Pressure Catteries (Climax): Causes, Stages and Treatment. Women's climax: age of offensive, symptoms and treatment of the menopausal period in women and men briefly

- The physiological period in the life of a woman characterized by a fuss reproductive function Due to hormonal changes in the body. It begins after 40 years and lasts about 10 years. Manifests itself to the gradual cessation of menstruation. May be accompanied by a complex of vegetative-vascular and endocrine disorders: sudden attacks of blood tide to the upper half of the body and face ("heat"), sweating, fusibility, irritability, oscillations arterial pressure, increased dry skin and mucous membranes, sleep disorder. May cause dysfunctional uterine bleeding, serious neuropsychiatric disorders.

General

it is a natural stage in the life of a woman and is characterized by reverse changes in the reproductive system - the cessation of childbearing and menstrual functions. The word "Climax" comes from the Greek "Klimax" - a staircase expressing symbolic steps leading from the heyday of specific female functions to their gradual fading.

The life of a woman consists of several age-related periods having their anatomy-physiological features:

• newborn period - up to 10 days;
• childhood period - up to 8 years;
• period of puberty - from 8 to 17-18 years;
• period of sexual maturity (reproductive, or childbearing) - from 18 to 45 years;
• climacteric period (climax), including:

1. premenopause - from 45 years to menopause;
2. menopause - termination of menstruation (49-50 years);
3. postmenopause - from menopause - up to 65-69 years;

• old age period - from 70 years.

With the average life expectancy of a woman of 75 years, a third of her life falls on Climax.

In some women, the climax has a physiological flow and does not cause pathological disorders, in other pathological flows of Klimaks leads to the development of menopausal (climacteric) syndrome. Menopausal syndrome with menopause in women occurs with a frequency of 26 - 48% and is characterized by a complex of various disorders of the functions of endocrine, nervous and cardiovascular systems, which often violates the normal life and ability of a woman. The pathological flow issues of Klimaks have important social and medical importance in connection with the increased average life expectancy of a woman and its social and active behavior.

Causes of menopausal syndrome

During the period of Changes, changes occur throughout the body: decreases immune defenseThe frequency of autoimmune and infectious diseases increases, aging processes progress. But the most active changes in the climax undergoes the sex apparatus of women. When climax in the ovaries, the development of follicles cease, cease to ripen and ovulate egg cells, there is a decrease in intracerecretory activity. Follicles in the ovaries are replaced connective tissueWhat leads to sclerosis and decrease in ovaries in size.

The hormonal picture of the climax is characterized by an increase in the level of gonadotropic hormones (follicularity and luteinizing) and a decrease in estrogen levels. During the year after the occurrence of menopause, the increase in the level of the follicularity immuling hormone occurs at 13-14 times, luteinizing - 3 times followed by a certain decline.

During the period of Klimaks, changes in the synthesis of estrogenic hormones are to stop the production of estradiol and the predominance of estron. Estrogens have a biological impact on the uterus, dairy glands, urethra, bladder, vagina, pelvic bottom muscles, brain cells, arteries and hearts, bones, skin, mucous membranes of conjunctivations, larynx, mouth, etc., and their deficit in the period Klimaks can cause various disorders in these tissues and organs.

Menopausal syndrome under Klimakse serves as a manifestation of estrogen deficiency and is characterized by vegetual-neurotic, urogenital disorders, dystrophic changes in skin, high risk of atherosclerosis and ischemia of vessels, osteoporosis, psychological disorders. With an increase in the average life expectancy of a woman, a climax elongation occurs and, accordingly, an increase in the estrogenic deficit period, which increases the likelihood of the development of menopausal syndrome.

Classification

In terms of its manifestations, menopausal syndrome is divided into early, average and lately manifestations of menopausal disorders. For high-time manifestations of menopausal climax disorders include:

• vasomotor symptoms - a feeling of "tides" heat, headaches, increased sweating, oznoby, vibrations of blood pressure, heartbeat;
• psycho-emotional symptoms are weakness, anxiety, irritability, drowsiness, inattention, forgetfulness, depression, reduced libido.

Early manifestations during Klimaks are captured by premenopause and 1-2 years postmenopause. Women with vasomotor and psycho-emotional symptoms during the period of menopause are often treated at the therapist about hypertension, coronary heart disease or in a psychoneurologist with neurosis diagnoses or depressive state.

The average manifestations of menopausal climax disorders include:

• urogenital symptoms - dryness of the vagina, painful sexual intercourse, burning, itching, disuria (urination and urinary incontinence);
• symptoms from the skin and its appendages - wrinkles, nail fragility, dry skin and hair loss, hair loss.

The average manifestations during the climax are celebrated after 2-5 years after menopause and are characterized by atrophic changes in the skin and the urogenital tract. As a rule, the symptomatic treatment of urogenital and skin symptoms during menopause does not give the desired effect.

To the late manifestations of menopausal climax disorders include:

• metabolic (exchange) disorders - osteoporosis, atherosclerosis, Alzheimer's disease, cardiovascular diseases.

Lately manifestations during the climax develop after 5-10 years the field of menopause. The insufficient level of sex hormones during the period of the Klimaksa gives impaired the structure of bone tissue (osteoporosis) and lipid metabolism (atherosclerosis).

Symptoms of menopausal syndrome

The development and severity of the flow of menopausal syndrome is influenced by hormonal, environmental, hereditary factors, the general condition of the woman to the period of the Klimaks.

Vegeta (vasomotor) symptoms in the pathological flow of Klimaks are marked with 80% of women. They are characterized by sudden "tides" with a sharp expansion of the capillaries of the scalp, face, neck, chest, with an increase in local skin temperature by 2-5 ° C, and body temperature is 0.5-1 ° C. "Flips" are accompanied by a feeling of heat, redness, sweating, heartbeat. The state of "tides" lasts 3-5 minutes with repeatability from 1 to 20 or more times per day, it is intensified at night, causing sleep disorder. The easiest degree of vasomotor disorders during menopause is characterized by the number of "tides" from 1 to 10 per day, the average - from 10 to 20, heavy - from 20 or more in combination with other manifestations (dizziness, depression, phobias) leading to reduction of working capacity.

In 13% of women with the pathological strength of Klimaks, asthenonevrotic disorders occur, manifested by irritability, the foolishness, a feeling of anxiety, fear, intolerance to olfactory and auditory sensations, depression. Psycho-emotional symptoms during menopause are developing in front of menopause or immediately after it, the vasomotor continues for about 5 years after menopause.

The course of menopausal syndrome during menopause can develop as atypical forms:

• sympathic-adrenal crises characterized by cutting headache, an increase in blood pressure, urinary delay with subsequent polyuria;
• myocardiodestrophs characterized by constant pain in the heart in the absence of changes to the ECG, the ineffectiveness of ordinary therapy;
• hardwrites, vasomotor rhinitis, allergies for drugs and food products indicating the change in the immunological reactions of the organism, etc.

