Menopausal syndrome

Description:

The menopausal syndrome is a symptom complex which develops in the period of age fading of function of reproductive system and is characterized by neurovegetative, exchange and endocrine and psychoemotional frustration of various degree of intensity and duration. Clinical manifestations of a menopausal syndrome are quite often interconnected and can be caused by various diseases of awkward age. The general frequency of a menopausal syndrome varies from 40% to 80%.

The menopausal syndrome can be shown in relation to time of the termination of periods (menopause) with various frequency: in the premenopauzalny period at 36% - 40% of patients, at once with approach of a menopause – from 39% to 85%, during 1 year after a menopause – at 26%, in 2–5 years after a menopause — at 3%.

Symptoms of the Menopausal syndrome:

Clinical manifestations of a menopausal syndrome can conditionally be divided into three groups: neurovegetative, exchange and endocrine and psychoemotional. In most cases the first signs of a menopausal syndrome arise in a direct connection with the termination of periods (menopause) or in the first year after a menopause. Often the beginning of a disease is preceded by stressful situations of various character. The phenomena of a menopausal syndrome quite often have wavy and seasonal nature in spring (February — March) or autumn (September — October) time.

Are most typical (90% - 98%) for a clinical picture of a menopausal syndrome inflows of heat to a face, the head and an upper half of a trunk which proceed of 30 sec. up to 1–2 min. The increased perspiration accompanies heat inflows more than in 80% of observations. These phenomena can be provoked by any irritants, including an emotional stress, change of meteoconditions and so forth. The heat inflows characteristic at a menopausal syndrome are caused by disturbances of process of thermal control from the central nervous system and 5 °C, expansion of peripheral vessels, increase of serdtsebiyeniye up to 130 blows/min. and more are characterized by increase in skin temperature on all body surface on ~.

Despite variety of separate clinical manifestations of a menopausal syndrome, in a clinical picture of a disease the main place is taken by neurovegetative manifestations.

The following vegetative frustration are characteristic of many patients with a menopausal syndrome: emergence of red spots on a neck and a breast ("a vascular necklace"); frequent attacks of the expressed headache; decrease or increase in the arterial pressure (AP); krizovy course of a hypertension; cardiopalmus; attacks with pronounced psychoemotional coloring.

At 66% of women after the first 0,5 - 2 after a menopause episodes of acute increase in the ABP which arise both at rest, and in an active state are observed, and sometimes provoked also by contagious excitation. In intervals between these episodes indicators of the ABP remain in normal limits. In some cases the fluctuations of the ABP at patients with a menopausal syndrome which are going beyond norm represent the first clinical manifestations proceeding before is reserved an idiopathic hypertensia.

Among the complaints shown by patients with a menopausal syndrome, the special place belongs to cardiovascular symptoms in this connection quite often there is a need of an exception of stenocardia and myocardial infarction. Emergence of pains in heart at a menopausal syndrome is caused by hypersensitivity of cardiovascular system to usual irritants in connection with disturbances of exchange processes in a cardiac muscle. Almost in 1/3 observations the climacteric cardiopathy is combined with initial stages of coronary heart disease.

As a result of change of an immune responsiveness after a menopause the clinic of a menopausal syndrome can be shown in a look: small tortoiseshells, hypostases on a face, vasculomotor rhinitis, intolerance of a number of the foodstuff, attacks of bronchial asthma resistant to traditional therapy.

In emergence of exchange and endocrine disturbances an important role is played as the general change of exchange processes, and the increased reaction of some bodies and fabrics to age decrease in level of estrogen.

Carry to urogenital symptoms: dystrophic changes of a vulva, inflammation of walls of a vagina, cystalgia. Atrophic changes of an urinogenital path are noted at 80% of women in 4–5 years after approach of a menopause. At urogenital frustration the itch, bleedings or a dispareuniya, the repeating vulval infections, a painful and involuntary urination and so forth are noted. Loss of a tone of the supporting ligaments and muscles can lead to omission and a falling of the vagina and a uterus.

Not only the urinogenital system, but also mammary glands, skin, hair and nails belong to estrogenzavisimy fabrics. All of them are subject to the atrophy caused by decrease in content of collagen in the period of a menopause. Along with it skin thickness decreases, its elasticity decreases and blood circulation in skin capillaries owing to deficit of estrogen is slowed down. At 15% of patients with a menopausal syndrome with approach of a menopause are noted: "dry" conjunctivitis, laryngitis, dryness in a mouth. Quite often there are problems using a kontaktna of lenses. At some women with a menopausal syndrome growth of hair in the person and decrease in a timbre of a voice can be noted. In a climacteric also certain changes of body weight are observed: reduction at 16%; increase at 40%; lack of changes of body weight at 44%.

Osteoporosis in the post-menopausal period is also a consequence of deficit of estrogen. In some cases patients with a menopausal syndrome are disturbed also: night pains in extremities sometimes are followed by a cryesthesia; defeats of a rachis as arthrosis with the degeneration phenomena; skin paresthesias.

In a climacteric tendency to increase in activity of coagulant system of blood is noted. At the expense of it the risk of development of tromboembolic episodes against the background of various provocative factors (injuries, operative measures, infections, liver diseases, etc.) increases.

Among psychoemotional frustration at patients at a menopausal syndrome are noted: emotional and mental disturbances; decrease in memory and attention; deterioration in working capacity; irritability; emotional instability. Allocate several options of a form of behavior at a menopausal syndrome: indifferent behavior; adaptation; active overcoming; neurotic behavior. At 13% of patients neurotic frustration which are shown by tearfulness, an irritability attack, feeling of fear, alarm, intolerance of sound and olfactory irritants are noted. At the same time considerable impact on behavior of the woman is exerted by perception of a climax by her as sign of aging, end of specific biological function of a female body. At 10% of patients the depression which is one of the heaviest and hardly the symptoms which are giving in to treatment found at a menopausal syndrome is observed.

Reasons of the Menopausal syndrome:

The menopausal syndrome results from age fluctuation of level of estrogen, but not their absolute deficit. On the other hand – the menopausal syndrome is result of consecutive development of age changes in certain centers of a hypothalamus.

Treatment of the Menopausal syndrome:

Stages of treatment of patients with a menopausal syndrome 1) non-drug therapy, 2) special medicamentous non-hormonal therapy 3) hormonal therapy. 1) non-drug therapy (a polyclinic stage) is important psychoprophylactic training of each woman for a transition period. It is reasonable to use special complexes of physiotherapy exercises. The general massage, walks before going to bed also promote improvement of health of patients. In awkward age control of body weight is especially necessary systematic. In a food allowance fruit and vegetables, fats of a plant origin have to prevail. It is necessary to limit consumption of carbohydrates. In the course of regulation of a dietary regimen inclusion in a diet of vitamin drugs is recommended. The natural vitamin deficiency during the period a klimakteriya can be covered by periodic purpose of special vitamin complexes. Use of vitamins "A", "E" and "C" is especially reasonable. For regulation of hormonal balance, completion of a vitamin deficiency and mineral substances during the periods pre-and postmenopauses are specially offered the drugs containing a complex of vitamins macro - and microelements: Менопейс. For prevention and therapy of osteoporosis at a menopausal syndrome drugs of calcium and complexes of minerals - Osteokea are recommended. 2) special medicamentous non-hormonal therapy (polyclinic stage).