No matter how sad it is to think about this period, you shouldn't take it so tragically. The phenomenon called "menopause" is the stoppage of a woman's reproductive function, and includes three periods: premenopause, menopause and postmenopause. Today we have a task - to answer the questions: what is postmenopause, what is happening in a woman at this time, what dangers await us, how to treat negative manifestations? Before that, let's take a deeper look at the secret processes of the female body that begin with menopause.
After 45 years, various changes occur in the body, and this is not just the extinction of the functions of the ovaries. The beginning was marked by disruptions in the production of sex hormones, and as a result - their imbalance. And hormones are designed to control the normal functioning of all systems in the body. Menopause does not begin when menstruation stops: premenopause passes over several years, the production of sex hormones by the ovaries gradually decreases, menstruation cycles go astray, hot flashes begin, subcutaneous fat increases, wrinkles appear, and unexpected mood changes. Menopause occurs at about 52 -55 years old, its main symptom is the complete cessation of menstruation. In the absence of menstruation throughout the year, menopause is considered to have begun, and this is the start of postmenopause.
Postmenopause is divided into 2 stages:
- early postmenopause has a beginning with a one-year stop of blood flow and lasts five years;
- late postmenopausal period takes an interval of ten years without the discharge of blood from the female organ.
Menstruation in postmenopausal women is absent as such, because the functioning of the ovaries is over, and the uterine lining does not exfoliate. And you need to be careful at the onset of bleeding in postmenopausal women and immediately contact a gynecologist.
Postmenopause itself is not considered a deviation from health: a woman's body after a long childbearing period is worn out and needs rest, and the supply of eggs in female organs by this time ends. Therefore, this is a good time to enjoy life, provided that there are no pathological processes, and when the woman's hot flashes have passed.
In a strong, not painful postmenopausal woman, the body is calmly rebuilding, because the stopping of ovarian functions takes eight to ten years, and gradual changes do not affect her condition so much. But in the case of accumulated diseases, this is reflected in the ability to rebuild to new conditions of life, and all systems of the body begin to malfunction little by little.
Postmenopause and statistics
In recent years, postmenopause has become a topic of discussion in the scientific world due to the fact that women have begun to live much longer compared to the last century. Almost a third of all women are in the postmenopausal age, and its duration lasts a third of their entire life. At this age, ladies get sick much more often than at a younger age. Malignant tumors of the endometrium and ovaries are found in women 60 - 62 years old, tumors of the cervix - after 50 years. Therefore, older women are at their peak for the likelihood of cancer.
The good news is that world medicine has begun to use the latest methods for detecting and treating these ailments, such as ultrasound, hysteroscopy, hydrosonographic examination, and in the early stages of the disease, which is important in oncology.
Postmenopause and hormones
The body produces about 70 types of hormones, but estrogens are responsible for the rearrangement in menopause. With the aging of the ovaries, female hormones become scarce, and this negatively affects all systems of the body. In the female body, this type of hormones is represented by estradiol, estrone and estriol. They are produced by the ovaries, but with the onset of postmenopause, their main synthesis occurs in the adrenal glands and adipose tissue.
Female hormones are able to interconvert and replace each other in case of lack. After the onset of menopause, the amount of estradiol falls, and the less active estrol becomes more, the female hormones become less male. And they are vital for bone, muscular, cardiovascular, nervous, excretory systems. Calculated digital indicators of sex hormones in the postmenopausal period, necessary for a healthy life without pathologies:
- the estradiol level should be between 10 and 20 lg / ml;
- estrol level ranges from 30 to 70 lg / ml;
- androstenedione indicator - from 1.25 to 6.3 nmol / l;
- testosterone, male hormone - from 0.13 to 2.6 lg / ml.
Clinics provide an opportunity to conduct a hormone test to find out what steroid levels you have and make adjustments.