The course of Clemaks falls on a period of important events in the life of a woman: growing and marriage children, achievements at work, pension change, and menopausal disorders are enjoyed on increased emotional loads and social problems. Almost 50% of women with the pathological flow of Klimaks occurs a severe form of disorders, in 35% of the disorder is expressed moderately and only 15% of menopausal syndrome has light manifestations. Light form Climax disorders are usually found among practically healthy women, while women with chronic diseases are susceptible to atypical forms of manifestation of male syndrome, a tendency to the critical nature of the flow, which violates the overall health of the patients.

The development of menopausal syndrome during Klimaks contributes to genetic factors, endocrinopathy, chronic diseases, smoking, menstrual disorders during puberty, early menopause, hypodynamine, lack of a history of pregnancies and childbirth.

Diagnostics

The diagnosis of the pathological flow of Klimaks is based on the complaints of patients appearing at the age of approaching or the occurrence of menopause. The exacerbations of concomitant diseases sometimes makes it difficult to diagnose menopausal syndrome during menopause, having taking his course and causing the development of atypical forms. In the presence of concomitant diseases, the woman, except for the consultation of the gynecologist, shows the consultation of other specialists: Cardiologist, neurologist, endocrinologist.

In order to properly diagnose the complicated climax flow, a study of the blood content of follicularity and luteinizing romons, estrogen, is carried out. To clarify functional state The ovaries during the climax are conducted by histological analysis of the oscillage of endometrials of the uterus and cytological studies of smears from the vagina in the dynamics, building a schedule basal temperature. The detection of anoint ovary cycles allows you to link functional disorders with menopausal syndrome.

Treatment of climax disorders

Adopted in modern gynecology approaches to the problem of treatment of climax pathology are based on a decrease in its manifestations and symptoms. Reducing the gravity and frequency of "tides" in the pathological course of the climax is achieved by the appointment of antidepressants (Venlafaxine, fluoxetine, paroxetine, cytalpram, sertraline, etc.).

In order to prevent and treat the development of osteoporosis during menopause, non-immoral biophosphonates (alendron and reizedry acids), which reduce the loss of bone tissue and the risk of fractures. Biophosphonates effectively replace therapy with estrogen in the treatment of osteoporosis in women during the period of Klimaks.

To reduce the manifestation of urogenital symptoms in the pathological flow of Klimaks, the local (vaginal) introduction of estrogen in the form of cream or tablets is recommended. Extraction in the tissue of the vagina of minor doses of estrogen reduces the sensation of dryness, discomfort with sexual contacts and urination disorders.

Most. effective method The treatment of menopausal syndrome during Klimaks is an individually designated hormonal therapy. The reception of estrogenic drugs is well eliminating, in particular, "stuff" and the unpleasant sensation in the vagina. For hormone therapy in the treatment of climax pathology, natural estrogens are used (estradiolerarat, 17-beta estradiol, etc.) in small doses of intermittent courses. For the prevention of hyperplastic processes in endometrials during menopause, the combination of estrogen with gestagens is shown or (less often) with androgens. Hormone therapy and hormoneopropropyrotic courses are carried out for 5-7 years with the aim of preventing myocardial infarction and mammography, the cytological analysis of smears separated from the cervix, a biochemical study of blood testing indicators and coagulating factors (coagulogram).

Hormone therapy mode

The choice of the mode of hormone therapy depends on the climax stage. In premenopause, hormone therapy not only fills the deficiency of estrogen, but also has a normalizing effect on the menstrual cycle, therefore is prescribed by cyclic courses. In the postmenopause, when atrophic processes occur in endometrials, for the prevention of monthly bleeding, hormone therapy is carried out in constant reception mode.

If the pathological course of the climax is manifested only by urogenital disorders, estrogens (estrilla) are prescribed locally in the form of vaginal tablets, candles, cream. However, in this case the risk of developing other menopausal violations of Klimaks, including osteoporosis remains.

The system effect in the treatment of climax's pathological flow is achieved by the appointment of combined hormone therapy (as an example, Tibolone + estradiol + norethysterone acetate). When combined hormone therapy, hormone reception combines with symptomatic drugs (hypotensive, cardiac, antidepressants, bladder relaxants, etc.). Combined therapy for the treatment of climax disorders is appointed after consulting narrow specialists.

The solution to the problems of the pathological flow of Klimaks is the key to the extension female health, beauty, youth, efficiency and real improvement in the quality of life of women entering the beautiful "autumn" course of their lives.

Climax in women is the laws of each woman's lyner physiological stage, when against the background of natural hormonal age-related changes There are signs of the involution of the reproductive system. In different sources, masturbation perestroika, lasts up to 10 years. Proper organization of life, special diet, psychological assistance, in some cases medical therapy, Create a worthy quality of a woman's life experiencing temporary difficulties.

Let us consider in more detail: what it is, at what age the climax comes and what characteristic signs for him, and that most often appoint a woman as a treatment to restore the hormonal background.

What is Climax?

Climax is a regular physiological process of the transition of a female organism from the reproductive phase with regular menstrual cycles to the phase of complete cessation of menstruation. The word "Climax" comes from the Greek "Klimax" - a staircase expressing symbolic steps leading from the heyday of specific female functions to their gradual fading.

On average, the beginning of the climax in women falls at the age of 40-43 years. However, there may be occasions when they begin at 35, and 60 years. Therefore, doctors allocate such concepts as "Early Climax" and "Late".

In some women, the climax has a physiological flow and does not cause pathological disorders, other pathological flows leads to the development of menopausal (climacteric) syndrome.

Menopausal syndrome during climax in women occurs with a frequency of 26 - 48% and is characterized by a complex of various disorders of the functions of endocrine, nervous and cardiovascular systems, which often disrupts the normal life and ability of a woman.

Periods of Climax

In Klimakse allocate several important periods:

Quality of the quality of life of a woman during menopause cost enough and relevant. At the same time, special attention is paid to the following parameters: physical and mental well-being, social and role-playing, as well as the overall objective perception of their health.

There are several types of climax:

• premature (after 30 and up to 40 years);
• early (from 41 years to 45);
• timely, considered the norm (45-55 years);
• late (after 55 years).

Premature and late climaks are usually pathology. After the examination and clarify the causes of deviations from the norm, treatment is assigned. With a timely occurrence of menopause in some cases, only facilitating associated symptoms is required.

The reasons

The climax is called the genetically programmed transformation of the female organism, during which the reproductive function is fading. The ovaries rapidly reduce the production of genital hormones, the menstrual cycle is upset, the probability of fertilization of the egg spermatozoids is reduced every year.

Most women for the point of reference of the beginning of the menopauscteric period takes the 45th anniversary, which coincides with the advent of the first clinical manifestations of Klimaks. As a rule, after three or five years (that is, by 50 years), the menstrual function is finally completed, and the climate clinic becomes brighter.

An early climax is called the process of manifestations of symptoms of menopauses aged to forty years. He may come both in fifteen years and thirty-nine. The main reason is the disturbed hormonal regulation, due to which menstruation is very irregularly.

There are inherited and acquired causes of early climax.

Genetically causes of early climax:

• Defect of the Women's X chromosome.
• Scharevsky-Turner syndrome.
• Dysfunctions of ovaries under the influence of s x chromosome.
• Other hereditary violations

Acquired causes of early climax:

• Hormonal diseases ( thyroid gland, others);
• Gynecological diseases, including infectious;
• Chemotherapy;
• Obesity;
• Exhalation ()
• Non-rational hormonal contraception;

At what age does women begin with a climax?

