Sometimes a woman’s life is compared to the seasons. Youth – spring, maturity – summer … Women also have their own autumn, when there is no longer that brightness of colors as before, but their own special beauty and mystery appear … The onset of such an “autumn” is associated with changes in the body that occur during this period of life women and are called menopausal.
Menopause means the completion of a woman’s reproductive ability, that is, the loss of the ability to conceive and bear a child.
The famous scientist V.M. Dilman referred it to the “normal diseases of aging”. That is, menopause is a normal and inevitable period in a woman’s life, during which, against the background of various changes in her body, the processes of extinction in the reproductive system play a dominant role. The average age of the onset of such transformations in the body of women is 48-52 years.
The climacteric period is conventionally divided into several stages:
The first symptoms of menopause are usually menstrual irregularities. Menstruation becomes shorter and scarce, and the cycle itself lengthens. Perhaps the “loss” of menstruation, that is, the absence of bloody discharge in any month. These cycle disorders usually appear at the age of 44-45 years, that is, they can be 4-5 years before menopause.
Time of onset The same menopause itself is determined by various factors, such as:
So, for example, if a woman’s mother, sisters and other blood relatives of a woman’s periods “ended” early, then with a high probability we can say that her menopause will also begin earlier than other women. In addition, women who smoke and nulliparous women are susceptible to the early onset of menopause. Let’s try to figure it out –
What happens in a woman’s body during menopause?
Of course, at this time, various transformations in the organs of the reproductive system come to the fore. Not only the work (function) performed by them changes, but also the anatomical structure itself. The mass and volume of the ovaries decreases, which gradually wrinkle due to the development of the connective tissue. Similar processes occur in the uterus, already in the first year of menopause, it decreases in length and width by 1 cm. The vaginal epithelium becomes thinner.
It’s no secret that these transformations are the result of changes in the hormonal background of a woman and, mainly, due to the aging of the ovaries.
How and why this happens is not yet fully understood by scientists. But there is still some knowledge about it.
It is known that the ovaries begin to obey the “orders” of the brain worse – the main center that regulates their work. This is due to a decrease in the number of receptors in them – special structures that evaluate the environment, capturing various information (mainly regarding the concentration of certain hormones) and thereby regulate the work of the ovaries. For each type of brain signal, there is a special type of receptor on the ovaries.
Gradually, the number of follicles in the ovaries decreases, they no longer receive full development, and therefore, the release of the egg (ovulation) occurs less and less. Already five years after the onset of menopause, only single follicles are found in the ovaries. In this regard, the synthesis of estrogen in the ovaries also decreases. Only in very small quantities, these hormones are obtained by converting androgens, which are synthesized by the woman’s adrenal glands and a little by ovarian cells. The process of formation of estrogens from androgens occurs in adipose tissue, which is why lean women sometimes have an increased risk of various complications due to a lack of estrogens (for example, bone fractures).
The role of estrogens in the female body is huge and multifaceted. In particular, they improve the blood supply to the uterus and promote the growth of the endometrium (internal uterine lining), increase libido, and are also actively involved in a wide variety of processes in the body as a whole. They make the skin beautiful and elastic, provide bone strength. Estrogens also affect the functioning of the heart, blood vessels, brain and other organs.
It is precisely with the lack of estrogens in menopause and postmenopause that the appearance of those negative symptoms and complaints that women associate with the word “menopause” is associated, and in medicine they are known as “menopausal syndrome”.
Deficiency of sex hormones can be the cause of such pathological conditions as:
Usually they follow each other in the specified sequence at the age of 50-70 years. Only the severity of their manifestations in different women can be different. Let’s talk a little about each of these states.
It includes the so-called vasomotor signs:
and emotional mental:
Climacteric syndrome is observed in 50-60% of women aged 45-55 years. The most constant are hot flashes, sometimes more than 20 times a day. Usually the frequency of occurrence of such complaints is determined by the state of health of the woman as a whole, the presence of chronic diseases and their severity.
With pronounced manifestations of menopausal syndrome, treatment is required: vitamins, diet, changes in motor activity, hormone therapy.