Postmenopause symptoms
With the onset of the postmenopausal period, the unpleasant manifestations of premenopause, such as weakness, headaches, insomnia, hot flashes, disappeared, although very rarely these symptoms are present after genital atrophy. They are being replaced by other manifestations:
- osteoporosis, leading to bone fractures;
- hair begins to fall out, nails exfoliate, gray hair appears;
- the skin becomes dry, wrinkled, age spots appear;
- blood vessels suffer: the walls become brittle, inelastic, causing poor blood supply to all organs;
- blood pressure rises;
- memory, hearing deteriorates, vision changes, motor coordination suffers;
- diseases of the heart and blood vessels: cholesterol grows, causing blood clots in the vessels. As a result, ischemic disease, angina pectoris, cardiac arrhythmias develop;
- nervousness, insomnia, suspicion, depression, difficulty with the thought process;
- metabolic disorders, constipation;
- warts appear, birthmarks change, they can turn into malignant;
- neoplasms inside the breast may begin;
- an increased level of the male hormone can lead to male-type hair (arms, legs, antennae), the pitch of the voice may decrease;
- with dysfunction of female organs, the production of a protective secretion of the mucous membranes decreases, opening a free path for infections of the genital tract and inflammatory processes. Diseases of the genitourinary system, such as cystitis, urethritis, vaginitis, are often observed in the postmenopausal period;
- the vagina descends, its microflora changes, dryness and burning inside interfere with enjoying intercourse;
- polyps, hyperplasia of the mucous membranes of the genital area;
- if a premenopausal woman has fibroids, polyposis, then in postmenopausal women they can be depleted and go away due to estriol deficiency, although a specialist should observe their change, and this should not be left to chance;
- more often the bladder becomes infected, its walls become thinner, become weak; this leads to urinary incontinence;
- deficiency of Ca and Mg leads to tooth decay, stoop;
- increased body weight. Reducing estrogen production forces the body to store fat - a source of female hormones;
- - is also a common occurrence. Therefore, in case of any ailment, you must immediately contact the clinic at your place of residence.
These manifestations are observed in seventy percent of postmenopausal women. Symptoms of severe postmenopause are most often present in slender, thin women, or in overweight or in alcohol and smoking abusers.
Men under forty more than ten times more often than women develop heart attacks, but by the age of seventy, their ratio is one to one.
Discharge rates in postmenopausal women
The altered level of hormones affects the state of the vaginal mucosa, therefore the composition and volume of secretions vary greatly. Having sex helps keep your vagina healthy.
Vaginitis - inflammation of the vaginal mucosa, occurs due to the drying out of the insides of the organ, does not infect through sex. This disease can serve as a basis for infectious diseases and complications in case of inattentive attitude towards oneself. Discharge is considered normal when it is colorless, in small quantities, odorless. Changes in signs may indicate a disease, and you need to take this seriously and treat it:
- if there is whitish or bloody discharge, there is blood during or after sex, then cervical cancer is possible;
- the appearance of liquid discharge interspersed with blood, then strong blood, and subsequently with blood clots, may indicate endometrial cancer;
- multiple, foul-smelling liquid discharge may be a symptom of uterine sarcoma;
- thrush (candidiasis) is given out by whitish, sometimes green, curd-like outflows, with a sour odor, like ointments, sometimes liquid;
- cervicitis is indicated by multiple mucus and pus, whitish or yellowish outflows, with blood clots;
- colpitis has a discharge with mucus, pus, gray or milky color, with a fetid odor of rot, after the development of the disease, yellow-green, with foam, sticky.
At the slightest indicators, it is necessary to go to the doctor's office and get tested for the type of disease, since many of them are masked at an early stage and are not very symptomatic. Do not delay the trip to the hospital so that tragic complications do not arise.
Postmenopause and osteoporosis
The lack of estrogen in forty percent of women with menopause ends in thinning of the bone structure, up to three and a half percent of the bone mass annually. At the age of 65, a third of all women are at risk of getting bone fractures, especially femoral neck injuries. Moreover, in old age, bones grow together for an extremely long time due to estrogen deficiency. The bad news is that the development of this disease in women begins without symptoms, and most often the lady learns about the diagnosis after the fracture. Prolonged osteoporosis is accompanied by bone tenderness, cracks and fractures after the slightest reason, stoop caused by scoliosis, kyphosis.
X-ray cannot detect this disease at the onset of the lesion, only when the bone mass is reduced by one third, therefore, densitometry of four types is used to detect osteoporosis: ultrasound, DXA, CMR, CKT. The procedure is absolutely safe for health, and is recommended to be performed twice a year, in order, in this case, to reveal thinning of the bones in women.
Prerequisites for osteoporosis
This complication can occur under the following conditions:
- with postmenopause;
- 4/5 of the population suffering from the disease - the fairer sex;
- forced postoperative menopause at a younger age;
- in women of the Caucasian race, the risk is much greater;
- thinness;
- lack of Ca in the diet;
- little movement;
- alcohol, smoking in women;
- genetic predisposition to lack of a gene for the assimilation of vitamin D.