The temporary tests of Climaqs are individual, the last menstruation of a woman is called menopause, whose offensive is on average at the age of 50 years. If this happened up to 45 years, menopause is considered early, up to 40 years old - premature.

In the ovaries of each woman, a certain number of follicles is genetically laid, and the time of the onset of menopausal syndrome is depends.

The fact is that women's hormones have a beneficial effect on the entire body as a whole and the ladies with the late menopause healthy heart and vessels, often smooth and clean skin, healthy hair and teeth.

But there is a late climax and substantial cons. For example, such women have a risk of cancer increasing a few times. They shown every six months to undergo surveys for the presence in the body of the neoplasms.

How the climax begins: the first signs

• Menstruation is often delayed and go irregularly. Their abundance and duration are several times stronger than usual.
• The sweat is formed too often in large quantities, there is a constant feeling of heat.
• In the vaginal opening there is discomfort, unpleasant dryness.
• Permanent sleep violation.
• The mood changes dramatically, frequent depression.
• Feeling anxiety and unfortunately alarm.
• Blood pressure changes dramatically.

Symptoms of Klimaks in women

Climaks may adopt in women in different age. At the same time, in the event of the need for need, treatment is selected taking into account the symptoms, which can also be different and have a different degree of severity.

Symptoms of Klimaks:

1. Menstruation cease to be regular, shortening and acquire less abundance of discharge in most cases, in a third of women, on the contrary, become more intense.
2. Unreasonable differences in the mood, a tendency to irritability, depressiveness, tear, aggressiveness, negativism.
3. Headaches: stupid, present in the area of \u200b\u200bthe nape from the morning; similar migraine states; Sharp and strong, localized in the field of temples and forehead.
4. Riding. Violation of thermoregulation and the frequent feeling of heat are the main signs of menopause. At first, such complaints may last a slight time interval, but over time, their appearance and intensity are only growing.
5. Sleep disturbance . Some women may have insomnia, some, on the contrary, increased drowsiness. Sleep problems are better not to solve independently with the help of drugs, but to consult a doctor.
6. The fluctuations in the level of female sex hormones during menopause are manifested by the diseases of the mammary glands, pulling the feeling at the bottom of the abdomen and emotional drops.
7. Exchange and endocrine disorders. In women during menopause, change is often noted food Behavior, improvement or degradation of appetite, increase body weight, fluid delay in the body, leading to the formation of edema.
8. Pain in the chest. Pain in the breast can be cyclic and non-cyclic. Cyclic pains coincide with the period of menstruation in the root portion. However, for women after 45, such pains are a sign of hormonal disorders.
9. At the occurrence of the preclimax period, almost all fair sex representatives complain of a decrease in sexual entry and libido, the impossibility of obtaining orgasm, as well as dryness of the inner walls of the vagina. This process is naturally connected and partial or a complete disappearance of female hormone organism.
10. Dry vagina. The symptom is usually accompanied by itching, is the cause of painful sensations during sexual intercourse. It occurs as a result of changes in the structure of the mucous membrane of the vagina under the influence of hormones. In this case, there is also a decrease in sexual entry.

To other manifestations of Klimaks are counted:

• changes in taste addictions and sensations;
• dryness mucous oily cavity;
• pain in the joints, bones and muscles;
• shortness of breath, tachycardia;
• migraine;
• violations of sight (thread and dryness in the eyes).

All unpleasant symptoms disappear after the immediate occurrence of menopause.

Climax is the process is not fast, he develops for a long time. Typically, menopause itself occurs only a couple of years after the manifestation of the first symptoms.

Diagnostics

The diagnosis of Klimaks takes place primarily on the basis of complaints of patients who are manifested as menopause approximation. The presence of any concomitant diseases complicates the diagnosis, since the symptoms of the climax may not be recognized, but the state of health is worse. Consultations of endocrinologist, neurologist and necessarily cardiologist are shown.

At the consultation, the doctor will ask questions:

• age when the failures menstrual cyclewhen there was the last menstruation, the character of menstruation,
• what symptoms are worried
• whether your close relatives of women have breast cancer or internal genital organs,
• transferred operations.

Mandatory gynecological examination and laboratory studies are carried out:

• Blood test on the content of estrogen,
• Study of the follicularity and luteinizing hormone,
• Histological analysis of endometrial of the uterus,
• Cytological examination of vaginal smear,
• Measurement of basal temperature,
• Detection of annoular cycles,
• Ultrasound examination of a small pelvis and abdominal cavity.

Why do I need to diagnose klimaks?

• Planning late pregnancy;
• differential diagnosis of Klimaks and other diseases;
• identification of complications and diseases associated with climax;
• examination before appointing substitution hormone therapy and contraceptives.

Treatment

Climax is a natural state at appropriate age. But it is fraught with the threat of new diseases, among which tumors, endocrine disorders ,. Nevertheless, when a woman is hard to carry climax, treatment is necessary. Even if its manifestations do not give much discomfort, the regularity of visits to the gynecologist should be maintained.

Treatment may include the following points:

• homeopathy;
• fitotherapy I. folk Methodsallowing to stabilize the hormonal background;
• hormonal therapy;
• treatment of related diseases, which have just arisen or chronic in an aggravated form;
• eating bioactive food additives In the form of a pill or tablets with a climax, for example, "Bonisan".

• proper nutrition with a large number of fruits and vegetables (food enriched with vitamins);
• mandatory presence in the daily diet of dairy products (cottage cheese, yogurt, milk, sour cream, etc.);
• elimination of oily, sharp and salty products;
• rejection of bad habits (smoking, alcohol);
• exercise fitness, gymnastics, wellness physical education or daily walks in the fresh air, on foot or by bike;
• reduce tea and coffee consumption that it is better to replace on herbal tea;
• take vitamins;
• wear clothes from natural fabrics;
• follow the rules of personal hygiene.

Preparations when climax

The first thing you need to make a woman in menopausal periodTo contact the district gynecologist for consultation. After the diagnosis, the specialist appoints medical preparations When climax, which reduce the number of tides, normalize the phase of sleep, remove increased irritability.

Hormonal replacement therapy. According to experts, hormone and replacement therapy is the most adequate method of treatment of menopacteric syndrome. Its appointment is advisable if the woman has such complications in the period of menopause as:

• cardiovascular pathology,
• central obesity,
• pronounced
• diabetes Type II, etc.

Hormone therapy as the treatment of climax pathology is contraindicated by patients suffering from:

• endometrial cancer, ovaries, breasts;
• coagulopathy (blood coagulation disorder);
• impaired liver function;
• thromboembolism, thrombophlebitis;
• uterine bleeding obscure causes;
• renal failure.

Non-immortal means (Qi-Klim, Estrovel, Climadinon). If for some reason hormonal therapy is contraindicated in the patient, then drugs are used based on natural plant phytoestrogen. These are biologically active additives for food. Their activity is significantly lower than the hormones, but safety is higher and side Effects almost not.

