Physiological periods of a woman’s life gynecology. Periods of a woman's life

N.V. Migileva, consultant doctor at Biolit LLC

Throughout her life, a woman must maintain her health, because only healthy woman can be beautiful and loved. Every age, every period of a woman’s life has its own characteristics. How to save women Health for life?

We often watch with affection how little girls play with dolls. With what pride they roll a toy stroller around the yard, with what tenderness and care they change clothes and put their pet to bed. Behind this simple activity lies not only a game, but also preparation of the child for the future. social role- the role of the mother.

Giving life is one of the most important purposes of a woman on Earth; without this, not only her own life, but the existence of entire countries is also threatened. Motherhood is a great happiness, but not all women get to experience it.

Recently, the demographic problem in our country has become very acute. It's no secret that the birth rate in Russia cannot exceed the death rate. Unfortunately, the number of women able to give birth to a child decreases from year to year. According to experts, the reason is not only economic instability, but also that women’s reproductive health is deteriorating. The incidence among newborn girls has increased 12 times. Gynecological diseases in three-year-old girls account for 3% (in the structure of diseases), and then increase exponentially by the age of 17, reaching 75%. Of these: 26% are deviations of sexual development (premature or delayed development); thirty % - inflammatory diseases; 45% - violations menstrual function. According to forecasts, by 2015 in Russia there will be 25% of infertile girls. That is, every fourth girl will not be able to conceive and carry a pregnancy to term!

GIVING LIFE IS ONE OF THE MOST IMPORTANT PURPOSE OF A WOMAN ON EARTH, WITHOUT THIS NOT ONLY HER OWN LIFE LOSES MEANING, BUT ALSO THE EXISTENCE OF ENTIRE COUNTRIES IS THREATENED

Various factors can contribute to the decline in reproductive health of modern children and adolescents. These include unfavorable ecology, natural and climatic conditions (in particular, in our region - short summer And Cold winter), eating disorders resulting in obesity or dystrophy, natural iodine deficiency, low motor activity, thoughtless adherence to fashion (tight trousers, short tops, synthetic fabrics, etc.). Wide spread of concern bad habits(smoking, alcohol and drug use) among adolescents and young women.

Thus, a decrease in the reproductive health of adolescents contributes to the formation of a vicious circle: sick girl - sick woman - sick mother - sick child. And so that the expectant mother can give birth healthy child, you need to take care of this from the first days of the girl’s birth. On the long journey of developing the reproductive health of a young creature, there are very important stages. This is the time when parents should take the girl’s health especially seriously.

In the sexual development of girls, several periods are distinguished: intrauterine, newborn, “neutral” (from 1 year to 7 years), prepubertal (from 8 years to the first menstruation), pubertal (from the first menstruation to 14 years) and adolescent (15-17 years). Each period has its own anatomical and physiological characteristics.

During the INTRAuterine period, the main components develop intensively and begin to function. reproductive system. The development of the female gonads in the fetus and the formation of the female genital organs are determined by the set of sex chromosomes formed after fertilization of the egg. Even before birth, a girl’s hormonal background is formed future woman and it is determined how many times she can become a mother, how many eggs (follicles) her body will produce and until what age the reproductive system will function properly. Already in the 8th week, a special structure of the brain is formed - the hypothalamic-pituitary system, which will subsequently regulate almost all work endocrine system, including the production of sex hormones. By the time a girl is born, 500-700 thousand eggs are laid in the ovaries. This first period of life is very important for the reproductive health of the future girl. Complications of pregnancy in the mother, such as the threat of miscarriage, fetal hypoxia, colds, the presence of somatic diseases, especially smoking and drinking alcohol during pregnancy, can have a negative impact on the correct formation of the genital organs and their subsequent full functioning in the baby.