Diagnostics in postmenopausal women
With the onset of menopause, in the case when the lady does not know whether postmenopause has begun, you need to go to an appointment, and the following tests may be prescribed by your doctor:
- the amount of follicle-stimulating hormone;
- to the level of estradiol;
- androgen levels;
- ultrasound examination of organs in the small pelvis, to identify the viability of the ovaries and the state of the uterine mucosa.
If women feel unwell, a survey should be carried out:
- Make a blood test for leukocytes to exclude inflammation, for blood clotting.
- Laboratory blood test for Ca.
- Ultrasound examination of female organs.
- Hysteroscopic procedure for detecting tumors, fibroids.
- A mammography procedure to rule out breast cancer.
- Endometrial cytology to make sure there are no abnormal tissues in the female organ.
- Densitometric analysis of bones.
Treatment measures in postmenopausal women
After completing the functions of the reproductive sphere, a woman does not need to ignore her health and wave her hand at herself, they say, life has passed. You can still live for many decades, and it is better to live them in health. The most important thing is to establish a healthy diet first.
Limit some foods:
- pork, especially fatty;
- carbohydrate foods;
- less sugar and salt;
- cut back on smoked, spicy;
- drink weak coffee in reasonable amounts;
- it is better to exclude alcoholic beverages.
Helpful for postmenopausal women:
- fresh fruits and vegetables;
- dairy products;
- porridge;
- fe-containing products;
- flaxseed, sesame seeds, with natural estrogens;
- broccoli, legumes, soy;
- pistachio nuts, dates.
In order to feel better in postmenopause, you need:
- exercise in the morning for up to twenty minutes;
- adequate physical activity, strengthening the muscles - helps the metabolism;
- walk in the fresh air, swim;
- massage and self-massage;
- wipe yourself, douche yourself with water;
- do not overload yourself with hard work that increases the deficiency of female hormones;
- sexual activity prolongs vitality, improves emotional state;
- to overcome dryness in the vagina, use special hormonal creams, ointments.
Postmenopausal medications
To eliminate the deficiency of female hormones, the attending physician may prescribe some drugs:
- Femoston, Livial - to eliminate the lack of estrogen and gestagens, helps with menopause symptoms, stops osteoporosis;
- Dermestril, Ovestin replenish the amount of female hormone;
- complex set of hormones - Femoston, Klimonorm;
- phytohormones Estrovel, Klimadinon, Remens;
- hRT medications such as Divitren, Kliogest.
Dear women, the treatment of the signs of postmenopause is impossible without your doctor, who will check the true state of the balance of hormones in your body, and will prescribe exactly the drugs that you need. Do not forget that every medicine has contraindications, and uncontrolled treatment will only harm your health. The wrong medication can open bleeding, lead to the development of oncology, if you have neoplasms, and you do not know about them. Therefore, visit a doctor twice a year and have an ultrasound scan.
To calm the nervous system in case of emotional instability, the following reception will help:
- Atarax;
- Grandaxin;
- Cleophyte;
- Afobazole.
It is possible to normalize the density of the bone structure:
- Calcemin;
- Aquadetrim;
- Osteogenone;
- vitamin complexes E and B.
Before treatment with hormones, you will be prescribed a blood clotting rate test, and the condition of the veins will be assessed. With blockage of blood vessels and other vascular diseases, hormones are contraindicated. Also, hormonal forms are not prescribed for tumors growing under the action of female hormones.
Herbal medicine for signs of postmenopause
To the misconception of many, herbs are considered weak remedies. But in fact, this method of relieving symptoms is very effective. Let's consider some:
- st. John's wort helps to calm the nerves, improves the supply of blood to organs, eliminates hot flashes;
- ginseng soothes, strengthens vitality;
- licorice stimulates the production of estrogen by your body, participates in strengthening the bone structure;
- sage used for symptoms of hot flashes.
Remember, dear readers, that there is nothing wrong with menopause, if you follow the above rules, do not forget to visit the gynecological office on time, continue to enjoy life, children, and communicate with grandchildren. We wish you happiness!
Informative video on this topic:
Minasyan Margarita
The onset of the extinction of the reproductive system depends on the individual characteristics of the female body and heredity. Menopause itself in women consists of several stages, each of which is characterized by its own characteristics. The final stage of menopause is postmenopause, and every woman should really know what it is.
You need to remember that postmenopause is just a new period in your life, which will come anyway. Therefore, it is worth preparing your body for a number of changes, as well as finding out the main signs of the postmenopausal period.
