Menopause: Symptoms and Treatment
Menopause (menopause), the literal definition of which means the complete completion of menstruation, occurs in women as a result of discontinuation of the functions performed by the ovaries upon reaching a certain age. Menopause, the symptoms of which are quite complex and expressed in their own manifestations, occurs if the menstrual period has passed at least a year since the last woman’s period.
The precursor to menopause, the process of ovarian decay is subject to its gradual course in conjunction with a decrease in the total amount of the estrogen hormone in the female body. At the age of forty, these processes are characterized by an increase in their own intensity. The transition, at the time of which the onset of menopause is marked, also has its own name and its corresponding symptomatology — it is defined as a perimenopause.
As a rule, women’s menstruation is completed by the age of fifty, in rare cases it is possible at the age of forty, in insignificant — from sixty. In addition, there is also a trend in which smokers are advancing menopause for several years earlier than, respectively, for women nonsmokers. In most cases, changes in the menstrual cycle may occur several years before menstruation stops. Such changes include a decrease in the duration of the menstrual cycle (shortening the time interval between menstruations), soreness and irregular menstruation.
The very period of menopause is characterized by a general deterioration in the state of health of most women. An order of more than 75% collides with tides, which often occur at night, thus provoking chronic insomnia. In addition, there are also a number of symptoms that are characteristic of this period, we will consider them below.
A condition in which the ovaries no longer produce eggs, accompanies the appearance of menopause. At the time of birth, female representatives have ovules in the order of more than three million, subsequently they are gradually killed. Before the onset of the first menstrual period, the girls have about 400,000 eggs, and by the time of menopause their number is reduced to 10,000 or less. In the process of ovulation, a small percentage of the available number of oocytes takes a direct part. As for the main reason for their death, it consists in such a process as atresia.
We also note that in addition to the production of ovaries, hormones (progesterone, estrogen) regulating the processes of ovulation and menstruation are also produced.
As for menopause (or menopause), it includes three main phases — premenopause and menopause, as well as the postmenopausal phase. Each of these phases corresponds to its own characteristics and symptoms.
Premenopause is characterized by the manifestation of the first clinical disorders, which are generally characteristic of the climacteric period, ending with menopause. Premenopause begins after the age of 45 years. It is noteworthy that premenopause may also be early, that is, before reaching the age of 45 years, or even completely premature (at the age of 40 years).
As for the symptoms of this period, it first of all arises against the background of a certain hormonal adjustment, which, in turn, is manifested in the violation of the normal state of proportions in the ovarian and pituitary hormones — it is due to these hormones that the menstrual cycle is regulated. As a result, there is a gradual depletion of the follicle-forming function in the ovaries, the hormonal activity peculiar to the yellow body (the follicle from which the egg leaves) also deteriorates.
The stage of ovulation from the menstrual cycle disappears more and more, while the duration of the cycles themselves is gradually shortened, respectively, and the intervals between them become longer. As for the discharge during menstruation, they have a meager character.
It should be noted that despite the hormonal imbalance that develops during this period, the structure of the uterus does not undergo any significant changes, moreover, its endometrium does not lose its characteristic shape and structure. Simultaneously, in the period of premenopause, there are also specific types of clinical manifestations, which are more typical for the symptomatology of the climatic period at its early stage. So, a number of disorders are noted, among which disorders are vegetative, neuro-emotional and endocrine. In addition, metabolism is also disturbed. All these disorders manifest themselves as hyperemia (i.e., in the form of redness zones) arising in certain areas, hyperhidrosis (increased sweating). Also there are headaches, insomnia, weakness, fatigue. The pulse becomes rapid, the pressure may be low or high.
With regard to the definition of the degree of manifestation peculiar to the period under consideration, one can note their fluctuation from a mild form of manifestation to a severe one. The arising neuro-emotional disorders appear in this case as a consequence of vegetative manifestations (for example, chronic fatigue and insomnia can lead to irritability and depressive states), and as a consequence of realizing the very fact of menopause associated with the inevitable approach of old age. Often, such a psychological state requires the appropriate therapeutic correction.
In the process of premenopause often develops urogenital pathology, which manifests itself in the form of cystitis, reducing sexual desire, urethritis. Often there are diseases in the cardiovascular sphere.
Quite often, the symptoms of premenopause treatment do not require. Meanwhile, there are also cases in which the features of clinical manifestations contribute to a significant deterioration in the quality of life, which requires the appointment of a specific symptomatic, and in some cases hormone, therapy for a woman. In the latter case, a specialist needs to have a complete picture of the general picture of the patient, including a general history during life. The additional factor requires the factor of hereditary predisposition with respect to possible tumor diseases.
