Climacteric syndrome: symptoms, treatment and prevention
Termination of menstruation in women indicates the onset of menopause and the physiological termination of the work of female reproductive organs. The process begins a year later from the moment of the past monthly. The last menstruation in the life of a woman is called menopause.
The onset of menopause is normal in women aged 45 to 50 years of age. However, there is an early menopause on the background of gynecological diseases and iatrogenic (after surgical removal of the gonads in women).
How does the climacteric syndrome?
Regardless of the beginning of the process, women undergo the same changes in the body:
- A change in the hormonal background (an increase in the concentration of follicle-stimulating and luteinizing hormones in the blood, a decrease in the level of estrogens).
- Termination of egg ripening in the ovaries.
Climacteric syndrome manifests itself in all patients in different ways and changes begin in the pre-menopausal period. The final relief of all signs of the syndrome occurs in the postmenopausal period. The duration of climacteric syndrome in women varies individually: from 3 years to 10 or more. In 50% of patients, the duration of symptoms is from 3 to 7 years.
There is also an alternative point of view, confirmed by studies, according to which in 80% of patients during the period of postmenopause all symptomatology passes definitively.
Climacteric syndrome is diverse in intensity and clinical symptoms. Rare lucky people can boast of an easy onset of menopause. Most women contact the doctor with the following complaints:
- hot flashes, sweating;
- feeling of heat;
- sleep disorders;
- nervousness, depression;
- development of hypertension and hypertensive crises;
- interruptions in the work of the heart;
- chest pain;
- pain in the bones;
- increased emotional sensitivity.
How does the climacteric syndrome?
The course of climacteric syndrome is divided into complicated and uncomplicated. At the first variant some symptoms which do not break a habitual way of life and working capacity of the woman are shown.
Features of the clinical course of climacteric syndrome are divided into groups:
- Vazo-vegetative manifestations (disorders of the cardiovascular system, increase or lowering of pressure, pains of different localization, hot flashes, sweating, a sense of running chills body).
- Disorders of the emotional-psychic sphere (frequent mood changes, depression, constant fatigue, a desire to sleep, insomnia, decreased performance, memory impairment, inability to concentrate, decreased sexual activity).
- Changes in the work of the genitourinary system and painful conditions (thrush, insufficiency of the function of generating protective mucus in the genital tract, soreness with sex, increased urination, leakage of urine during physical exertion, weakening of the ligamentous apparatus of the uterus and vagina, pain during urination, urinary incontinence).
- Withering of the skin, changes in hair, nails (appearance of new wrinkles and deepening of existing, thinning and hair loss, stratification and nail breaking).
- Change in metabolism (propensity to obesity, atherosclerosis, osteoporosis, cardiovascular diseases and Alzheimer's disease).
The main cause of all pathological changes in the body of a woman is a decrease, and then a cessation of the synthesis of estrogens. Such a clinical variety of symptoms is associated with the presence of receptors for female sex hormones in all tissues and organs.
By the order of manifestation, the first appear tides. A characteristic feature of suddenness. The patient feels an unexpected heat in her face, neck and then all over her body. The tide is accompanied by hyperemia (reddening of the skin), difficulty breathing, rapid heart rate, sometimes chest pain and sweating, and this symptom occurs in 90% of cases. The period of the development of tides varies from six months to 10 years.
The severity of the clinical picture is determined by the frequency of manifestation:
- light degree (1 - 10 times a day);
- average degree (11 - 20 times a day);
- a severe degree (more than 20 times a day).
Patients report symptom manifestations mainly at night, in summer, in a well-heated room, with the use of hot drinks, spicy foods, tea, coffee.
Variations of the menstrual cycle
The next sign of menopause is the cycle changes. After reaching the age of 40, the monthly cycle is shortened or lengthened, the allocation becomes less abundant. The increase in menstrual flow is an alarming symptom and indicates the development of the pathological process in the female sexual sphere.
The work of the genitourinary system
The main manifestation of inflammatory diseases of the genital tract against the background of atrophy of the mucosa (vulvovaginitis, colpitis) are the appearance of dryness, burning and itching in the vagina, dyspareunia (pain at having sex). Atrophy secondary sexual characteristics.
Dystrophic processes of the urethra lead to leakage of urine during physical exertion, pain in the bladder (cystalgia), dysuria. The lack of adequate therapy leads to the progression of all symptoms.
The change in the elasticity of the ligamentous apparatus leads to the omission and prolapse of the uterus, rectum.
Other manifestations of menopause
The decrease in the synthesis of estrogens entails a decrease in the amount of collagen fibers in the skin, resulting in the appearance and deepening of wrinkles. The skin itself becomes thinner, loses its elasticity and dries up mainly on the face and hands.
In postmenopausal women, the percentage of cardiovascular pathology is equal to that of men.