At what age does postmenopause occur?
The exact date in this matter cannot be named, because each organism is individual. Here it is necessary to take into account heredity, various diseases, other reasons that affect the rate of extinction of reproductive function.
The postmenopausal period is not characterized by a sharp onset. This is the last stage of menopause, which is preceded by premenopause and menopause:
- Premenopause. It occurs after about 40 years, but in some women, a decrease in estrogen levels is noted as early as 35 years. Menstruation continues, but the nature of the discharge becomes unstable. This period is a preparatory stage for the completion of the functioning of the ovaries.
- Menopause. The shortest stage (when compared with other stages of menopause), which is characterized by the last menstruation. Doctors diagnose menopause after twelve months from the last menstrual period.
- Postmenopause. The final phase of menopause, in which menstrual flow is completely excluded. Most often occurs after 55 years of age, but earlier cases are possible. Allocate early (5 years without menstruation), late (10 years without menstruation) postmenopause.
It is worth remembering that menopause and postmenopause represent just a new inevitable period in life, for which not only can, but must be prepared. And for this you need to find out everything that will happen to the body at this time.
The main symptoms of the period
The onset of postmenopause does not have a specific time frame, so the main focus is on menstruation. Only with the complete cessation of menstruation (the absence of menstruation for about a year) can we talk about the final stage of menopause. But
there are other signs of postmenopause:
- dryness of the vagina,
- arterial hypertension,
- problems with the cardiovascular system,
- thinning of bone tissue,
- the appearance of excess weight,
- sudden mood swings
- tides,
- increased sweating,
- decreased libido,
- sagging breasts, loss of their shape,
- the skin loses its elasticity,
- wrinkles begin to appear sharply,
- (incontinence, the occurrence of corresponding diseases of the urethra),
- metabolism in the body is disturbed (affects not only the appearance, but also the work of organs),
- (insomnia).
The number and nature of symptoms depends on heredity and characteristics of the organism. It is impossible to get rid of all unpleasant symptoms, but inaction on the part of a woman can lead to the development of many pathologies, so it does not hurt to visit a doctor to find out the current state of health and choose the right drugs.
Diagnostics of the last stage of menopause
Postmenopause can start unexpectedly, but its main distinguishing feature is a decrease in the production of female sex hormones by the body. The results of laboratory studies will accurately tell about the onset of the postmenopausal period:
- FSH level. Lack of estrogen provokes an increased production of follicle-stimulating hormone (more than 20 mU / ml).
- Estradiol index. If before menopause the level of this hormone exceeds 35 pmol / l, then during premenopause this figure is much lower.
- LH content. Luteinizing hormone at this time is greatly increased, therefore, for postmenopausal women, its value exceeds 52 mU / ml (the normal limit in the reproductive age).
But it should be borne in mind that only if there are earlier analyzes, the doctor can compare the data to check the indicators. Therefore, there is no clear rate of hormones during this period. In the course of these studies, you will receive data, thanks to which the doctor will select the appropriate treatment, methods of dealing with unpleasant symptoms. In addition, additional examination may be required:
- general blood analysis,
- Organ ultrasound,
- checking bone density (densitometry),
- cytological examination,
- hysteroscopy.
Possible complications in postmenopausal women
Lack of body support and treatment for the signs of menopause can lead to various diseases, the manifestation of which is especially noticeable in the postmenopausal period. This could be:
- atherosclerosis,
- osteoporosis,
- diseases of the cardiovascular system,
- urinary tract infections
- problems with the nervous system;
- diseases complicated.
It can be concluded that the symptoms of menopause act as a kind of signal that the body needs support. All diseases are easier to prevent than to deal with their consequences later.
How to support the body during this period?
The most important thing that any woman should understand is that her health needs to be protected long before the onset of menopause. According to statistics, patients who have started hormone replacement therapy in advance, have improved their lifestyle, less likely to suffer from signs not only of apopause, but also of the postmenopausal period.
Important! You should not take any remedy if your body does not need it. For example, the drug Zoladex, although it reduces the production of FSH and LH, but its appointment suggests serious diseases, in which it is necessary to cause the so-called "artificial" menopause. Remember that Zoladex enhances hot flashes, mood swings, and it is necessary only in those cases when it is necessary to suppress the work of the ovaries (cancer, uterine fibroma, etc.).
- Systematic hospital visits. To prevent possible health problems and early detection of diseases.