Genitourinary disorders:
Similar violations occur in almost every third woman. Usually they appear at the age of 55-60 years, and after 75 years their frequency reaches 80%.
These complaints are also due to a lack of estrogen, as a result of which so-called “atrophic” changes occur in the organs of the reproductive and urinary systems. In other words, the trophism of these organs is disturbed – their nutrition.
This manifests itself in the form of thinning of the vaginal mucosa, a decrease in its folding, and the formation of microcracks. As a result, even with the slightest injury (sexual intercourse, defecation, etc.), the vaginal mucosa is easily damaged and bleeds.
The composition of the normal microflora of the vagina, which usually provides protection against pathogens, also changes. As a result, at this age, women are more susceptible to various inflammatory processes in the vagina.
The treatment of such disorders is selected in each case based on the severity of the disorders and the health status of the woman as a whole. Sometimes doctors again decide on the appointment of hormone therapy.
that is, a decrease in bone density. It is known that The bone tissue reaches its highest density by the age of 30-35, and then there is a gradual decrease in its density by 0.1-1% per year. This process takes place both in women and men and does not depend on nationality or race, on profession, on the wealth of the family and the geographical area of \u200b\u200bits residence, as well as on sports. It is a universal phenomenon of human biology.
But after the onset of menopause in women, especially in the first five years, this process accelerates dramatically, and by the age of 70, almost half of the bone mass is lost.
Some women lose bone density faster than others due to their constitution and race.
In addition, it is known that Bone loss is also affected by factors such as:
If we compare the number of fractures in men and women at this particular age, then in women they occur 4 times more often, which is again due to a change in their hormonal levels.
Sometimes osteoporosis in menopause and postmenopause is called a “silent epidemic”, because the process of bone loss can take a very long time or not manifest itself at all, or complaints such as weakness, fatigue, aching pain in the sacrum and lower back, and a stoop are formed. (“widow’s hump”). Often there is a desire to lie down, relax during the day. Such women are treated for a long time and unsuccessfully for radiculitis and osteochondrosis. And the correct diagnosis is made by them only when a fracture occurs, which is already referred to as a late manifestation of the disease.
Treatment of osteoporosis at this age is a very complex and long process, sometimes not allowing to achieve the desired result. This pathology refers to those diseases that are easier to prevent than to treat …
Preventive measures to slow down the process of bone loss long before the onset of menopause are:
a complex violation of metabolic processes in the body, which ultimately leads to damage to the heart and blood vessels. Atherosclerosis is one of the causes of coronary heart disease (CHD) and vascular lesions (including cerebral vessels). Such lesions of the heart and blood vessels occupy a leading place among the causes of mortality in our country, ahead of even tumor processes.
In recent years, a clear relationship has been established between the occurrence of cardiovascular diseases caused by atherosclerosis and estrogen deficiency. And if before the onset of menopause, coronary heart disease and atherosclerotic vascular lesions are mainly the lot of men, then after the onset of menopause, the frequency of such lesions in women and men is approximately the same.
The development of this disease is directly related to the content of cholesterol and certain types of blood lipids, which are deposited in the form of “plaques” inside the vessels, blocking their lumen. Estrogens are able to keep the concentration of such substances at a certain level, preventing vascular damage. After menopause, when there is a lack of these hormones, the risk of atherosclerosis increases dramatically.
The treatment of this disease is also complex and no less complicated. As with other manifestations of the menopausal syndrome, sometimes doctors have to prescribe hormone replacement therapy to increase the amount of estrogen in a woman’s body after menopause.
But the very appointment of female sex hormones with a substitution purpose is also a difficult issue, which is decided in each case individually. Hormone therapy has its indications and contraindications. In some cases, it gives a strikingly good result, and in other situations, its appointment can be dangerous for a woman’s life. That is why only a specialist should deal with the treatment of such conditions.
These are just some of the manifestations of the female menopause. But, one way or another, with the help of hormones or thanks only to the intake of vitamins and nutrition correction, it is possible to achieve that all the above problems and discomfort will not cause ill health and will not overshadow the special beauty and charm of the female “autumn”.
Elena VYSOTSKA,
gynecologist