MOTHERHOOD IS GREAT HAPPINESS, BUT NOT ALL WOMEN HAVE TO EXPERIENCE IT

The second period is NEWBORN (from birth to one year). A newborn girl has internal and external genitalia formed according to the female type. This first year of a girl’s life is important for proper hormonal development, despite the fact that the hormonal activity of the ovaries during this period is minimal. The fact is that the cellular apparatus of a girl’s ovary during this period loses up to 10% cells that are supposed to produce hormones. This is normal physiological process, but losses should not exceed the norm! The main factors that increase the death of hormone-producing cells include artificial feeding, frequent respiratory diseases and gastrointestinal tract, allergic conditions. In case of death large quantity ovarian tissue, hormonal deficiency occurs, which will then affect the further sexual development of the child. This can lead to delayed sexual development and subsequently affect the course of pregnancy, childbirth, and even infertility may develop. Therefore, it is very important to preserve ovarian cells expectant mother. To do this, you need to exclude unfavorable factors, i.e. the child should grow up healthy, go for walks more often fresh air, be breastfed, hardening and hygiene procedures, massage according to age. During this period, parents can be advised to strengthen the baby’s health with FLORENTA. FLORENTA - an extract of young shoots of fir legs - will help the child’s body not only quickly adapt to new living conditions, but also adequately resist infections and stress factors of the outside world. Aqueous extract fir contains a wide range of microelements and vitamin complexes, which is important for proper hematopoiesis and the formation of adequate immunity. Regular use of FLORENTA promotes the proper functioning of the central nervous system and the formation of adequate reflexes (remember that FLORENTA has proven its stabilizing effect on the nervous system in clinical studies in children with perinatal lesion CNS). Taking FLORENTA at such a tender age is calculated based on weight, 1 drop per 1 kg of child’s body weight per dose. This amount of extract is added to boiled water for drinking or in expressed breast milk.

MOMS AND GRANDMOTHERS SHOULD NOT ADVISE THEIR GIRLS TO “PATIENCE.” IT IS NECESSARY TO CONTACT A CHILDREN'S GYNECOLOGIST, SINCE PAINFUL MENSTRUATIONS CAN BE ONE OF THE SYMPTOMS OF SERIOUS GYNECOLOGICAL DISEASES.

PREPUBERTATE PERIOD (from 8 years to the first menstruation). In pediatric gynecology, puberty is considered as the 1st phase of puberty (1st phase of puberty). The prepubertal period begins with the development of secondary sexual characteristics and ends with the onset of the first menstruation (menarche). From the onset of secondary sexual characteristics to menarche, an average of 1-3 years pass. According to experts, for the start of menstruation, a girl must reach a minimum weight of 45-46 kg. By the time of puberty, approximately 250-300 thousand eggs remain in the girl’s ovaries. During this period, significant changes occur in the genital organs as a result of activation of the hypothalamic-pituitary region, ovaries and adrenal glands. The hormonal explosion causes rapid growth in the child, which can manifest itself as aching muscles and bones. To alleviate this condition, it is good to do a relaxing massage at night with FLORENTA cream or ARCTIC gel. During this period, secondary sexual characteristics begin to appear: enlarged mammary glands, pubic and armpit hair growth. The first changes in the figure appear: the hips are rounded, the growth of the pelvic bones begins. At this stage, the girl’s body is quite sensitive to the effects of various external factors (frequent colds, chronic tonsillitis, traumatic brain injuries, surgical interventions in the pelvis (appendectomy), violation of daily routine, etc.). The girl’s nutrition during this period should be complete, including the maximum range of vitamins and microelements. And here VITAMIX comes to the rescue again, which contains whey and fruit and berry extracts. It contains everything a growing body needs. Make sure that during this period the girl does not wear tight trousers, this can lead to improper growth and formation of the pelvic bones. Monitor the state of the immune system, gastrointestinal tract and other body systems.