- Balanced diet. You can not sit on strict diets, because the body needs a normal amount of all useful vitamins and minerals.
- Supplemental intake of vitamins (especially calcium and vitamin D). Eliminating the deficiency of nutrients has a beneficial effect on the production of estrogen.
- Active lifestyle. A woman's best friend at this time is fresh air and frequent walks in a pleasant atmosphere.
- The use of physiotherapy. This includes not only physiotherapy exercises, but also electrophoresis, essential oils, spa treatment.
- Use only products approved by your doctor. It makes no sense to inject Zoladex and other similar drugs if you do not have corresponding serious diseases.
If a woman began to take care of her health long before menopause, then the manifestation of postmenopausal symptoms may be insignificant.
Features of HRT
It must be remembered that at this age the female body does not need a large amount of hormones, so it makes no sense to take not only birth control pills, but also stronger means.
Important! hormone replacement therapy is selected according to the nature of the symptoms.
Surprisingly, some women practically do not suffer from the signs of menopause, when other representatives of the fair sex begin to notice the early ones by the age of 35.
Therefore, to begin with, we distinguish three groups of symptoms:
- Early (vasomotor, psychoemotional).
- Medium-term (urogenital, trophic skin changes).
- Late metabolic disorders.
Studying postmenopause, we can conclude that short-term hormone therapy is simply not enough. At this age, women are prescribed combined monophasic drugs in a continuous mode:
With a preserved uterus:
- Femoston (low-dose therapy - 1/5),
- Kliogest,
- Climodien,
- Livial Tibolon.
Important! Estrogen monotherapy is only suitable for women who have already had their uterus removed
With a removed uterus:
- Klimara,
- Ovestin,
- Estrogel,
- Dermestril,
- Premarin.
It should be noted that the funds can be produced in the form of tablets, plasters, gels and suppositories. And once again, let's pay attention to Zoladex, which is prescribed for breast cancer, uterine fibroids, for thinning of the endometrium, as well as for in vitro fertilization. In addition, Zoladex has a number of side effects, including metabolic disorders, depression and decreased libido.
Improving the condition of the nervous system and bones
Paying too much attention to HRT, we often forget about supporting our nervous system, which suffers especially in the postmenopausal period. Here sedatives will help:
- Gelara,
- Atarax,
- Cleophyte.
In addition, do not forget about the increase in bone density:
- Bonviva,
- Calcemin,
- Osteogenon,
- Aquadetrim.
Important! Only a doctor can tell how long the treatment with a particular drug lasts.
The benefits of taking phytoestrogens
If you cannot use hormonal drugs, then you can switch to phytoestrogens, which are the only alternative to HRT. In addition, they have no side effects and are absolutely safe for health.
But do not forget that you may have a banal allergy to some components of the drug, so be sure to consult with your doctor. Still natural hormones not only eliminate the symptoms of menopause, but also:
- lower pressure;
- protect against osteoporosis;
- block the accumulation of cholesterol in the blood,
- have a beneficial effect on the psychological and emotional state,
- slow down the aging of the body.
ethnoscience
It makes no sense to pay attention to Zolodex and other powerful drugs without reason, when nature is rich in useful substances. You can talk about for hours, so it is worth highlighting only the main groups (with the content of phytohormones):
- Isoflavones,
- Lignans,
- Kumestans.
In addition, the symptoms of menopause and postmenopause will help to cope with:
Mint and sage (hot flashes);
- Valerian root, St. John's wort, hops (natural soothing);
- Hawthorn and motherwort (lower blood pressure);
- Borage oil (relieves dry skin).
Ten Steps to Women's Health During Postmenopause
- We constantly monitor blood pressure (morning and evening).
- We systematically visit the gynecologist, make the necessary smears and undergo the prescribed examination.
- Be sure to do a mammogram, as well as constantly independently check the condition of the mammary glands.
- Get tested for diabetes and find out your cholesterol levels.
- Find out the condition of your bones.
- Constantly control your weight so as not to create unnecessary stress on the organs.
- Adhere to an active lifestyle (gymnastics, slow walking, swimming).
- Give up bad habits completely.
- Eliminate coffee and strong tea from the diet.
- Find a suitable hormone replacement therapy with your doctor.
Postmenopause occurs sooner or later in the life of every woman. You should not be afraid of this new period in life, you need to carefully prepare for it. In other words, the body is undergoing quite normal changes programmed by nature. And in order not to face unpleasant diseases, it is necessary to systematically pass tests and undergo an appropriate examination.