Reducing the calcium content in the bones of the skeleton leads to osteoporosis. With this disease, the strength of bones decreases and the slightest traumas cause fractures, which is of great social importance. The course of the disease is asymptomatic for a long time and manifests itself directly with injuries. Characteristic sites of fractures: the neck of the hip, the body of the vertebrae and the bone of the forearm in a typical place (lower third).
Alzheimer's disease menopause can manifest from the side of the nervous system. With this nosology, the cerebral cortex atrophies, the cortical neurons and subcortical structures die. Clinically manifested by gradual progressive deterioration of memory and the development of mental dementia.
To prevent the development of all the expressed and undesirable consequences for the health of the patient, it is possible with the help of substitution therapy (estrogens and progesterone).
Diagnosis of menopausal syndrome
The diagnosis of "climacteric syndrome" is based, above all, on clinical data. Laboratory confirmation is the study of hormonal background of the patient (follicle-stimulating hormone and estrogens, thyroid hormones).
All women in the postmenopausal period should undergo an annual examination with a gynecologist. The appearance of pathological spotting on the laundry during premenopause, the change in the nature of menstruation should alert the malignant diseases of the female genital organs. The absence of menstruation during this period in rare cases can be a sign of pregnancy.
Non-pharmacologic correction of climacteric syndrome
Remember that any change in the body is a way of life. Climax is no exception. Early treatment for specialized care provides more chances for the prevention of diseases and prevention of their health consequences.
First of all, change the habitual way of life:
- Do fitness or yoga - physical activity reduces the risk of heart and vascular disease, obesity, diabetes. Riding a bicycle or simulating it is a great way to strengthen the pelvic floor musculature.
- Drink more water, reduce the amount of carbohydrates consumed. Enrich your diet with foods rich in fiber.
- Take a multivitamin.
- If possible, refuse or reduce the consumption of coffee and alcoholic beverages.
- Get enough sleep (the normal duration of sleep of an adult is 8 hours).
- Start walking before going to bed.
- After consultation of the physiotherapist, go through a general strengthening course of procedures.
In the case of severity of symptoms of climacteric syndrome, the attending physician will prescribe drug therapy.
Hormones in the treatment of menopause
Substitution therapy with a complex of estrogens with progesterone improves well-being, neutralizes the manifestation of vegetative-vascular reactions, stabilizes the emotional and mental state and eliminates the symptoms of inflammatory and atrophic diseases of the genitourinary system.
Replacement hormone therapy is indicated for patients with a severe course of menopause.
The risk of breast and uterine cancer, cerebral circulation and vein thrombosis are undesirable consequences of hormone replacement therapy.
The decision on the use of hormonal drugs is taken by the doctor after a full examination, weighing the risks and detailed information of the patient.
The complex of examination before the appointment of estrogens and progesterone includes:
- detailed collection of anamnesis;
- studying the cellular composition of smears;
- ultrasound examination of organs of the reproductive system and mammary glands;
- densitometry of bones;
- studying indicators of coagulogram and biochemical analysis of blood.
The number and composition of drugs that are assigned to a woman is affected by surgical interventions on the organs of the reproductive system. For example, patients after hysterectomy are assigned exclusively estrogens. Progestogens with estrogen in the menopausal period are recommended for patients who have all organs preserved, in order to prevent the development of malignant diseases.
Ways of getting medicine into the body
Methods for administering hormonal drugs are diverse and you can choose the optimal variant for the patient: intramuscular, cutaneous - patches and gels, vaginal - suppositories, tablets and capsules).
Manifestations of atrophic vulvovaginitis can be corrected by intravaginal administration of estrogens (cream, tablets, uterine rings).
Prevention of diseases of other organ systems
The intake of estrogens in the body of a woman slows down the process of collagen fibers disintegration and thus prevents skin atrophy.
Treatment and prevention of osteoporosis with climacteric syndrome is carried out with calcium, vitamin D, bisphosphonate and the recently appeared synthetic steroid prohormone, which possesses estrogenic, progestagenic and androgenic effect.
Correction of changes in the emotional-psychological sphere is carried out by tranquilizers, antidepressants, sedatives.
To normalize the lipid spectrum prescribed statins, with obesity - drugs that affect metabolism, diuretics. Changing pressure in the patient requires the appointment of antihypertensive drugs.
With progressive memory impairment, a consultation of a neurologist and an MRI of the brain is recommended for the timely recognition of Alzheimer's disease.
Actually, the use of homeopathic medicines or the use of herbal teas, infusions and broths of herbs (boron uterus, chamomile, red brush, etc.).
Timely diagnosis, correction and prevention of climacteric syndrome helps to maintain a woman's health and high quality of life. Drug treatment (hormone therapy) should be used according to strict indications, which is determined by the attending physician.