Menopause itself is a natural condition that, as we have already noted, occurs when a woman reaches a certain age. The term is also used as a designation for any type of physiological changes that occur before the termination of menstruation or after it, which indicates the completion of the reproductive cycle of the female body.
Often, menopause occurs at an earlier age, facilitated in particular by the transfer of surgical operations, damage to the ovaries, etc. Regardless of the causes that caused menopause before reaching the age of forty, it is defined as premature menopause.
Premature menopause often occurs because of poor heredity and impaired immune system. We also note the following conditions that provoke the early onset of menopause:
- Premature exhaustion of the ovaries. As we have already mentioned, ovaries produce hormones such as progesterone and estrogen. Change in the level of these hormones is accompanied by premature termination of the process of egg production, which, in turn, can occur against the background of various causes. Ovarian exhaustion in this case, in contrast to premature menopause, is in many cases a reversible process.
- Menopause caused artificially. The emergence of «artificial» menopause provokes removal during surgery of the ovaries in the treatment of cancer or diseases caused by violations of the endocrine scale. Radioactive radiation, chemotherapy — these factors can also cause «artificial» menopause.
As with the approach of menopause, premenopausal women face such a phenomenon in the form of hot flashes, which manifest themselves in the form of an unexpected heat that spills along the entire upper half of the body, accompanied, in addition, by reddening and intensifying sweating. Menopause also occurs with hot flashes, except for which the following symptoms are also noted:
- mood changes, depressive states
- vaginal dryness that contributes to the difficulty of sexual intercourse, which can also often lead to infection in this environment
- decreased sexual desire, which may be insignificant, and in some cases characterized by an absolute loss of interest in sex
- increased urination, susceptibility to infection in the bladder area
- dry skin, loss of elasticity, graying of hair, formation of deep wrinkles
- reduction of mammary glands in size, appearance of laxity in them
- the need for nocturnal urination
- Dry eyes.
Note also that not every woman encounters all manifestations of this symptomatology.
After the end of menstruation, a postmenopausal period occurs in women. This period is concluded in the absence of menstruation for a period of more than 12 months. In addition, this period is the final in a complex of involutive processes occurring in the body of a woman, which, accordingly, leads to a loss of his ability to bear birth.
During the post-menopause, hormonal processes are also continuing to progress. The production of hormones in the ovaries decreases, while in the production of male hormones, also carried out in the body of a woman, there is a relative increase. Thus, there is a change in the ratio in the varieties of sex hormones, in which estrone predominates over the hormone estradiol.
The difference in the action of these hormones is that in addition to controlling the reproduction and growth of epithelial cells in the inner layer of the uterus, estradiol also helps to ensure correct differentiation in tissue elements. This process is extremely important in the context of considering the prevention of the formation of atypical cells, which become a basic factor in the early formation of cancerous tumors. There is also an increase in the synthesis of the hypothalamus and pituitary gland.
As for the symptoms accompanying the post-menopausal period under consideration, it manifests itself in the following:
- the symptoms of climacteric symptoms are somewhat reduced, but the tides and some of the vegetative manifestations in the form of sleep disorders and sweating, all can also persist, along with emotional changes
- Because of the characteristic thinning that occurs in the vaginal mucosa, its blood supply is disturbed in a complex, which is accompanied by dryness and unpleasant sensations experienced by a woman during sexual intercourse
- Due to a violation in the processes of collagen synthesis, weakness in the ligamentous apparatus of the internal organs may develop, which in turn can provoke the omission of the uterus and the vagina (sometimes — prolapse)
- the manifestations such as urethritis and cystitis noted during the examination of previous menopausal periods also remain relevant, and urinary incontinence may occur due to an abnormality in the urogenital diaphragm in the pelvic floor
- The bone system is also subject to characteristic changes. Thus, increased activity in cells promotes the destruction of osteoclasts (bone substances), which leads to osteoporosis with its characteristic manifestations in the form of bone fragility even with insignificant effects on them. Correspondingly, the phenomena in the form of dislocations and fractures of bones become more frequent
- Because of the decrease observed in the level of female sex hormones, there is a progression in the phenomena of atherosclerotic vascular lesion and arterial hypertension
- Development often occurs in the uterine cavity of various types of proliferative processes in the form of tumors, polyps, glandular hyperplasia. This determines the possibility of uterine bleeding.