Taking care of your own health is the sure way to a happy and long life, where menopause is not a problem. Now you know what postmenopause is and its main symptoms, as well as how you need to support your body during this period of life.
Postmenopause is a period of time that begins when menstruation stops and lasts up to 65-69 years. Such a segment in life is also called. In the first three years of postmenopause, single follicles can still appear in the ovaries, but over time they completely disappear. So what is postmenopause and how to deal with it?
Postmenopausal problems
As a result of the lack of female hormones in the body in the postmenopausal period, a woman may develop serious disorders. They are usually divided into early, manifested even in the premenopausal period, middle and late. The average postmenopausal period begins 4 years after the cessation of menstruation and is characterized by:
- on the part of the skin and mucous membranes - dry skin, the appearance of wrinkles, increased fragility of hair and nails, dry mouth and respiratory tract;
- on the part of the vaginal mucosa - pain arising from sexual intercourse, frequent inflammation of the mucous membrane, dryness and general discomfort;
- urethral disorders - frequent urination, urine discharge when coughing, laughing, runny nose, frequent inflammation of the kidneys and bladder.
Late postmenopausal symptoms appear 6-7 years after menstruation has stopped. Such manifestations often include cardiovascular diseases. Not everyone knows that such a concept as postmenopause is interconnected with osteoporosis in women. During this period, the risk of developing this disease is quite high in women:
- fragile physique;
- have had fractures over the age of 50;
- smokers and alcohol abusers;
- with diseases of the thyroid gland, liver;
- leading a sedentary lifestyle.
If you fall into one of the risk groups, it is imperative, after the cessation of regular menstruation, no matter how long postmenopause lasts, to take preventive measures aimed at combating osteoporosis. Otherwise, after 5-7 years, 25-50% of the bone mass may be lost.
Treatment during postmenopause
Before starting the treatment of postmenopause, or rather the disorders that arise against its background, women are recommended to undergo examinations to identify all hormonal indicators, because they can fluctuate depending on the period of menopause. In postmenopausal women, the rate of hormones is 9.3-100.6 FSH, the rate of progesterone is less than 0.64, and the rate of LH in the blood is 14.2-52.3, with other indicators, an individual hormone replacement therapy must be prescribed by a gynecologist.
The main advice to every woman who feels that the postmenopausal period is not far off is to tune in to the fact that all hormonal changes in the body are the norm. Not to be nervous and not associate it with something negative, but to perceive it as a certain period of a new period of life, which has its own advantages.
Content
Postmenopause is the last stage of menopause. In the postmenopausal period, a woman's body functions without hormones synthesized by the ovaries. Understanding what is happening in the postmenopausal female body will help avoid various consequences.
Menopause and postmenopause
It is known that menopause is a long, multi-stage process in which the female reproductive function is gradually completed. As a result, physiological infertility develops due to the extinction of the production of sex hormones. Thus, the body functions under conditions of estrogen deficiency.
Contrary to popular belief, the symptoms of menopause are observed long before the complete cessation of menstrual function. The climax develops over many years. The onset and duration of menopause have individual characteristics.
Gynecologists distinguish the following phases of menopause:
- premenopause;
- menopause;
- postmenopause.
The ovaries begin preparing for the end of reproductive function at about 45 years of age. This age period is conventionally taken as the onset of menopause or premenopause. It is noteworthy that the ovaries still synthesize sex hormones. However, their number is reduced, which leads to menstrual dysfunction and the appearance of various symptoms.
After the end of the last menstruation, menopause is observed during the year, which is the shortest stage of menopause. In principle, menopause directly means the last menstruation, which is not considered a pathology. Since in premenopause there are long delays in menstruation, menopause is established only after twelve months after the last menstruation.
After menopause comes the final stage of menopause, which is called postmenopause. Gynecologists classify postmenopause as:
- early, flowing within the first five years;
- late, developing ten years without menstruation.
It should be borne in mind that any spotting during the postmenopausal period is excluded. This is due to the lack of ovarian function and endometrial changes. That is why spotting in any amount in postmenopausal women indicates a serious pathology.
Experts also distinguish perimenopause, which combines the first two stages of menopause. The division into phases is conventional. Establishing menopause directly is important.
Menopause usually begins at age 50. An insignificant percentage of healthy representatives have an early menopause before the age of 45. Some women report the onset of menopause after 55 years. Early menopause occurs in 3% of healthy women, while late menopause occurs in 5%. Often, early and late menopause is associated with pathology.