PUBERTY - 2nd phase of puberty (from the first menstruation to 14 years). During this period, the central nervous system, which is involved in the formation and regulation of menstrual function, is labile and vulnerable. The maturation of hypothalamic structures is accelerated, and a close connection is formed between cells that secrete various hormones and control factors. Gradually established circadian rhythm hormone releases. The number of receptors for sex steroids in the cells of all organs of the reproductive system, including the hypothalamus and pituitary gland, increases. Their sensitivity to estrogen changes. In 20% of girls in the first 2 years of puberty, an ovulatory cycles. Regular menstruation in some girls is established only in the first 2 years of puberty. It is at this time that secondary sexual characteristics reach full development. By the end of puberty, the formation of a female-type physique ends as a result of the expansion of the pelvic bones and the development of subcutaneous fatty tissue. The timbre of the voice changes, psychological traits characteristic of a woman are formed (shyness, desire to be liked, increased interest in one’s appearance). For proper development the body needs to adhere to a daily routine, normal sleep at least nine hours, stay in the air for at least two hours, exercise physical exercise, maintaining personal hygiene and proper nutrition. It is during this period that one can notice any deviations in the development hormonal health girls. First of all, these are menstrual cycle disorders. For modern teenage girls, hypomenstrual syndrome is more typical, when the interval between menstruation increases, and their intensity and duration decrease. An extreme manifestation of this syndrome is amenorrhea: primary - in the absence of menstruation at 15-16 years of age, secondary - a delay in menstruation for 6 months or more. There is another problem faced young girls- This painful sensations during menstruation varying intensity: from aching discomfort in the lower abdomen to debilitating pain, accompanied by nausea, vomiting, and a pronounced decrease in performance. Mothers and grandmothers should not advise their girls to “be patient.” You need to contact pediatric gynecologist, since painful menstruation can be one of the symptoms of serious gynecological diseases. And after consultation, add to therapeutic measures reception of CLIMATON. Yes, yes... we were not mistaken. It's about about the phytocomplexes CLIMATON and CLIMATON-PLUS, which were originally developed to alleviate the symptoms of menopause in women. However, many years of experience in using and clinical observations proved that CLIMATONES containing hormone-like substances of the cuff herb (phytoestrogens). help normalize hormonal levels and even out the menstrual cycle in a growing body. Motherwort, which is part of CLIMATONES, will relieve tension and calm the nervous system, normalize vascular tone, and St. John's wort, being a natural antidepressant, will restore a joyful feeling of life. In addition, CLIMATON and CLIMATON-PLUS have anti-inflammatory and antispasmodic effects. Do not forget that CLIMATON-PLUS is intended for girls prone to hypotension, and CLIMATON - for those prone to hypertensive conditions. If a girl is worried about pain, swelling or discomfort due to the intensive growth of mammary tissue and the reaction to hormonal changes, you can use the MAMAVIT gel, which will relieve tension and pain, increase skin elasticity and normalize capillary blood flow in breast tissue. Of course, we should not forget about other systems. Needs to be supported correct work liver, since the processing of all sex hormones occurs in it, and here true friend and GEPATOSOL will become your assistant.

YOUTH PERIOD begins at the age of 15. There is a significant activation of the reproductive system both in the central (pituitary) and peripheral (ovaries) parts. The formation of the mature functioning of the reproductive system ends with the transition to ovulatory menstrual cycles. During this period, a stable hourly rhythm of hormone secretion is established, the formation of secondary sexual characteristics ends, a stereotype of menstrual function is formed, and the girl’s body becomes completely ready for pregnancy. Often young girls begin to worry about their overly rounded figures and begin to abuse diets. This is fraught with consequences. Severe weight loss can cause persistent menstrual irregularities, and sometimes a complete absence of menstruation. A girl's daily diet must include foods containing vitamin D, phosphorus and calcium. Correct calcium metabolism necessary for the formation of the pelvis, which, in turn, is very important for gestation and a successful birth. During this period, in addition to the above products, it is worth paying attention to the new products of the Biolit company from the marine series, namely CALCIUM-BIOLIT. Sufficient content of calcium and phosphorus with high bioavailability allows us to recommend this therapeutic and prophylactic agent for correct formation bone skeleton and ligamentous apparatus, as well as to improve the condition of skin, hair and nails.

WEIGHT LOSS CAN CAUSE PERSISTENT DISRUPTION OF THE MENSTRUAL CYCLE, AND SOMETIMES A COMPLETE ABSENCE OF MENSTRUATION.

A young woman enters PUBERTY, which lasts an average of 30-35 years. A woman's hormonal background is what largely determines her entire life. And the general hormone here is estrogen. If its amount in the body is normal, the woman will feel great and look much younger than her peers. With estrogen deficiency, a woman does not feel well and does not look too good. It would seem that in order to always feel good, one must strive to increase the amount of female hormones. However, this is a double-edged sword. On the one hand, a woman looks youthful beyond her years, on the other, an excess of estrogen leads to infertility, menstrual dysfunction, and the formation of tumor processes. Another female hormone, produced by the ovaries - progesterone - is responsible for mood stability, primarily in the second half of the menstrual cycle. If progesterone levels are low, women experience pain in the mammary glands and periods become painful. Such women are more susceptible to mood changes, depression, and irritability in the second phase of the menstrual cycle. If there is a lack of progesterone, pregnancy either does not occur or ends in miscarriage. Unfortunately, every year the question of hormonal disorders during middle age of a woman and - alas! - even youth. Disturbance in the production of estrogen in the body of a young woman can be due to many reasons: for example, serious diseases of the internal organs (liver, kidneys, thyroid gland, ovaries), prolonged sexual abstinence, severe or early birth, inflammatory processes in the reproductive system and simply severe stress. This disorder can manifest itself as chronic fatigue, apathy, depression, lack of sexual desire, obesity or, conversely, sudden weight loss, headaches, dry and sagging skin, painful periods, and the development of mastopathy. When there is a shortage of female sex hormones, they “take over” male hormones and the so-called hyperandrogenism develops, which manifests itself increased growth hair on the arms, legs, chest, back, the appearance of a mustache and beard, irregular periods, a tendency to acne.