In addition to hormones, a number of other drugs are appointed: vitamins, phytopreparations, calcium preparations (for the prevention and treatment of osteoporosis), tranquilizers, antidepressants, biphosphates, nootropics and others. The feasibility of the use of certain drugs at menopause is determined by the attending physician.

Proper nutrition

Despite the unpleasant symptoms, accompanying climax in women, when appropriate proper treatment and compliance with the principles of a healthy lifestyle, one can significantly reduce the severity of the main signs. Upon reaching the age of the onset of menopause, attention should be paid to the right nutrition.

Proper nutrition during menopause is based on such rules:

• it is necessary to reduce portions, but increase the number of meals for up to 5-6 times;
• it is necessary to eat regularly at the same time;
• need to drink up to two liters of pure water;
• the dishes should be prepared for a couple, in the oven or extinguishing, but in no case fry (the taboo is introduced into the frying pan);
• as many vegetables and fruits can be used in raw form;
• eliminate or minimize salts consumption;
• exclude from the diet "harmful" products, and include a wide range of "useful".

Selecting the products for their diet, you need to ensure that vitamins and minerals fall into the body. Especially vitamins A, E, D and C, group B, potassium, calcium and magnesium.

It is necessary to strongly limit or remove from the diet the following products and dishes:

• salt, sugar;
• semi-finished products, fast food;
• salo, fatty meat, Smarler, Margarine, Spread;
• alcohol;
• sausage products, smoked, offal;
• coffee, chocolate, cocoa, sweets;
• sharp spices;
• sweet soda, juices from packages.

Menu on day

It is desirable to start a day from a cup of clean cool water, drank on an empty stomach. The men's menu, which came menopause, may look like this.

1. Breakfast - oatmeal with bran and raisins.
2. The second breakfast is a salad with fruits and nuts.
3. Lunch - chicken soup and salad of sea cabbage.
4. Half date - baked apples with low-fat curd.
5. Dinner is boiled fish and vegetable salad.

In the interruptions between food receptions, the use of dried fruits and drinking various juices.

Folk remedies

In the treatment of tides, headaches and other manifestations of Klimaks, funds are successfully applied. folk Medicine: Plant decoctions, herbal soothing baths.

1. Soothing bath on herbs. 10 tbsp. L Mixtures of the root of AIRA, CHAMPER, Yarrow, souls, sage, pine kidneys are brewed in a bucket of water to cooling, flicker and add to the container. 10-minute procedure will be enough;
2. Rhodiola pink. Alcohol tincture (pharmacy) Ramiols take 15 drops divorced in 20 ml of drinking water to breakfast and dinner.
3. For the preparation of infusion from the soul 2 tablespoons of plants pour 400 ml of boiling water and insist in thermos. Take a drink on a half package several times a day 30 minutes after meals. This decoction is particularly effective in neurosis arising against the background of Klimaks.
4. Lemon. Grind on the meat grinder lemons (with peel). Shell 5 chicken eggs Grind to powder condition. Mix and let it breed 7 days. Take 3 times a day for 1 tbsp. spoon for a month.
5. Hawthorn. 3 tbsp. Spoons of hawthorn flowers pour 3 glasses of boiling water. Take 1 cup 3 times a day.
6. Irritability will help to remove teas And drinks based on mint, Melissa, Hypericum and souls. These medicinal herbs have a powerful antidepressant action and help get rid of nervous tension.
7. Valerian contributes to the removal of emotional stress, as well as improved sleep. The decoction is preparing on the recipe shown above. You need to take 100 ml in the morning and in the evening.
8. Salfa juice will help cope with high pressure. To do this, you need to take 20 ml three times a day for three weeks.

Diseases arising against the background of Klimaks

Discussing climaxes in women, symptoms, age, treatment, it is necessary to consider diseases in detail that arise under the influence of changes in the hormonal background.

Estrogens are necessary not only for fertility. Throughout the reproductive age, these hormones protect the woman from various diseases, strengthening almost all structures in the body. When the level of estrogen begins to decline in menopause, the influence turns out to be on many systems.

Prevention

As preventive eventsaimed at preventing the early onset of climacteric changes are:

• Regular survey among relevant specialists - every 6 months.
• Timely treatment of pathological processes arising in the sphere of the endocrine and gynecological system of organs.
• The right attitude towards the reception of hormone-containing drugs.
• Total hardening.
• Balanced diet.
• Moderate physical exertion.
• Regular sexual intercourse.

At the first signs of Klimaks, be sure to go to the gynecologist and the endocrinologist for consultation. Take care of yourself, we wish you good health and well-being!

The menopausal period (synonymous: Climax, menopause, climacteries) is a physiological period in a person's life characterized by the reverse development (involution) of a sexual system, which occurs against the background of the general age-related changes.

CLIMATIC PERIOD OF WOMEN
The onset of climax in a woman is associated with functional changes in the system - the pituitary gland - the ovaries and is expressed in the gradual fussing of the menstrual function, and then the hormonal activity of the ovaries.

During the climax, there are two phases, or stages, development. The first of these is the periodical change period of the menstrual function - comes in 43-45 years and later, it lasts about one and a half or two years before the complete cessation of the menstrual function (menopause). The most typical in the first phase of Klimaks is the violation of the rhythm of menstruation and the duration of the menstrual cycle. Most women gradually increase the intervals between menstruation and decreases the intensity of bleeding. It is less likely to shorten the intervals and strengthening of bleeding. The time of the onset of menopause ranges from 45-46 to 50 years. The duration of the second phase of the Klimaks is the extinction of the hormonal activity of the ovaries after the cessation of the menstrual function - to establish quite difficult, but sometimes for 3-5 years (or more) after the occurrence of menopause in women of elderly, bleeding of menstrual type can appear and even come. At the end of the second phase of the Klimaks, the hormonal activity of the ovarian stops and occurs the so-called physiological peace of the sexual system.

The premature onset of menopause (up to 40 years) is celebrated in women who had adverse working conditions and life, after frequent genera and abortions, after massive blood loss during childbirth, in chronic infectious diseases. Later, the extinction of the menstrual function (over 50 years old) is observed during the fibromomy of the uterus, with diabetes. Heavy mental injuries, long-term emotional tension in women in transition can contribute to the sudden termination of menstruation.

Among the complications of Klimaks are the highest attention, menopausal uterine bleeding and the so-called climacteric syndrome deserve.

Climacteric bleeding is caused by violations of growth processes, ripening and reverse development of follicles in the ovaries. Hormonal Balance Disorders often cause excessive growth of the endometrium.

The detachment of the functional layer of the mucous membrane is disturbed, as a result of which the patients appear long irregular bleeding of various duration and intensity. Part of patients with bleeding appear after menstruation delay.

To clarify the diagnosis, it is necessary to study in the dynamics of the ovarian function using the Colpocytogram, the use of the test with the crystallization of the cervical mucus, measuring the basal (rectal) temperature (see). The most important is the diagnostic scraping of the uterus mucous membrane, which must be preceded by the beginning of treatment. For histological research Soskoba manages to identify the nature of endometrial changes, and most importantly - to eliminate the presence of a cancer process.

To the menopausal syndrome refer to a kind of symptom complex, manifested by "heat tides" to the head and upper half of the body, rapid, sweating, dizziness, impaired sleep and performance. The diagnosis of menopausal syndrome is made on the basis of a typical clinical picture, developing at the end of the period of menopacteric changes in the menstrual function or at the beginning of menopause.

