Menopause


Menopause

Description menopausal syndrome

Menopause is a natural process that occurs in women between forty and sixty years ago. It is a physiological process, the female sexual organs cease to fulfill its main function and prepare for their own pregnancy and pregnancy. In this age slowly ceases production of sex hormones ovaries, especially estrogen. Their loss is a major cause of all the problems associated with this “syndrome”.
Estrogen together with progestin are female sex hormones. Estrogen is produced by the ovary, placenta, and in small amounts by the adrenal glands. The most important group of estrogen is estradiol (E2). Its daily production is dependent on the stage of ovarian cycle of 50-500 micrograms.

Ovaries are controlled so. Hypotalamohypofyzárního system. Neurohormone pituitary gland, which regulates the hypothalamus called gonadotrophin (GnRH – gonadotrophin releasing hormone).It is produced in cycles and under the influence of pituitary produces gonadotropins (GT): luteinizing hormone (LH) and follicle stimulating hormone (FSH). Another pituitary hormone, which is applied in the management of ovarian cycle is prolactin.

At the time of birth in the ovary is 1-2 million follicles. During the first period there are 500 000. In each ovarian cycle under the influence of FSH increases one of follicles, which ripen in the so-called. Graafian. It produces hormones and contains egg ready for ovulation and subsequent fertilization. During menopause, the decreasing number of follicles at about 1,000th

Generally, estrogens affect sex organs, secondary sexual characteristics, and their effects on the metabolism – the conversion of nutrients. They are used during growth of the vaginal mucous membrane, increasing the formation of glycogen and its splitting into lactic acid, which plays a significant role in maintaining proper vaginal environment. Affect growth mucosa and cervical musculature and body. It affects the mucosal cells of the urinary tract. It acts on the ovary, the pituitary hormone secretion, the development of secondary sexual characteristics, psychological behavior. They affect the metabolism of carbohydrates, fats, minerals and water, calcium – act against osteoporosis, affects the thyroid and adrenal glands. Strengthen blood vessel walls, reduces the formation of red blood cells.

stages of menopause

Menopause can be a time-divided into phases

premenopause

Period before menopause, characterized by regular menses, normal values of E2, GT, lower progesterone loss cyclicality GT.

Menopause

Permanent amenorrhea due to loss of ovarian follicular activity in the Czech Republic an average age of 51 years.

perimenopause

Period immediately before menopause and up to 1 year after menopause, irregular menses, significantly increased FSH normal E2.

postmenopause

Period dormant ovarian function starting at 1 year after menopause, sustained amenorrhea, persistently elevated FSH and E2 reduced.

Premature menopause is menopause, which will be held prior to the 40th year.

Induced menopause arrest menstruation surgical removal of the ovaries or the termination of their functions chemotherapy, radiotherapy. May be reversible, but after 40 years of age is usually permanent.

Menopause or if the transition is a sequence of hormonal changes during the transition from pre to postmenopause, with 75% of women appearing set of specific symptoms that they still came up.They called climacteric syndrome.

Symptoms of the climacteric syndrome

Symptoms of the climacteric syndrome can be based on the speed with which we come to distinguish between acute, subacute and chronic.

acute symptoms

Symptoms are self-climacteric syndrome. It comes on a very individual basis. They can manifest as a few years before and after menopause own, and may also persist for many years after.

Today the term earmarked for symptoms of the psyche and the vascular system.
Hot flashes are sudden feelings of heat generated mainly in the upper body, ie. The face, neck, chest. It can measure a higher temperature of the skin of the fingers. It is explained by a transient impairment of vascular regulation in the periphery. The duration is about 0.5 – 5 minutes with individually different frequencies. The nights are one of the causes of sleep disorders.

Sweating is usually an accompanying symptom of hot flushes, sometimes they appear separately.Sweating can have a different character and explore the various locations on the body.
Other symptoms as headaches, dizziness, palpitations, heart rhythm changes, problems with digestion such as nausea, vomiting or constipation, difficulty of a sexual nature.

An indispensable part of the symptoms are the psychological problems such as depressed mood, anxiety, nervousness, edginess, impaired concentration, etc.

To assess the severity of menopausal problems were fixed so. Menopausal index, which evaluates 10 syndrome symptoms: hot flashes, hot sweat, irritability, sleep disturbances, dizziness, impaired concentration, depression, joint pain, headaches, heart palpitations.

  • Light Syndrome – 20 points
  • Central syndrome – 35 points
  • Heavy syndrom- more than 35 points

subacute trouble

The second group of symptoms of the syndrome are short-term problems caused by lack of estrogen production, which is mainly manifested atrofizací, or if the thickening of the lining of the hollow organs female reproductive system.

