Despite the fact that currently there is a persistent tendency to increase the average life expectancy of women to 70-80 years, the age of menopause remains fairly stable - about 48-50 years. This is evidence that the last third of the life of a modern woman passes in the state of menopause. Sooner or later, every representative of the beautiful half of humanity has to face the symptoms of menopause, and it is very important to be ready to overcome this next stage of life.
What are the symptoms of menopause in women? Is treatment necessary? How to eat and what kind of lifestyle to lead? You will find answers to these and other questions below.
What is the menopause?
The term "menopause" in Greek means "stage". There is an opinion that this is one of the most difficult stages in the life of a woman, associated with the extinction of sexual function and a steady increase in the level of gonadotropins, indicating the onset of menopause.
The concept of menopause combines several periods:
Preklimax (premenopause)- several years preceding the onset of menopause. During this period, ovarian production of estrogen gradually decreases. Preclimax may occur at the age of 40-45 years, less often at 30-40 years.
- Menopause - a period of steady cessation of menstruation and intermenstrual cycles (their one-year absence). Menopause is an early menopausal period that lasts for five years after the cessation of menstruation.
- Postmenopause (late menopause) lasts up to 70-75 years.
- Old age - The period of life after 75 years.
Questions about the quality of life of a woman during menopause are quite acute and relevant. At the same time, special attention is paid to the following parameters: physical and mental well-being, social and role-based functioning, as well as a general objective perception of the state of one’s health.
Factors that affect a woman's body during menopause
- Natural aging processes, accompanied by receptor and mediator changes, nerve cell death, decreased motor activity, an increase in cognitive impairment and exacerbation of depressive processes.
- The presence of chronic somatic and neuropsychiatric diseases that are formed during life under the influence of adverse environmental factors, as well as due to genetic predisposition. Many women are diagnosed with atherosclerosis, obesity, diabetes, hypertension, degenerative-dystrophic diseases of the musculoskeletal system, as well as anxiety disorders and past episodes of depression.
- The effect of climacteric hormonal changes on the central and peripheral nervous system. The most characteristic peripheral signs of menopausal syndrome are flushes of heat and urinary disorders. The main clinical manifestations of the reorganization of the central nervous system include endocrine, metabolic, psychovegetative, cognitive and motivational.
- Psychosocial status of women. In this case, an important role is played by the financial, domestic and professional situation¸ the presence or absence of a sexual partner, the care of adult children from home, disharmony in intimate relationships, especially the perception of yourself as a woman.
Symptom # 1 - psycho-emotional menopausal syndrome
At the moment, many people who are not directly related to medicine are familiar with terms such as "menopausal neurosis", "menopausal depression", "involutional hysteria". Of course, these psycho-emotional disorders can occur during other periods of a woman’s life, but during menopause they occur much more frequently and, as a rule, are accompanied by more complex somatovegetative disorders. Women who have entered menopause often experience increased fatigue, loss of interest in themselves and others, unmotivated anxiety, anxiety, suspiciousness, excessive sensitivity, increased vulnerability, fear of impending old age, tearfulness and lability of mood.
Symptom # 2 - sleep disturbance
Sleep disturbance is one of the most characteristic manifestations of the period of menopause. About 60% of women during menopause complain of increased sleep time, poor sleep quality and frequent night waking. When choosing a treatment strategy, the causes of dyssomnia are taken into account. During menopause, they may be associated with central and peripheral nervous disorders. Disorders of the central nervous system include vascular and toxic-metabolic brain disorders and emotional disorders (depressive states, increased anxiety, fears).
During sleep, women of climacteric age often have respiratory disorders (snoring, respiratory arrest) and movement disorders (the so-called “restless legs” syndrome), as well as morning headaches, increased blood pressure and daytime sleepiness.
Disorders of the peripheral nervous system include nocturia (frequent urination at night), hot flushes of night, parasthesia in the hands (numbness, tingling, goosebumps) and other disorders arising or aggravated at night.
Symptom # 3 - vegetative and psycho-vegetative disorders
Most often, autonomic permanent or paroxysmal disorders are combined with emotional disturbances. Many women complain of discomfort in the left half of the breast, heart rate failures, increased heart rate, lack of air, jumps in blood pressure, disorders of the digestive tract, and chills or hot flushes. Sometimes it is possible the development of attacks of aggression, fear or anxiety that develops into panic attacks. There are frequent headaches and back pain.