In the menopacteric period in connection with unstable nervous Women in some cases are observed blood pressure fluctuations, typical forms of arthritis can develop, the flow and other diseases are escalated.

Treatment. In the menopacteric period, much attention should be paid to the rational general regime, to establish the correct diet (increase the number of vegetables in food, limit meat, meat soups), in order to avoid stagnation in a small pelvis woman should move more, do morning gymnastics, when constipation and obesity is recommended ,.

With menopausal bleeding, the diagnostic scraping is produced before starting treatment. therapeutic action - Part of patients after scraping bleeding are stopped. With recurrent menopacteric bleeding only after special functional research, the doctor conducts. Women at the age of 45-47 prescribe the preparations of a yellow body hormone - in tablets of 0.01 g 3 times a day under the tongue in the second half of the menstrual cycle. Women of older ages, as well as during recurrent polyposera structures of the endometrium, for the purpose of suppressing the menstrual function, use drugs for men (androgens) hormones - methyl testosterone to 0.01 g 3 times a day under the course of 1-2 months. or testosterone propionate (25 mg 2-3 times a week intramuscularly for 3-4 weeks) for the appointment of a doctor.

For the treatment of menopausal syndrome, sedatives (soothing) preparations are recommended - Valerian with bromide (2-5 mg per night for 1-2 months), Frenolon, etc., as well as small doses of hormonal drugs, also after careful special examination And only by appointing a doctor.

Climax women's

Climax is a female - the age physiological period of the involutional restructuring of the genital glands, as well as all other organs and systems. There are three phases of the menopacteric period, usually coming in women aged 45 to 55 years. In the first phase in the body, a large amount is found in the second content, they are reduced, in the third estrogen, no, but many gonadotropic pituitary hormones. Often in the menopacteric period in women develop menopacteric neurosis representing a special neuroendocrine syndrome associated with the age involution. Pressure disorders can appear with the onset of menopause, as well as long before it.

The syndrome is due to complex changes in central and vegetative nervous systems and systems internal secretion. It is characterized by heat tides to the head and torso, sweating, dizziness, vasomotor lability, increased excitability, insomnia, a sense of unfortunate concern, etc. There is an inferiority of the ovaries of a functional or structural order, the atrophy of the uterus and outdoor genital organs may develop, which does not depend on Contents in the organism of estrogen. The involution of the uterus and external genital organs precedes the age-related rebirth of the ovaries, the hormonal connection between these bodies is disturbed. It is often noted an increase in the thyroid gland, and sometimes an increase in its function. Due to the hyperfunction of the adrenal cortex, a male type may appear. Solving, voices and so on. Increases the number of 17-ketosteroids allocated with urine. Some acromegaloidability of the person and limbs may be observed.

Treatment. Bromide treatment is used (from 0.05 sodium bromide to the reception twice a day; in the absence of the effect of the dose increases to 0.2-0.4 per day) before disappearing or mitigating neurotic phenomena. It is advisable to use Rauolfia preparations, trioxazine, mespotan, Andaxin, Devincana, etc.

Hormonal treatment of menopausal phenomena is carried out, taking into account the phase of the menopausal period, the age of the patient and preserving the menstrual function.

In the first phase of the climax, characterized by sufficient estrogen saturation, in the presence of signs of neurosis, if the menstrual function is preserved, permissible to use small doses of estrogen (in accordance with the phase of the menstrual cycle). Estrogens act on the central nervous system, activating the brake cortical process weakened in the menopauscical period. In the first half of the intermenstrument period for 12-14 days, folliculin is prescribed 1000 me to the muscles daily or an octestrol one tablet (10,000 me) 1-2 times a day.

In the presence of uterine functional bleeding, it is possible to use progesterone 5-10 union intramuscularly for 5-6 days and testosterone propionate in 25 mg intramuscularly 2 times a week (only 6-8 injections) or methyltestosterone 0.005 1-2 times a day Under tongue for 10 days.

However, the use of progesterone and androgens requires special caution, because it knows the presence of psychoneurotic shifts in women in front of menstruation, when the body is saturated with a yellow body hormone. In addition, this hormone, as androgens, has a virilizing property. Only with severe climacteric neurosis, when there is no effect on other measures, it is possible to resort to these hormonal drugs, of course, with the complete cessation of their reception in the event of signs of virilization.

In the second phase of Klimaks, when the hormonal level is sharply reduced and resistant menopause has occurred, with pronounced vegetative-nerve disorders, the use of the following drugs is recommended:
Folliculin 1000 me to the muscles (10-12 injections) or 3000 me to the muscles in the day (only 8-10 injections);
Estradiol-dipropionate of 10,000 me in the muscles 1-2 times a week (total 5-6 injections);
Octestrol or sinestrol 1 tablet (10,000 me) inside i-2 times a day for 2-3 weeks.

The course of treatment with estrogen can be repeated 2-3 times with interruptions of 4-6 months. In the second phase, the estrogens are prescribed to replace the missing follicular hormone.

In the third phase of the Estrogens Klimaks, applied to oppress the function, pituitary gland and reduce the formation of gonadotropic hormones. Therefore, combine the male and female sex hormones according to the following scheme: Testosterone-propionate in 25 mg is intramuscularly three times a week (only 6-8 injections) or methyltestosterone at 0.005 under a tongue 2-3 times a day for 3-4 weeks; It is also advisable for the use of metylandrostandiol at 25 mg per day - 10-12 days; Folliculin 3000 me in the muscles 2 times a week (only 6-8 injections) or an octestrol or sinestrol 1 tablet (10,000 me) 1-2 times a day for 3-4 weeks.

During estrogenic therapy, it is necessary to control the degree of saturation of the body by estrogens to change the cytological picture of the vaginal smear or other than the described tests.

If, before the end of the course of treatment, the symptoms of menopausal neurosis disappear, the dose of estrogen is reduced.

Contraindications to the use of genital hormones are neoplasms of genital organs and mammary glands (in the past or present), as well as repeated uterine bleeding.

Hormonal treatment must be combined with use sedatives, eliminating the possibility of all the injuries of the nervous system of factors, observance of hours and days of rest, reasonable use of vacation, normal sleep, physiotherapeutic procedures, rational psychotherapy.

This section outlines modern ideas On the physiological climax and the causes of the pathological flow of the Pressure period. Data on the features of the flow of somatic and gynecological diseases in the menopausal period (diabetes, hypertensive disease, metabolic disorders, tumor and inflammatory diseases genital organs) and determined the treatment tactics of patients. Considered issues of forecasting, diagnosis and prevention of pathological climax.

The section is designed for gynecologists, therapeutors, psychoneurologists, neuropathologists.

Preface

The problem of aging of a person with deep antiquity attracted the attention of the outstanding thinkers of humanity. In the second half of the 20th century, this problem has gained particular relevance due to the fact that significant changes occurred in the age structure of the population - the life expectancy has increased. Consequently, the duration of the menopausal period has increased. In this regard, all the increasing interest, manifested by this period, is clear, primarily in terms of conservation of health.