Many women complain of premenstrual tension or premenstrual syndrome. PMS is not just irritability, bad mood or a tendency to tears, but a whole complex of symptoms such as headache, joint pain, allergic manifestations, absentmindedness, intolerance and aggression, the feeling that the whole world is against you, awkwardness in movements and a tendency to injury, weight gain, insomnia. About 70% women childbearing age are susceptible to PMS, and about 10% of them suffer from PDD (premenstrual dystrophic disorder).

And again CLIMATONS come to the rescue! With all these problems, CLIMATON and CLIMATON-PLUS in the composition complex therapy significantly alleviate the condition of women and contribute to a faster restoration of normal hormonal levels. A complex of herbal extracts of these products will help the body cope with stressful situation, quickly and adequately respond to changes in the external world and internal fluctuations. REISHI-KAN can become a good friend for a woman. The extract of the legendary Reishi mushroom has a powerful immunomodulatory effect, primarily restoring the body's antitumor shield. In conditions modern life this is very important - after all, according to statistics, more than 60% of modern women have neoplasms of the reproductive system (mastopathy, fibroids, cystic formations, etc.). REISHI-KAN normalizes the functions of the endocrine system (primarily the thyroid gland and gonads), restores blood pressure and tone of the heart muscle, protects the liver and improves kidney function. Reishi mushroom extract contains unique ubiquinones for their anti-aging effect, better known to us under the name coenzyme Q10! REISHI-KAN is a source of vitamins, micro- and macroelements, and also a source Have a good mood, excellent performance and good sleep! If a woman is diagnosed with diseases such as mastopathy or fibroids, the development of which is also associated with hormonal imbalance, “MAMAVIT” gel and TOXIDONT-MAI are added to the complex therapy. Their use is also justified for the prevention of these diseases. For several decades, Biolit products have been helping to protect women in the most active period her life.

Next comes a relatively short period - CLIMACTERIC. Its duration ranges from six months to 2-3 years. Then comes the time from the persistent disappearance of menstruation to 53-55 years, which is usually called menopause. And then, the woman enters the postmenopausal period. Menopause is not a pathology, not a disease requiring treatment. This is an absolutely physiological process, another “step” in a woman’s life. The process occurs over many years - menstrual and reproductive functions decrease and eventually disappear. At this time, a woman experiences severe hormonal changes. The consequence is changes in all organs female body. The most typical manifestations of menopause are “hot flashes,” which can appear after 40 years. In addition, menopause is accompanied by a mass unpleasant symptoms: headaches and dizziness, tremor (shaking), insomnia, chronic fatigue, as well as disorders of the nervous system, as a result of which a woman becomes irritable, whiny, and depressed. During this period, it is necessary to observe a work-rest regime, maintain physical activity, avoid stress. Today, the Biolit company has developed therapeutic and prophylactic agents that help, if not completely get rid of unwanted manifestations menopause, then significantly reduce them. These are all the same CLIMATONES! Precisely in order to color the autumn of a woman’s life with bright colors and add to it sun rays these two non-hormonal herbal remedies were developed. CLIMATON and CLIMATON-PLUS can significantly reduce, and with regular use, completely smooth out the neurovegetative manifestations of the menopause. It is during this period of life that a woman’s risk of developing hypertension, atherosclerosis, diabetes, thyroid and genitourinary diseases. To prevent osteoporosis, periodically use CALCIUM-BIOLIT. Be sure to remember about the therapeutic and prophylactic drug REISHI-KAN, which will prolong the youth of the body and cope with impending problems.