Symptom # 4 - deterioration of performance
Cognitive impairment during menopause is manifested by a deterioration in working capacity, a decrease in the rate of switching from one type of activity to another, a weakening of memory and a disorder of attention. Most often, this condition is a consequence of emotional problems, that is, is reversible.
Symptom # 5 - metabolic and endocrine disorders
In women during menopause, there is often a change in eating behavior, improvement or deterioration of appetite, weight gain, fluid retention in the body, leading to the formation of edema. Joint pathologies, osteoporosis and cardiovascular diseases become frequent “satellites” of postmenopause.
Symptom # 5 - psychosocial syndrome
Some women who entered the period of menopause, against the background of dissomnic, cognitive, psycho-vegetative and sexual disorders, have difficulty in communication and social adaptation, develop insularity and stress-accessibility, there is a lack of mutual understanding in the family, difficulties at work. Of course, all this causes a decline in the quality of life and can even provoke the development of serious diseases. That is why women, who are dominated by immature styles of psychological protection and ineffective coping mechanisms for stress, require medical assistance.
Symptom # 6 - sexual dysfunction
According to statistics, 50-75% of women in the period of menopause show a decrease in sexual activity, or rather, interest in sex and a value estimate of sexual attitudes decrease.
This condition is due to hormonal changes that occur in the female body during the premenopausal period: dying ovaries produce fewer estrogens, androgens and progesterone.
Insufficient production of estrogen leads to thinning of the mucous membrane of the vagina, slowing down and reducing the production of vaginal lubrication and the development of dyspareunia (pain during intercourse).
Lack of free testosterone causes a decrease in sexual desire, and insufficient production of progesterone provokes lethargy, fatigue, headaches and other negative symptoms, significantly reducing the interest in sexual contacts.
Elimination of unpleasant symptoms
The elimination of individual symptoms of menopause can normalize a woman’s physical condition and restore her quality of life. Thus, clonazepam (an anti-paroxysmal drug) is recommended to eliminate nighttime tides and to correct nighttime sleep, and dopamine receptor antagonists and dehydroxyphenylalanine are prescribed to relieve restless legs syndrome.
With high blood pressure, patients are shown to continuously take AT2 blockers and ACE inhibitors. With an increased level of glucose in the blood, drugs lowering blood sugar are prescribed, and for insomnia and neuropsychiatric disorders, hypnotics and sedatives are prescribed.
Clinical gymnastics courses, physiotherapy, hydrotherapy, massage and spa treatment have proven themselves as symptomatic therapy.
Hormone replacement therapy
According to specialists, the most adequate treatment for menopausal syndrome is hormone replacement therapy. Her appointment is advisable in the event that a woman in the period of menopause began such complications as: cardiovascular pathology, central obesity, severe osteoprosis, type II diabetes, etc. It should be emphasized that the appointment of hormone treatment with a number of contraindications is a prerogative attending physician. Preliminary, a woman is assigned a comprehensive diagnostic examination.
Contraindications for hormone replacement therapy:
Uterine bleeding of unknown etiology,
- Malignant tumors of the female genital organs,
- Mammary cancer,
- Recently suffered a stroke or heart attack,
- Severe hepatic and renal pathologies,
- Thyroid disease,
- Preparing for surgery.
Combined hormone replacement therapy drugs contain small doses of progesterone and estrogen. For patients undergoing amputation of the uterus, hormone replacement monotherapy (premarin, proginova, hormoplex, estrofem, etc.) is indicated.
During the premenopausal period, when the woman has not yet completed her menstrual bleeding, Klimen, femoston, Divina, cycloprogen, divitren, klimonorm are recommended to relieve discomfort and discomfort and normalize the cycle. Women who already have no menstruation are advised to take Livial or Cliogest.
Treatment of depression during menopause
Patients are prescribed the latest generation of antidepressants (selective serotonin reuptake inhibitors) to relieve psycho-vegetative syndromes. This group of drugs includes sertraline, fluoxetine, citalopram, etc.