Diagnosis and treatment pathological conditions In the menopacteric period, there are certain specificity, which obstecred-gynecologists do not always take into account. The features of this period are primarily that it is at this time many diseases arise or appear: benign and malignant tumors, psychosis, neurosis, diabetes, obesity, function disorders endocrine glands, vegetative-vascular disorders, etc. Clinical symptoms of listed diseases can be similar to the manifestations of aging of the body and the pathological flow of the climacteric period, in other words, the nature of the manifestations of many diseases and age changes can be almost the same, while treating methods should be fundamentally different.

In this regard, the purpose of this work was primarily the presentation of data on physiological and pathological age-related changes in the body of women, in particular in the reproductive system during the aging period. The high frequency of the pathological flow of climacterium and diseases in this period of life obliges doctors to pay special attention to the prevention of climatic pathological flow. In this regard, it was advisable to dwell the most detailed in this aspect of the problem under consideration. Pathological processes developing in the Climacteric period are often due to the carrying out of not always reasonable symptomatic therapy, therefore the book is paying much attention to differential diagnosis and methods of pathogenetically substantiated therapy.

The section is written on the basis of these literature, personal long-term experience of the author and the results of research conducted under the leadership of the author for 25 years in the endocrinological department of the All-Union Center for the Protection of Mother's Health and Child MD USSR.

Climax is another stage of physiological changes in the body of a woman associated with the extinction of the reproductive function. The greatest probability of its attack falls at the age of 45-52 years. Depending on the characteristics of the body, transferred diseases, the living conditions of the climax may occur earlier or later. Hormonal changes occurring gradually lead to the aging of a woman. If it leads an active lifestyle, pays the necessary attention to his appearance, takes care of his health, then the aging of the body slows down.

Threaten 3 Stages of Klimaks:

1. Premenopause - the beginning of the hormonal perestroika, in which the level of estrogen begins to decline, menstruation becomes irregular. The probability of conception is reduced.
2. Menopause is a period of 12 months from the beginning of the last menstruation. If in the previous period, the woman can still doubt the cause of the menstrual cycle failures, the absence of menstruation during the year is an accurate sign of the onset of Klimaks.
3. Postmenopause - the period after the end of menopause is about 3-5 years. Estrogen levels reaches a minimum.

Video: menopause and its types

Types of climaks and the age of their offensive

Symptoms of menopause in women depend on age. Treatment is also appointed in accordance with the age of menopause, which depends on the characteristics of the physiology, general status Health, conditions and lifestyle. There are several types of climax:

• premature (after 30 and up to 40 years);
• early (from 41 years to 45);
• timely, considered the norm (45-55 years);
• late (after 55 years).

Premature and late climaks are usually pathology. After the examination and clarify the causes of deviations from the norm, treatment is assigned. With a timely occurrence of menopause in some cases, only facilitating associated symptoms is required.

Causes and consequences of the premature occurrence of menopause

The onset of menopause B. early age Perhaps for several reasons. First of all, this is due to diseases of the ovaries, their removal or treatment with hormonal drugs. Sometimes premature climax caused congenital genetic disorders. In this case, there is insufficient egg generation. Such pathology is inherited.

One of the reasons is too early puberty. Girls. The usual age of the onset of the first menstruation is considered to be 13-14 years. But sometimes monthly appear already in 10-11 years.

Menopause comes too early in those who suffered a disease of the thyroid gland, reproductive organs, immune system, liver. Provice the offensive of menopause can be ray therapy in the treatment of tumors, chemotreage.

The emergence of early climax also contributes to an unhealthy lifestyle and bad habits (smoking, alcohol abuse, drug addiction). The provoking factor is obesity, as well as the passion for diet, long starvation.

The onset of early menopause is usually associated with hormonal violations in the body. Reducing the level of female sex hormones leads to infertility and early aging. In addition, hormonal disorders increase the risk of tumors of the mammary glands, reproductive organs. The risk of heart attack, stroke and other cardiovascular diseases also increases. The imbalance of hormones leads to diseases of the thyroid gland, the operation of the urogenital system is disturbed. Early Climax It becomes the cause of neurosis, depression.

If the first suspicion appears to reduce the sexual activity of the body, you must consult a doctor. In case of doubt, due to violations of the menstrual cycle, an FSH test is made (follicle-stimulating hormone). When climax, its level rises and remains constantly high. If the temporary violations, the level of this hormone fluctuates.

Video: Hormone tests to determine the onset of Klimaks

Causes and Complications of Late Climax

As a rule, the afterpelling factor of the late Climax is heredity. If it does not occur to 55 years, while there are no health problems, then the late menopause plays only a positive role. The normal composition of bone and muscle tissue remains longer. Less problems with the work of the heart, vessels, brain.

However, in some cases, a serious gynecological disease or treatment with chemotherapy and irradiation can be the cause of the late menopause. In this case, the woman must constantly be under the supervision of a doctor, as it is possible to exacerbate or relapses from diseases that caused the delay in the climax. The irregular occurrence of bleeding of various intensity sometimes masks the symptoms of diseases, including malignant tumors.

Symptoms of Klimaks.

There are a number of features for which you can determine what the climax has come.

Riding - Periodic suddenly advancing attacks, accompanied by a feeling of heat, as well as blood flow to face. At the same time, the woman sweats greatly. After a few minutes the state of chills occurs. Such tides can last for years, appearing a day of 20-50 times. In this case, the doctor will tell you how to reduce their number, facilitate the symptoms.

Headache, dizzinessthat usually appear in the morning. The woman is forced to give up the usual affairs, quickly tires. She is experiencing an unfortunate alarm, becomes irritable.

Sleep disorders. Tides, arising during the day and at night, will be a woman. After that, it is difficult for her to fall asleep. Insomnia comes not only because of the tides. The cause of sleep disorders may be neurosis arising due to deterioration of the nervous system and brain. The inability to sleep normally deprives forces and causes even greater anxiety and irritation.

Frequent mood change. Woman becomes touchy, tearful. Merry mood is sharply replaced by irritability and critches.

Lump in the throat. The reaction of the autonomic nervous system at which there is a feeling of interference in the throat. There is a need to make swallowing movements. A woman at the same time does not experience pain or any unpleasant sensations. This state usually passes independently. However, if the symptom does not disappear within a few months, pain appears, it is necessary to contact the endocrinologist. Such sensations arise for diseases of the thyroid gland.

Weakening memory. During this period, most women complain about "sclerosis", diffuse, the inability to focus.

Dry vagina. The symptom is usually accompanied by itching, is the cause of painful sensations during sexual intercourse. It occurs as a result of changes in the structure of the mucous membrane of the vagina under the influence of hormones. In this case, there is also a decrease in sexual entry.

Violation of the work of the urinary organs. Violation of the vaginal environment makes urinary system more vulnerable to infection penetration. Often there are diseases of the kidneys, bladder, inflammatory diseases of the ovaries, uterus. The weakening of the tone of muscles leads to urinary incontinence.

Enhance arterial pressure, rapid heartbeat. This indicates changes in the structure of vessels and in the heart muscle. The risk of heart disease in a woman is significantly rising.