Most often it is vaginal atrophy. This occurs in the vast majority of climacteric women. First symptoms occur several months after the menopause. Changes in peak after 10 to 15 years. Lower mucosa is dry, easily vulnerable, in addition there is a change in acidity of the environment.Disappears normal vaginal flora and appears room for pathogenic microbes. This sheath more susceptible to infection. Inflammation is reflected dryness, itching and burning in the vagina.Another affected organ is part of the urethra and bladder, because they are also under the influence of estrogen. This translates to problems with urination such as: – frequent urination, nighttime urination, feeling the urge to urinate, so. Stress incontinence – wetting with an increased intra-abdominal pressure, eg. In laughter, pain passing urine, recurrent urinary tract infections and the like.

It can also occur to the involvement of other mucous membranes. For example, in the mouth it will produce a burning or dry mouth, taste disorders, inflammation of the oral cavity. Other symptoms may include dry nose, pharynx, larynx, eye. When impaired intestinal mucosa as this can lead to bleeding disorders or blood supply to the intestines. The skin is thinner, drier, more broken nails, the hair and the hair is dry and thinning. Breasts lose fat and breast tissue, which is being replaced by connective tissue. It occurs magnified the risk of breast cancer. Pelvic floor muscles weaken, and hanging apparatus uterus thinner, so it occurs higher percentage of drop and prolapse of the uterus and vagina walls decline.

chronic problems

Finally, the last group of symptoms of menopause are chronic – long-lasting changes that include:

Metabolic postmenopausal syndrome

Diseases of the heart and blood vessels now holds first place in the causes of death for both men and women. In the younger age exceeds the incidence of coronary heart disease among men, but after menopause, this difference was blurred. It was found that the development of ischemic changes lags in women as men by about 7-10 years. This is explained by the protective effect of estrogens. The main risk factors for coronary heart disease are: dyslipidemia, or if the reduced proportion of HDL and LDL cholesterol and / or triglycerides in the blood increased, hypertension, smoking, lack of physical activity, stress, old age, genetic influences.

Postmenopausal osteoporosis – thinning of the bones

Risk again significantly increases with age, lack of calcium in the diet, smoking, excessive drinking coffee, alcohol, lack of exercise or osteoporosis in the family. Osteoporosis can occur fracture, but also need to bother backache, joint pain, long bones. The most common fractures in postmenopausal women forearm fractures are called. Colles fracture, vertebral fractures, femoral neck. Vertebral fractures can occur only at low pressure and manifest as back pain, limitation of motion, indigestion. Causing a reduction in the height of a typical posture of old women.Osteoporosis and its lower stage or when osteopenia is diagnosed by measuring bone density – bone density and its changes over time.

Treatment options for postmenopausal syndrome

The possibility of post-menopausal syndrome therapy, either estrogen replacement therapy (ERT-estrogen replacement therapy) or hormonal therapy in a broader sense (HRT hormone replacement therapy), ie. combining estrogen with progestogen.

Choice of therapy should be guided by the individual patient’s difficulties. HRT is effective for acute symptoms ie. headache, sweating and flushing, dizziness, palpitations up with a 90% success rate.Even with genitourinary complaints it is more effective than alternative treatments. Improving incontinence, eliminates vaginal and urological symptoms. Further prevents returns and infections of the urinary and genital tract. But the main importance lies mainly in the prevention of cardiovascular diseases and osteoporosis. In most cases, HRT is very useful and improves the life of women in the menopause. No evidence was found that HRT itself provoked some serious side effects. HRT should however not be used in women with breast cancers, uterine cancer, deep venous thrombosis, acute or chronic inflammation of the liver with impaired hepatic function. Another group of women, which require a special assessment of the benefits of HRT are women with endometriosis, leiomyoma of the uterus, gallbladder disease, familial combined hyperlipidemia and hypertriglyceridemia, migraine, epilepsy. However, each patient must be considered individually medication administration. Each menopause are recommended preparations with various combinations of hormones and also depends on the overall health of the patient.

HRT side effects such as spotting, bleeding, pain in lower limbs veins are usually caused by too high a dose of hormones and therefore they can be avoided lowest possible dose of hormones.

If a woman does not use hormone therapy should not postmenopausal bleeding. If this happens, it should first undergo ultrasound examination of the uterus. This may indicate a minor polyps, as well as cancer.
The basis of treatment and prevention of osteoporosis is a diet with adequate calcium intake (1 g premenopausal, postmenopausal 1.5 g daily), protein and vitamin D (400 IU daily). What is important is regular exercise, which stabilizes the bone mass and is a good prevention of falls and subsequent fractures.

How do you help yourself

As already stated, menopause is totally physiological action and should therefore be considered as a disease. However, for every woman runs very differently, and certainly can be your body ready for this change and leave nothing to chance. The main thing is to regularly visit your gynecologistand think that if periods stopped, that such a visit is not worth. On the contrary, almost all serious diseases are a risk factor for age. Gynaecological tumors exception. It is also very important to a healthy lifestyle, keep in physical shape, eat regular and balanced. Every day, indulge at least one dairy product for coffee lovers this is doubly true. When in doubt about their health, then visit your GP.

Other names: Climacteric, menopause, menopausal syndrome, menopausal syndrome, estrogen-deficient syndrome

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