Physiological changes
The only reason for all changes in any phase of menopause is the cessation of the functioning of the ovaries. It is noteworthy that the functioning of the ovaries is almost static throughout the reproductive cycle. The exception is the periods of pregnancy and childbirth.
During the intrauterine formation of the ovaries, follicles are laid, which are spherical formations in the form of bubbles. Each follicle can become a source of a mature egg.
The ovaries usually function alternately during each menstrual cycle. During the cycle, several follicles begin active growth, while structurally changing. As a result, the follicles turn into a kind of hormonal gland that can produce hormones. Then, as a result of "natural selection", only one, the most viable follicle develops, which can ensure adequate functioning of the egg. The rest of the follicles are reduced until the end of maturation.
At the end of the first phase of the cycle, the follicle membrane breaks, which ensures the release of a mature egg outside the ovary. This process is called ovulation. If fertilization does not occur, the egg dies on the second day. The so-called luteal phase starts. In place of the elements remaining from the follicle, a corpus luteum is formed, which is a temporary hormonal structure. The corpus luteum produces progesterone and stops functioning before the onset of menstruation.
The functioning of the ovaries is controlled by the pituitary gland and hypothalamus. The maturation of the follicle and egg is provided by FSH produced by the pituitary gland. LH directly affects the corpus luteum.
The cyclic hormonal activity of the ovaries not only realizes the reproductive function, but also affects the entire body of a woman. Thus, the completion of the hormonal function of the ovaries causes, in addition to the occurrence of infertility, various symptoms associated with the adaptation of organs and systems.
Ovarian function does not suddenly stop. Nature has programmed a fairly long transition from a normal concentration of sex hormones to their complete absence. This transition usually takes about ten years.
Postmenopause is a kind of final stage of menopause, during which the maximum severity of all symptoms is noted. This is due to the complete absence of estrogen in the postmenopausal period. With the severity of symptoms in postmenopause, the patient is prescribed drugs. Often, treatment is carried out as part of symptomatic therapy.
The postmenopausal period is the longest in menopause and lasts until old age. Postmenopause is a natural stage in a woman's life, therefore, it cannot be considered a pathology. Healthy women usually enter postmenopause with good compensatory opportunities. While the presence of pronounced symptoms indicates compensatory dysfunction. This means that the body cannot adapt to changing conditions. Estrogen deficiency disrupts the work of the entire female body.
After the cessation of reproductive function the synthesis of estrogens has an extraglandular origin.
There are several important estrogens:
- estradiol;
- estrone;
- estriol.
A significant amount of these hormones is synthesized in the ovaries. The adrenal glands and adipose tissue can also produce these hormones. Estrogens have the ability to convert themselves. That is why the deficiency of one hormone can be replenished at the expense of another. For example, estradiol is converted to estrone. It is noteworthy that this so-called interconversion occurs in various tissues of the woman's body. The place where estrogen is utilized is the liver.
The normal amount of hormones in postmenopausal women has not been established. It is associated with changes in premenopause and menopause.
In menopause and postmenopausal period, there is an absence of follicles in the ovaries. This increases the concentration of FSH by 10-20 times. In turn, LH production increases by 3 times. In postmenopausal women, estrogen synthesis is carried out not by the ovaries, but by peripheral structures. The concentration of estradiol decreases and estrone increases. The ratio between androgens and estrogens also changes in favor of the former.
Symptoms and Causes
Extra-glandular estrogen sources continue to function several years after menopause. It is necessary to support the functioning of the vagina, uterus and mammary glands. In addition, the excretory, musculoskeletal and cardiovascular systems need estrogen. With a lack of hormones, pathological symptoms may appear.
The most famous symptom is hot flashes. In postmenopausal women, this symptom may persist. However, it is no longer so pronounced in the postmenopausal period. The following symptoms do not replace hot flashes:
- urogenital disorders;
- cardiovascular disorders;
- musculoskeletal changes.
Urogenital disorders
As a result of estrogen deficiency, mucosal atrophy develops. Thinning of the mucous membranes of the vagina and urethra leads to the loss of their protective properties. As a result, the mucous membranes become vulnerable to infection and trauma. There is also a decrease in the number of lactobacilli, which leads to the development of vaginal dysbiosis.
In postmenopausal women, vaginitis, urethritis and cystitis often occur. The inflammatory process in the urethra changes the function of the sphincters. This causes urinary incontinence and frequent urination.