The use of antidepressants is justified in the presence of pronounced emotional and affective disorders. However, they can be prescribed in the case when there are contraindications to hormone replacement therapy, as well as if the patient does not want to take hormonal drugs.
Psychotherapy with pathological menopause
If a woman develops a tendency to depressive reactions during menopause and anxiety levels increase, psychotherapeutic treatment is prescribed in combination with hormone replacement therapy and antidepressants.
The main task of psychotherapeutic correction is the normalization of self-perception and the reduction of stress levels. A hypnotic psychotherapy is shown to the patient, psycho-regulation, relaxation and autogenic training sessions are held.
Folk remedies to relieve tides
In the event of hot flashes, often one of the most agonizing symptoms of menopause, it is recommended to use medicinal herbs as an alternative means. However, this technique, like any other, has side effects, so before starting treatment, it will be wiser to consult a specialist.
To facilitate menopausal hot flashes, traditional healers recommend the use of vegetable estrogens, contained in soy products in sufficient quantities.
In this situation, the greatest effect is not biologically active food additives containing soy components, but directly soy products obtained by fermentation.
Another vegetable remedy to alleviate hot flushes is black cohosh. It is allowed to take no more than 6 months. One of the side effects is an upset stomach.
Also, black primrose oil is used to treat menopausal disorders. It is contraindicated in patients who use blood thinners and may also cause diarrhea, nausea and vomiting.
What is the early menopause in women?
Early menopause is a rare occurrence, occurring in just 1-2% of women. Early menopause is a very strong stress for the female body, adversely affecting physical and mental health. In this situation, the woman loses the ability to conceive, as the secretion of female sex hormones stops, which for many years affected the various tissues and organs of the female body.
In recent years, among experts there is a perception that the state of early menopause would be more appropriate to be called premature ovarian failure.
Causes of premature menopause
- Genetic predisposition
- Viral infection,
- Autoimmune processes
- Iatrogenic factors (surgery on the uterus and ovaries, chemotherapy, radiotherapy),
- Idiopathic factors (smoking, fasting, adverse effects of the external environment).
Symptoms of early menopause in women
The development of menopause always occurs in one of two scenarios:
- Complete depletion of the follicular apparatus (ovarian depletion syndrome).
- Ovarian insensitivity to gonadotropic stimulation (resistant ovary syndrome).
In either case, a woman with well-developed secondary sexual characteristics has secondary amenorrhea and infertility. With a high level of follicle-stimulating and luteotropic hormone, a low level of estradiol is noted, characteristic symptoms of menopause appear: irritability, hot flushes, excessive sweating, loss of memory and disability, sleep disturbance. As early as 1-2 years after the onset of menopause, the development of osteopenia is observed (decrease in bone mass and bone mineral density), the level of cholesterol in the blood rises, and osteoporosis may develop. Some women complain of itching, burning and dry genitals. When taking hormonal drugs marked a significant improvement.
Classification of climacteric disorders in premature ovarian failure
Early symptoms. Menopausal signs of vasomotor symptoms include an increase or decrease in blood pressure, chills, alternating tides, headaches, increased sweating, and tachycardia. Emotional-vegetative symptoms include decreased sexual desire, excessive irritability, weakness, drowsiness, increased anxiety and anxiety, decreased memory, and a tendency to depression.
- Medium-term symptoms (signs that develop approximately 2-3 years from the onset of menopause). There are complaints of pain during sexual contact, vaginal dryness, burning and itching, frequent and painful urination, urinary incontinence. Dryness and brittleness of the nails and hair are also observed, the skin wilts rapidly, the body mass increases and the type of female figure changes, insulin resistance increases.
- Late metabolic disorders (observed after about 5-7 years). Cardiovascular pathologies (atherosclerosis, coronary heart disease) develop or get worse, the development of postmenopausal osteopenia or osteoporosis is accelerated.
Diagnosis of premature ovarian failure
Diagnostic measures for suspected early menopause include a physical examination on a gynecological chair and a thorough examination of the history. Next, the patient is assigned a laboratory and instrumental examination methods:
- Blood test for hormones LH, FSH, TSH, prolactin and estradiol levels,
- Blood lipogram (lipid profile determination),
- Blood on tumor markers,
- Ultrasound of the internal genital organs,
- CT or MRI (with headaches),
- Densitometry of the lumbar spine (with prolonged amenorrhea).