Diseases of the joints, bone fragility. This indicates a lack of calcium. At the occurrence of Klimaks, a woman worsens the assimilation of beneficial substances. Insufficient flow of calcium weakens bones. In addition, they become brittle nails, hair loss is observed and the deterioration of their structure. Thread also tooth enamel, more often arises caries.

Video: Symptoms of Klimaks, from which their severity depends, how to treat them

Diagnostics when climax. How to facilitate symptoms

With the appearance of such signs, as a breakdown of the menstrual cycle, a decrease or an increase in the volume of discharge, a sharp change in body weight and other unexpected signs, a woman must contact the doctors: a gynecologist, an endocrinologist, a mammologist. Examination with the help of ultrasound, x-ray, and biochemical analysis Blood on hormones and oncomarkers will allow you to detect serious diseases in time, which must be urgent.

If a woman is healthy, unpleasant symptoms are associated with menopacterid deviations, then it will be appointed therapy to eliminate insomnia, the reception of soothing means and vitamins. Preparations containing calcium and silicon will help prevent the appearance of osteoporosis. The means to enhance blood supply, eliminate increased pressure.

The most effective method of getting rid of tides and other symptoms of Klimaks is hormonal therapy. Sometimes it is enough to choose with the help of a doctor suitable hormonal contraceptives. Candles containing hormonal preparations, special plasters, intrauterine spirals are also used. With these means, the estrogen level increases, which allows you to slow down the onset of menopausal changes. Replacement hormone therapy is carried out for at least 1-2 years. To prevent osteoporosis, it is sometimes required to use it for several years after menopause.

Warning: Any hormonal drugs should be taken to appoint a doctor. Excess estrogen leads to an increase in weight, the expansion of the veins on the legs, diseases of the breast, the emergence of mioma of the uterus and other serious health problems.

For a soft decrease in the symptoms of menopause, non-coronal agents based on plant components are used, for example, a biologically active additive to Estrovel® capsule food - a complex of phytoestrogen, vitamins and trace elements, whose components operate on the main manifestations of Klimaks.

Treatment with folk remedies during climax

In the treatment of tides, insomnia, headaches and other manifestations of Klimaks, the funds of traditional medicine are successfully used: plant decoctions, herbal soothing baths. The lack of estrogen is replenished with the help of phytoestrogen, which refers, for example, sage.

Infusion to eliminate sweating and facilitating

Mix sage, valerian root and hat in a 3: 1: 1 ratio. Glasses of boiling water poured 1 tbsp. l. Collection. This healing infusion drink every day in several techniques.

Infusion of herbs at elevated pressure, rapid heartbeat, sweating

1 tbsp. l. Mixtures of the hawthorn, dyeing, dryers, daisies (4: 4: 4: 1) insist in 1 cup of boiling water and drink a 3-4 spoons medicine several times a day.

MENOPAUSE (Greek, Klimakter Stage, Age Turning Moment; Sin: climumAkteria, Climax) - the physiological period of transition from puberty to the period of termination of the generative function.

CLIMATIC PERIOD OF WOMEN

The menopausal period of women covers a period of 45 to 60 years and is characterized by a gradual cessation of the menstrual function, and then the hormonal function of the ovaries against the background of the general age-related changes in the body. K. p. It is inextricably linked to the aging process of both cortical nerve centers and hypothalamic structures that regulate the activities of the pituitary and ovarian.

In the first phase of the climacterium - in the phase of climacteric dysfunction of the ovaries, or premopause, changes in the function of ovaries are characterized by irregular luteinization of follicles, a decrease in the secretion of progesterone and estrogen, irregular menstruation marks. The time after the last uterine bleeding caused by the influence of the ovarian hormones is called menopause. Its offensive is preceded by a period of reduced ability of a female organism to fertilization. The term "menopause" is also used to designate the second phase of K. P.-Postmenopause, when the function of the yellow body of the ovary is completely stopped, against the background of a significant reduction in estrogen products, there is a residual secretion in the ovarian tissue, the menstrual function stops.

Changes in the neuroendocrine system of women in K. P. are characterized by a decrease in the reactivity of summer houses on gonadotropic incentives from the hypothalamic-pituitary system, arising from the reduction of the estrogenous influences of the ovaries, and function. Changes in the thyroid gland, disregulation of vegetative centers, increased excitability of sympathetic centers and the lability of the vasomotor system.

The duration of the ovarian function refers to genetically programmed physiol. processes. By 40 years in the ovaries there are 30,000-40,000 follicles, in the subsequent decade, their number is significantly reduced. Dystrophic changes In the ovaries begin with thickening of the basal membrane of follicles, followed by fibrous transformation.

The pace and the degree of reduction of the number of follicles are individual; In the outcome of the dystrophy there is an atres of follicles with filling their cavity with a connecting cloth. In K. p. Follicles are found in the ovaries at different stages of development, fibrous and atrethic bodies, there is a tendency to small-cycle reincarnation of follicles. 3-4 years after menopause, the concerns and atrethic follicles are ever less common. In the future, it comes so called. Functional of ovarian, the amount of them decreases by 2 times. Sclerotic changes in the ovarian vessels predominantly medium caliber are discovered after 30 years, long before the first wedge, the manifestations of K. p., Then they apply to larger vessels. The lumen of the vessels is narrowing, the inner shell thickens, the elastic membrane disappears, well and guialic dystrophy Vascular walls. The vascular network of genital organs and especially the uterus is significantly solvable. Large changes undergoes its value. Only in those women who suffer from climacteric bleeding due to increased extraction of estrogen, the uterus in premenopause increases. In postmenopausal weight it decreases to 30 g. The number of anastomoses between the branches of the vessels of the left and right half of the uterus is reduced, and in the midline, it is found as if a violent zone is found. Differences in the structure of cervical and body of the uterus disappear, an anteflex is replaced by a light retroflexia. Bubble and straightforme-uterine space are flattened. Endometrium acquires an atrophic structure: the stroma becomes fibrous, the gland is poorly developed, the spiral artery becomes straightforward. The boundary between the function and the basal layer disappears; In the basal layer, the remains of glands are preserved, often in a state of cystic atrophy. The cervical epithelium is atrophy. The vagina is unevenly narrowed, especially in the upper third, the composition of the vaginal content is changed. In the field of external genital organs, subcutaneous adipose tissue disappears, large sex lips become flabby, and small decrease and depugmented, the clitoris decreases. Involutionary changes are detected in lactic glands: ironic fabric disappears, the nipple loses pigmentation; Sometimes the mammary glands increase significantly in size as a result of excess fat deposits.

The first phase of K.p. occurs at the age of approx. 45 years. To premature development K. P. Refers its offensive to 40-42 years, to late - after 55 years. In the presence of hypertensive disease, the duration of premanopause increases to 3-3.5 years. A typical feature of changes in the menstrual function in this period is violations of the rhythm and duration of the menstrual cycle and a gradual transition from a two-phase (ovulatory) to a single-phase (an inhibent) cycle. After 43 years, the average duration of the menstrual cycle increases (see), a significant part of women has a single-phase cycle with a disturbed rhythm of menstruation. The time of the second phase of K. P. fluctuates in fairly wide limits even from completely healthy women (as a rule, in 45-46 years).