Signs and symptoms of dysbiotic disorders are often detected in smears. Discharge in the postmenopausal period can be purulent or serous, have an unpleasant odor and be accompanied by itching. Against the background of nonspecific inflammation, spotting is sometimes observed. However, this symptom needs differential diagnosis.
Uterine bleeding in the early postmenopausal period may be due to hyperplasia and polyposis. In women over the age of 65, bleeding sometimes indicates a malignant tumor of the endometrium.
Change in skin condition
It is known that the necessary level of estrogen maintains the elasticity of the skin and helps to strengthen nails. In conditions of estrogen deficiency, the skin gradually becomes thinner, which leads to the formation of wrinkles. The nails become brittle, the hair gradually loses its elasticity and is prone to falling out.
Possible complications
In the late postmenopausal period, severe symptoms may appear.
Metabolic syndrome
Symptoms usually include hypertension, atherosclerosis, and impaired glucose utilization. Patients may be concerned about the following symptoms in postmenopausal women:
- increased heartbeat;
- attacks of angina pectoris;
- pressure surges.
Weight gain is often noted due to changes in lipid metabolism. That is why most postmenopausal women gain weight. If a woman's weight increases in the absence of changes in the diet, this may indicate metabolic disorders.
Neurological disorders
In the late menopausal period, neurological disorders are often observed. Estrogen deficiency provokes disorders associated with vision, hearing and memory.
Pathology of the musculoskeletal system
Adequate estrogen levels are the building blocks of bones. However, in the postmenopausal period, due to estrogen deficiency, muscle tone and bone structure change. Over time, symptoms of osteoporosis appear due to the fact that calcium ceases to accumulate in bone tissue. On the other hand, calcium begins to wash out of the bones, causing their fragility.
Postmenopausal women lose 3% of bone tissue annually. The danger of osteoporosis is that the pathology proceeds without symptoms until the first fractures appear. Particularly dangerous is a hip fracture, which leads to disability.
Weakening of manifestations
45% of postmenopausal women are asymptomatic. It is not possible to cure postmenopause, since this age period in a woman's life is not a pathology. Treatment in the postmenopausal period is used only to eliminate unwanted symptoms when the body is unable to adapt to estrogen deficiency.
Drug therapy
Both hormonal and non-hormonal drugs are used. In particular, agents are used that suppress excessive excitability of the emotional sphere and the autonomic system. B vitamins and antidepressants have a good effect.
To eliminate the symptoms of estrogen deficiency, Tibolone is used, which is considered a gestagenic drug. Tibolone has no effect on the endometrium, so there is no cyclic discharge. The drug prevents the development of osteoporosis.
Hormone therapy in the postmenopausal period is a subject of controversy on the part of specialists. It should be noted that hormone replacement therapy can alleviate postmenopausal symptoms in women, however, there is no anti-aging effect.
Hormone therapy in the postmenopausal period is prescribed only if there are strict indications. The use of hormonal drugs is possible only after a preliminary thorough examination. Many hormone therapy drugs have severe side effects and cannot be prescribed for some somatic diseases.
Phytoestrogens and folk methods
Phytoestrogens are an alternative to hormonal agents in the postmenopausal period. Unlike the latter, phytoestrogens act mildly, the development of side effects is rare. Gynecologists use various phytoestrogenic drugs to eliminate symptoms in postmenopausal women, in particular, Klimadinon, Klimaktoplan.
Many medicinal herbs have proven effective and have been recognized by traditional medicine. In particular, plants such as boar uterus, red brush and yarrow can be used to eliminate the pronounced symptoms of disorders from various organs and systems in the postmenopausal period.
Nutrition and exercise therapy
The severity of symptoms in the postmenopausal period often depends on the woman's lifestyle, her compliance with the work and rest regimen, and rejection of bad habits. Good eating habits and physical activity are essential.
In the postmenopausal period, metabolic processes slow down, which requires a review of the diet. It is advisable to consume as many vegetables and fruits as possible. Lean meat and sea fish are useful. The way food is prepared also affects a woman's well-being. Fatty, salty foods, smoked meats should be limited to the maximum in the postmenopausal period. Frequent consumption of confectionery products negatively affects the gastrointestinal tract, provoking stool disorders.
Adequate physical activity in the postmenopausal period prevents congestion in the small pelvis, helps to fight diseases of the musculoskeletal system. It is advisable to choose the types of physical activity in postmenopausal women after the examination. For example, abdominal tension exercises are contraindicated for uterine tumors.
Name: Perimenopausal period