Treatment of early menopause in women
В связи с тем, что ранний климактерий связан с недостаточным функционированием яичников (эстроген продуцируемой функцией), в данной ситуации наиболее эффективными являются гормональные средства, в состав которых входят эстрогены. The dosage of hormones is selected taking into account the age, and the regimen of hormone replacement therapy therapy depends on the presence or absence of menstrual bleeding.
Indications for hormone replacement therapy
- The presence of menopausal syndrome (hot flashes, insomnia, excessive sweating, irritability, frequent mood changes, etc.),
- Urogenital disorders (nocturia, dysuria, vaginal dryness),
- Complete cessation of menstrual function up to 40-45 years.
When selecting drugs for hormone replacement therapy, the presence and amount of surgical interventions on the reproductive organs, the desire (or unwillingness) to normalize the monthly menstrual rhythm, the reduction or absence of sexual desire, the presence of pathologies of the liver, thrombophlebitis, heart attacks in relatives at a young age, and fear of pregnancy .
As drugs for hormone replacement therapy in the early development of menopause, agents are used which include natural estrogens or their analogues. In clinical practice, there are three main modes of hormone replacement therapy:
- Estrogen monotherapy. In women who have undergone uterine hysterectomy, estrogen treatment can be administered in a continuous mode, or courses.
- Combination therapy (estrogen and progestogen) in continuous mode.
- Combination therapy (estrogens and gestagens) in a cyclical mode.
Hormonal correction of premature ovarian failure helps to normalize blood pressure, prevents the development of osteoporosis and atherosclerotic changes, contributes to the disappearance of menopausal symptoms, and also provides skin elasticity.
Due to the fact that hormone replacement therapy (HRT) has a lot of contraindications and side effects, treatment should be carried out only with the permission and under the supervision of a physician.
Contraindications to carrying out ZGT at an early climax
- Uterine bleeding of unknown etiology,
- Malignant tumors of the female genital organs,
- Mammary cancer,
- Recently suffered a stroke or heart attack,
- Severe hepatic and renal pathologies,
- Thyroid disease,
- Preparing for surgery.
A diet that helps survive menopause
Even in ancient times, Oriental healers asserted that there was a close connection between the physiological and pathological processes occurring in the body and the environment. Based on this, the unequivocal conclusion was made: to alleviate the symptoms of menopause, you need to adjust the diet, and then menopause will not be a tragedy, but a velvety season in a woman's life.
Even with an increase in body weight, you should abandon exhausting diets, as this may provoke the development of metabolic disorders and lead to depletion of energy reserves. But at the same time, we should not forget that with age, the body's need for calories gradually decreases. After fifty years, the daily calorie consumption of food should not exceed 2000-2100 calories.
In the period of menopause, it would be wiser to abandon excessive consumption of tea and coffee, "interfering" with the absorption of magnesium and calcium, which are indispensable components involved in the formation of bone tissue. You should also limit the consumption of sweets - sources of fast carbohydrates, and salty foods that contribute to enhanced removal of calcium from the body. Also, in order to avoid the development of atherosclerosis, it would be wiser to abandon the consumption of fatty meat, mayonnaise, trans fat and sausages.
Products that are useful during menopause
- Whole grain bread (source of magnesium, B vitamins and dietary fiber),
- Soy products (source of dietary fiber and phytoestrogens),
- Lean meat (source of protein and iron),
- Low-fat dairy products (source of calcium and vitamin D),
- Vegetable oil (source of polyunsaturated fatty acids),
- Oily marine fish (source of omega-3 fatty acids),
- Fresh fruits and vegetables (source of β-carotene, dietary fiber, folic and nicotinic acid, vitamins A, C, K).
Physiological aging of the female body is an irreversible process, causing an ambiguous attitude towards itself. Some women perceive it calmly and contemplatively, and live with the changes taking place in the body, while others resist reality, not wanting to change their usual ways. However, in either case, you can live a full, vibrant life, continue to work and strengthen family values.