Most women have both phases of K. p., And the periodicals period of menstrual changes precedes the onset of menopause: the intervals between menstruation gradually increase and the intensity of menstrual-like discharge decreases. Less often changes in menstrual function are characterized by the appearance of irregular, abundant and long-term menstrual bleeding. In a third of women, menstruation stops suddenly. The more early termination of the menstrual function is facilitated by frequent repetition, abortions, long lactation, although approximately half of women, it is due to primary hypothalamic disorders. Menopause comes later in patients with the uterus, hypertensive disease and etc.

The level of hormone secretion in the residual ovarian follicles is reduced in the premopause, in the initial stages of age restructuring, the concentration of estradiol blood plasma is reduced with an unchanged product of the yellow body of progesterone, the secretion of each of these hormones is reduced later. Gradually, the reserve of ovarian follicles capable of ripening, and by the time of menopause, the level of selection with urine of total estrogen decreases to 20 μg / day. Within the first year of the postmenopause, there are still cyclic fluctuations in the level of estrogen effects, by the end of its level of extraction of estrogen with daily urine decreases almost twice as much as possible - up to 10 μg. This amount of estrogen is not enough for physiol, stimulation of endometrial, although the sensitivity of the latter to stronger endo and exogenous hormonal stimuli is maintained for a fairly long period. After declining and subsequent termination of the production of estrogen in the follicular apparatus of the ovaries, extracollicular products of steroid hormones persist in women's body For a long time and steroid hormones or their predecessors in small quantities. With pronounced individual oscillations, they continue to form mainly in the field of ovarian gate, where the hyperplasia of the cell elements of stroma is often found with signs of enzymatic activity. 6-10 years after the onset of menopause, a small part of estrogen is formed in the ovary, the rest is the product of the aromatization of androgenic precursors outside the ovarian tissue - in the subcutaneous tissue and the gastrointestinal and hepatic complex. The products of the genital steroids with the screw substance in transition remains unchanged within 10-20 years after menopause.

The progressive reduction in the formation of ovarian hormones, especially estrogen, in transition is accompanied by a violation of the influence of the latter on the hypothalamicpofizar system. This is manifested by the cessation of the effect of ovarian steroids on hypothalamic centers, increased cyclic products of hypothalamic rhythm hormones and gonadotropic hormones in the front share of the pituitary gland. The content of gonadotropins in the front of the pituitary gland increases 10 times; This is combined with an increase in the weight of this share and the content of basophil elements in it. The content of the luteinizing hormone (LH) in the blood plasma, according to radioimmune definitions, increases with 30 ng / ml ml to 500 ng / ml, the follicularity of the hormone (FSH) - from 20 to 760 ng / ml, and the ratio of LH / FSH equal to the reproductive Aged 1.0, decreases to 0.4-0.7. The ratio of LG / FSH in plasma less than 0.7 serves as a sign of the onset of K. p. Maximum content of L G and FSH in the blood is observed in the 3rd year of postmenopause and is preserved for 10 years. With the onset of menopause, a decrease in estrogen activity is noted in 50% of women, signs of moderate estrogenic effects are found in 33-40% of women, 10- 17% have signs of enhanced estrogenous influences.

Violations of K. P.- Climacteric dysfunctional uterine bleeding (see) and climacteric syndrome (see).

The state of estrogenic deficit, developing, as a rule, in the late stages of the postmenopause period, contributes to the development of atrophic changes of vulva, vagina and urinary tract, atherosclerosis, systemic osteoporosis, dystrophic arthropathy. When preserving in this period estrogenic effects there is an inclination to hypertension, diabetes, the development of hyperplastic processes in endometrials and milk glasses.

In K. p. Many women have obesity, the development of hron, constipation, the overall weakening of the body. Walking, gymnastics, massages, restriction of food, especially meat dishes contribute to the prevention of these phenomena. Alcohol, spices, sharply exciting nervous system, should be excluded. The intestine is better to regulate the appointment of the corresponding diet.

In K. P. Practically healthy women should undergo a medical examination at the gynecologist at least 2 times a year. Serious attention and careful examination requires the emergence of unusual symptoms in this period.

Men's menopausal period

The men's maternity period is determined by age involutionary processes occurring in germ glances, and most often occurs between the ages of 50 and 60 years. Atrophic changes in glindulocyte eggs (leydega cells) in men of this age lead to a decrease in testosterone synthesis and a decrease in the level of androgenic saturation of the body. At the same time, the products of gonadotropic hormones of the pituitary gland tends to increase. A decrease in the incredio function of the testicles plays the role so called. The starting factor in violating the mechanisms of regulation of the hypothalamus system - hypophysis - gonads. As a result, complex neuroendocrine changes occur, including a violation of the C function. n. with. and determining the picture of the male climax. In the overwhelming majority of men, the age extinction of the function of the genital glands is not accompanied by any clinical, manifestations, although sometimes there are characteristic symptoms Klimaks and in such cases the current C. p. is regarded as pathological.

Wedge, manifestation of patol. K. p. In men are characterized by cardiovascular, psychoneurol, and urinary disorders. Cardiovascular disorders manifest themselves with a feeling of tide to the head, sudden redness of the face and neck, heartbeat, pain in the heart, shortness of breath, increased sweating, dizziness, etc. Sometimes non-permanent arterial hypertension occurs.

Psychoneurol, disorders in K. P, may be weakly or sharply expressed. Patients complain about easy excitability, fast fatigue, sleep impairment, muscle weakness, headache. Depression, unpretentious anxiety and fear, loss of previous interests, increased imperidity, plasticity are observed.

Among the symptoms of the violation of the function of urinary organs, there is a varying degree of dysuria (see). Violations of sexual potency are observed at the overwhelming majority of men (see Impotence). At the same time, all the composite moments of the copulatory cycle suffer, but there is a prevailing weakening of erection and premature ejaculation.

Patol treatment. K, n. In men, it includes normalization of the regime and recreation, dosage of physical. Load, creating the most favorable psychol, climate. The obligatory component of treatment is psychotherapy (see). Medicia treatment Includes funds normalizing fuscation C. n. with. (sedatives, psychostimulating antidepressants, tranquilizers, etc.), vitamins, biogenic stimulants, drugs containing phosphorus, antispasmodic agents. In some cases, it is shown the purpose of the drugs of sexual and gonadotropic hormones in order to correct disorders of endocrine relations, as well as the use of anabolic hormones.

Bibliography: Arsenieva M. G. Colpocytological studies in the diagnosis and therapy of endocrine gynecological diseases, p. 206, L., 1973, Bibliogr.; Vikhlyaev E. M. Climacteric syndrome and its treatment, M., 1066, bibliogr.; 3 m and n about ink to and y yu f. Age neurophysiological features and menopausal disorders in women, M., 1975, bibliogr.; Malinovsky M. S. and C in E T - M O L D A C C K A I V V. D. Klimauchea and Menopause, M., 1963, Bibliogr.; Mandelshtam V. A. Uterine bleeding in Menopause, L., 1974, bibliogr.; TETER E. Hormonal violations in men and women, per. with Polish, Warsaw, 1968.

E. M. Wychlaeva; D. V. Kan (Urol.)