles during pregnancy. The most important progestogen is progesterone. Other progestins are pregnandiol and pregnenolone.

Typical symptoms of menopause

Menopause is characterized by symptoms that are mainly caused by a lack of estrogens (female sex hormones). Women react differently to these changes:

• about a third of women go through menopause without symptoms;
• in another third, the symptoms of menopause are so mild that women do not consider it necessary to treat them;
• the last third of the typical menopausal symptoms are severe, often requiring treatment.

Approximately 2-7 years before the last menstruation (the so-called menopause), the first phase of menopause begins.

Typical symptoms of this so-called premenopause are cycle disturbances: before menopause, bleeding is usually more severe, and the cycle is shorter.

Complications occur during the impending menopause entry with persistent bleeding that can last for several weeks: doctors call this menopausal bleeding. With the transition to premenopause, menstrual bleeding becomes less and less, and ovulation stops altogether.

The symptoms that occur during the menopause are also called the climacteric syndrome. For typical signs of menopause, the following manifestations are mainly characteristic, some of which are caused by narrowing or expansion of blood vessels:

• hot flashes (affects about 7 out of 10 women);
• sweating (in about 5 out of 10 women);
• cardiopalmus ();
• dizziness (about 4-5 out of 10 women)
• insomnia;
• decrease in working capacity;
• nervousness;
• depression;
• headache;
• dryness of the vagina;

• decreased sex drive (loss of libido).

At the beginning of menopause, psychological symptoms and so-called autonomic disorders(eg, hot flashes, sweating, tachycardia). The autonomic symptoms of menopause are caused by changes in the autonomic nervous system: the autonomic nervous system regulates vital body functions such as respiration, digestion, metabolism, and water balance. The cause of menopause is primarily estrogen deficiency: it makes the autonomic nervous system more excitable.

With the further course of menopause, as additional symptoms, for example, changes in the genitals may appear. Cause: the typical estrogen deficiency during menopause leads to physical changes in the long term. The uterus, vagina, vulva and mammary glands are especially weakened and narrowed.

In addition, during menopause, the skin and mucous membranes (including the vulva and vagina) of a woman are also subject to changes: the affected skin is thinner and less elastic. As a result, this can lead to pain during intercourse (dyspareunia).

In addition, during menopause, the following symptoms are observed:

• high blood pressure (hypertension) in about one in two women;
• weight gain;
• osteoarthritis;
• chronic pain.

Diagnostics

Is it easy to determine if a woman has menopause? The complaints and age of the woman, as well as a gynecological examination, are decisive for the diagnosis.

The last menstrual bleeding spontaneously controlled by the ovaries (called menopause) can be diagnosed retrospectively if the last bleeding occurred a year ago.

If two or more of the following factors are present at the same time, this may be a sign of menopause:

• age 45 or older;
• flushes of heat;
• menstrual irregularities;
• changes in the uterus, vagina, or breasts.

A blood test can also be helpful in diagnosing menopause, it will help determine the concentration of various female sex hormones, such as FSH (follicle-stimulating hormone) and estradiol, which belongs to estrogens. Among other things, estradiol is responsible for regular menstrual bleeding.

Hormone levels during menopause usually change:

• estradiol decreases;
• FSH increases.

Typical hormone levels after menopause

Explanation:

• IU (International Unit), sometimes - ED (Unit of Action);
• ml = milliliter;
• ng = nanogram (10 -9 grams, 1 billionth of a gram);
• pg = picogram (10 -12 grams, 1 trillionth of a gram).

Treatment: how to relieve the symptoms of menopause?

The menopause often does not require treatment: about a third of women have no menopausal symptoms, and a third have mild symptoms, they also do not need treatment.

If you experience mild hot flashes and sweats during menopause, lifestyle changes can be done to treat these symptoms. Should:

• bring the weight back to normal: since being overweight is associated with more frequent hot flashes, a body mass index of 25 or less is desirable;
• exercise regularly: those who exercise regularly can reduce hot flashes;
• do relaxation exercises in a relaxed state, hot flashes during menopause are less common and weaker;
• walk in the fresh, cool air: in overheated rooms, hot flashes occur much more often than in fresh, cool air.