Menopause in men: symptoms
Perhaps someone will be surprised by a similar section in our article, but menopause really happens. Naturally, some of its manifestations are purely physiologically impossible, however, hormonal changes are a matter that can concern equally the representatives of both sexes. In particular, doctors noted a symptomatology that is relevant for women during perimenopause and, respectively, menopause in men.
Such a pronounced period characteristic of menopause in women is somewhat different in men, for this reason, experts determine the cause of the onset of age problems by the gradual drop in the level of testosterone (or androgens) in the blood.
When a certain age is reached, men face a decrease in testosterone levels, which, however, is also characteristic of diabetes mellitus. Simultaneously with the decrease in their level of these sex hormones, symptoms also appear in the form of weakness, feelings of anxiety, depression and, in particular, sexual problems. The connection between this symptomatology and the deficit of sex hormones is still a subject of controversy and discussion.
In comparison with menopause, which is quite clearly expressed in women and is accompanied by a complete cessation of hormone production, in men the climacteric period proceeds with a gradual decrease in testosterone levels, as we have already noted. Again, unlike the features that are relevant in the period under consideration for the female ovaries, in men the testes do not stop producing the substance required for secretion and for the synthesis of testosterone.
It is noteworthy that in the body of a healthy man, sperm production can last up to 80 years or more. Meanwhile, a violation in the function peculiar to the male sex glands is possible, which usually occurs against the background of a different type of disease, and occurs at the age of about 50 years. Changes, more pronounced in some cases, are also observed among men who are about 70 years old.
In order to establish the diagnosis of menopause in men, a diagnostic examination is carried out in the appropriate specialist with a clarification of the symptoms of symptomatology. In addition, a number of diagnostic measures can also be assigned to ensure that there are no diseases in the patient that occur in conjunction with similar symptoms. Blood tests are also taken, among which there may be an analysis that determines the level of hormones in it (including testosterone).
Diagnosis of menopause
After the appearance of the relevant menopause symptoms, its onset is either determined by itself, or by referring to a doctor, which is accompanied by a survey and examination on its side. An exact definition of the stage of menopause, corresponding to the condition of women, is also possible due to the simplest type of tests. A significant increase in the level of FSH (follicle-stimulating hormone) occurs when the ovaries are depleted, and this level can be determined on the basis of a routine blood test.
In addition, as we noted earlier, internal vaginal walls are exposed to thinning, the cells of which, respectively, experience changes in the content of estrogen, that is, there is a decrease in it. To determine atrophy (the degree of thinning of the walls of the vagina and its dryness), the doctor takes a swab from the inner wall of the vagina (this procedure is completely painless and easy to perform). These analyzes are also useful in that, due to them, it becomes possible to determine the menstrual cycle and then compose its schedule. This, in turn, provides the opportunity for the doctor to establish the fact of the woman’s presence in the period of interest in this case.
Treatment for menopause
Modern gynecology has such approaches to the treatment of menopause, which are focused on reducing / eliminating its main symptoms. So, to reduce the frequency of tides and the degree of their severity in the case of a pathological course of menopause, antidepressants are used.
For the prevention of osteoporosis and its treatment during the menopause, biophosphonates are used, due to which the level of loss of bone tissue is reduced, and as a consequence, the risk of fractures decreases. Biofosfonates are also an effective substitute for estrogen therapy in the treatment of osteoporosis during this period.
To reduce the manifestations of urogenital symptoms in the case of the pathological course of menopause, the administration of estrogen in a tablet or cream form is recommended.
The most effective method in the treatment of menopause is hormone therapy, appointed individually by a doctor. Meanwhile, contraindicated hormone therapy is for those patients for whom the following conditions are relevant:
- breast, endometrial, or ovarian cancer
- disorders in blood coagulation functions
- thrombophlebitis, thromboembolism
- impaired liver function
- uterine bleeding for unexplained causes that provoke them;
- kidney failure.
Before the appointment of hormonal medications a number of studies are assigned:
- Ultrasound of the mammary glands and pelvic organs
- biochemical blood test
To soften the symptoms of menopause, non-hormonal products based on herbal components are used, for example, the biologically active food additive ESTROVEL® capsules are a complex of phytoestrogens, vitamins and trace elements, the components of which act on the main manifestations of menopause. ESTROVEL® contains vitamin K1 and boron, which contribute to reducing the risk of osteoporosis.
In case of appearance of a symptomatic symptomatology urgent it is necessary to consult a gynecologist (urologist, andrologist — for men).