THE CLIMACTERIC PERIOD IS NOT A PATHOLOGY, NOT A DISEASE REQUIRING TREATMENT. THIS IS AN ABSOLUTELY PHYSIOLOGICAL PROCESS, ANOTHER “ONE STEP” IN A WOMAN’S LIFE.

Rehabilitation after inflammatory diseases of the female genital organs Antonina Ivanovna Shevchuk

2. AGE PERIODS OF A WOMAN’S LIFE

Having become familiar with the anatomical and physiological characteristics of the female genital organs at different age periods, it will be easier for you to understand many of the biological processes occurring in a woman’s body.

Age, functional features The reproductive system of a woman is closely dependent on a number of factors. First of all, the periods of a woman’s life are of great importance. It is customary to distinguish:

1) period intrauterine development;

2) the period of childhood (from birth to 9-10 years);

3) period of puberty (from 9-10 years to 13-14 years);

4) adolescence (from 14 to 18 years);

5) period of puberty, or childbearing (reproductive), age from 18 to 40 years; transition period, or premenopause (from 41 to 50 years);

6) the period of aging, or postmenopause (from the moment of permanent cessation of menstrual function).

During the prenatal period the formation, development and maturation of all organs and systems of the fetus, including the reproductive system, occurs. During this period, the formation and embryonic development of the ovaries occur, which are one of the most important links in the regulation of the function of the reproductive system of the female body after birth.

During prenatal period various factors (intoxication, acute and chronic infections, ionizing radiation, medications etc.) can have a damaging effect on the embryo or fetus. These factors can cause developmental defects various organs and systems, including the genitals. Such congenital abnormalities in the development of the genital organs can lead to disruption of the functions characteristic of the female body. Intrauterine developmental defects that arise under the influence of the factors listed above may be accompanied by damage to various parts of the regulation of the menstrual cycle. As a result, girls during puberty may experience various menstrual irregularities, and subsequently reproductive function.

During childhood There is relative rest of the reproductive system. Only during the first few days after the birth of a girl can she experience the so-called sexual crisis (bloody discharge from the vagina, engorgement of the mammary glands). This occurs under the influence of the cessation of the action of placental hormones, which occurs after childbirth. In childhood, there is a gradual growth of the organs of the reproductive system, however, the typical features for this age are preserved: the predominance of the size of the cervix over the size of the body of the uterus, convoluted the fallopian tubes, absence of mature follicles in the ovaries, etc. During childhood, there are no secondary sexual characteristics.

Puberty characterized by relatively rapid growth of the organs of the reproductive system and primarily the uterus (mainly its body). In a girl of this age, secondary sexual characteristics appear and develop: a female-type skeleton is formed (especially the pelvis), female-type fat is deposited, hair growth is noted first on the pubis, and then in the armpits. Most a clear sign The period of puberty is the onset of the first menstruation. For girls living in the middle zone, their first menstruation appears at the age of 11–13 years. Then, for about a year, menstruation may be irregular, and many periods occur without ovulation (the appearance of an egg). The onset and formation of menstrual function occurs under the influence of cyclic changes in the nervous system and glands internal secretion, namely the ovaries. Ovarian hormones have a corresponding effect on the uterine mucosa, causing characteristic cyclic changes in it, i.e. the menstrual cycle. Teenage years also known as transitional, since at this time there is a transition to the onset of puberty - the flourishing of the function of the organs of the female reproductive system.

Puberty period is the longest in a woman's life. Due to the regular maturation of follicles in the ovaries and ovulation (the release of an egg), as well as the subsequent development corpus luteum everything is created in the female body the necessary conditions for pregnancy. Regular cyclical changes occurring in the central nervous system, ovaries and uterus, which outwardly manifests itself in the form of regular menstruation, are the main indicator of the health of a woman of childbearing age.

Premenopausal period characterized by the transition from the state of puberty to the cessation of menstrual function and the onset of old age. During this period, women often develop various disorders of menstrual function, which may be caused by age-related disorders of the central mechanisms that regulate the function of the genital organs.

Aging period characterized by a complete cessation of menstruation and general aging of the female body.