However, about a third of women experience severe menopausal symptoms that reduce their quality of life. Then during the menopause it makes sense to carry out more extensive therapy. Since hormonal deficiency resulting from menopause is the main cause of complaints, so-called hormonal therapy is often recommended.

For hormone therapy in the context of menopause, various individual estrogen and progesterone preparations, as well as estrogen-progesterone combination preparations, are available. The goal of treatment is not to restore the pre-menopausal state, but above all:

• relieve symptoms of hot flashes;
• prevent changes, deterioration in the reproductive system;
• reduce the risk of fractures due to osteoporosis.

Which hormonal drug is right for you depends on whether you have a uterus or had a hysterectomy (removal of the uterus), at what phase of menopause the symptoms appear and how serious they are.

Hormone therapy is especially effective against so-called autonomic disorders, such as hot flashes and. Hormonal drugs can also help with swelling of the tissues in the genital area, which is manifested by vaginal dryness or pain during intercourse.

Long-term hormone therapy also reduces the risk of developing and prevents osteoporosis, reducing the risk of bone fractures during menopause.

However, treatment with hormonal drugs also carries certain risks: for example, hormonal therapy during menopause - depending on the drug used - may, for example, slightly increase the risk of developing breast cancer and strokes.

In addition, hormone therapy started late increases the risk. However, in some cases, early treatment (in women under 60 years of age) may reduce the risk.

If you are considering hormonal therapy, it should ideally begin with the onset of menopause.

Hormone therapy during menopause can lead to various side effects, such as:

• nausea;
• headache;
• weight gain;
• painful enlargement in the chest area;
• water retention in the subcutaneous adipose tissue (edema)
• discomfort in the stomach;
• migraine;
• leg cramps.

Therefore, all risks of hormone therapy for each woman should be assessed individually and regularly checked.

In addition to hormonal therapy, herbal active preparations with a hormone-like effect (so-called phytohormones, for example, from black cohosh or rhubarb root) are also used to treat menopausal symptoms.

However, according to modern scientific data, phytohormones, as well as other herbal and non-hormonal preparations, cannot replace hormone therapy: herbal supplements have little effect on menopausal symptoms. Whether these remedies work in individual cases is impossible to predict. Herbal remedies are not recommended for women with severe menopause symptoms.

If during menopause serious irregularities in menstruation recur, it may be necessary to remove the uterus surgically (hysterectomy).

When should you stop hormone therapy?

Treatment of symptoms during menopause with hormones is necessary and appropriate only in certain cases. People who do not have menopausal symptoms usually do not need therapy.

In addition, under certain health conditions, even though the symptoms are severe, hormone therapy is contraindicated, for example:

• breast cancer or uterine cancer;
• vascular occlusion (embolism) caused by thrombosis;
• severe hypertension;
• cerebrovascular disease;
• autoimmune disease;
• some tumors in the brain, spinal cord (meningioma);
• allergy to active substances or adjuvants of hormonal drugs.

When is hormone therapy needed?

Estrogens may be indispensable in the treatment of menopause. Such hormonal therapy is necessary, for example, in cases of:

• severe symptoms of menopause,
• if menopause begins prematurely, i.e. up to 40 years of age;
• when the ovaries are surgically removed;
• premature ovarian failure.

Course and forecast

Menopause is part of the natural aging process in women. This stage of transition from full puberty to old age is individual for each woman.

On average, menopause lasts 10 to 15 years. During this stage, the production of certain female sex hormones, estrogen, decreases. In most cases, menopause occurs between 45 and 70 years of a woman's life.

Without treatment, the symptoms of menopause caused by estrogen deficiency usually disappear after a year or two. Hormonal drugs help with severe menopausal symptoms.

Without hormone therapy, menopause leads to osteoporosis (in about 25 percent of women).

Can menopause be prevented?

Menopause is not a disease that can be prevented, it is part of a woman's natural aging process. However, to a certain extent, you can protect yourself from the possible symptoms of menopause through a healthy lifestyle.

A balanced diet containing a lot of calcium and, as well as healthy sleep, has a positive effect on hormonal balance. Depending on the situation, the following measures may also help relieve symptoms during menopause:

• physiotherapy (heating and cooling);
• balneotherapy (eg mud baths, Kneipp treatment, etc.);
• psychotherapy or psychotropic drugs (eg, antidepressants).

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