The frequency of diseases of the genital organs in women is closely related to the age periods of their life. Thus, during childhood, inflammatory diseases of the external genitalia and vagina occur relatively often. During puberty, uterine bleeding and other menstrual dysfunction are common. During puberty, inflammatory diseases of the genital organs most often occur, as well as menstrual irregularities of various origins, genital cysts, and infertility. At the end of the childbearing period, the frequency of benign and malignant tumors of the genital organs increases. Less common during premenopause inflammatory processes genital organs, but the frequency of tumor processes and menstrual dysfunction (menopausal bleeding) increases significantly. During the postmenopausal period, prolapse and prolapse of the genital organs, as well as malignant tumors, occur more often than before. The age specificity of diseases of the female genital organs is mainly determined by the anatomical and physiological characteristics of the female body in individual periods life.

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Based biological features The female body is currently distinguished following periods woman's life:

• embryonic,
• childhood period,
• period of puberty,
• period of puberty,
• transitional (menopausal),
• postmenopausal (menopause),
• senile (senile).

Embryonic (prenatal or fetal) the period begins from the moment of conception until the full maturation of the fetus and its birth. An essential feature of the development of the female reproductive gland - the ovary - in ontogenesis is the bisexuality of its rudiment. The gland acquires gender-specific features as the sexual center of the nervous system differentiates. The acquired sexual identity remains persistent and does not disappear either after castration or during menopause. From the end of the eighth week of embryonic development, primary ovarian follicles appear in the ovary, after some time they turn into vesicular ovarian follicles and begin to function. The development of the fetal reproductive system is partly associated with the influence of maternal, predominantly placental, estrogenic hormones. Signs of their influence are revealed in the first weeks after birth.

Childhood period begins at birth and lasts until 10-11 years. In this period of life there is no functional difference between the female and male body. The period of childhood is characterized relative peace female reproductive system. A well-known exception is represented only by the first weeks of the newborn period, during which the influence of maternal estrogens on the genitals and mammary glands of the girl continues. In this regard, signs of a sexual crisis may appear - bloody discharge from the vagina, keratinization of the multilayered squamous epithelium vaginal mucosa, enlarged uterus, engorgement of the mammary glands with the release of colostrum. During the first week of life, estrogen saturation decreases and signs of sexual crisis reverse. The hormonal function of the children's ovary is extremely small. However, a small amount of estrogens (as well as androgens) is already detected in the girl’s body. The amount of androgens secreted by a girl is almost the same as that of boys. During this period, both estrogens and androgens in girls are formed in the ovaries and adrenal glands. From the age of 10, the release of estrogen increases significantly, and 1-1.5 years before the onset of menstruation, their release becomes cyclical. By this time, increased release of gonadotropic hormones begins. The release of androgens after ten years of age increases slightly and without much cyclicity. Girls' height in childhood more intense compared to boys. In this case, the ovaries enlarge, but their specific functions do not appear. The uterus is relatively small; the cervix is ​​longer and thicker than the body of the uterus. The fallopian tubes are relatively long, thin, and tortuous. The vagina and its vaults are short, narrow, the folding of the mucous membrane is well expressed, but the folds are mobile, easily smoothed out, and do not have elasticity, as in adults. The vagina in the small pelvis is located almost vertically and only with age it becomes at an acute angle to the horizontal plane of exit from the small pelvis. The epithelium of the vaginal mucosa does not contain enough glycogen, the reaction of the contents is slightly alkaline, which often contributes to the development of vaginitis. The external genitalia and mammary glands are formed, but not developed, and there is no pubic hair.

Puberty — puberty(from 10-11 to 16 years), associated with the growth and development of primary ovarian (primordial) follicles. During this period, the secretory function of the ovaries begins with the formation of estrogenic hormones. Under the influence of estrogenic hormones, secondary sexual characteristics develop, the uterus, ovaries, vagina, external genitalia, and mammary glands grow and develop; hair appears on the pubis and in the axillary fossae. An increase in the size of the pelvis and its formation according to the female type is accompanied by the development of the subcutaneous fat layer. The menstrual cycle is accompanied by monthly changes in the ovary (growth and development of follicles producing estrogen hormones, rupture of the vesicular ovarian follicle (Graafian vesicle) - ovulation and development of the corpus luteum secreting progesterone) and the uterine mucosa (phase of regeneration and proliferation of the endometrial epithelium, phase of secretion and phase of desquamation of the functional layer of the endometrium). The menstrual cycle is regulated by releasing hormones of the subcutaneous region and gonadotropic hormones (FSH, LH and LTG) of the pituitary gland, the function of which is closely related to all the endocrine glands of the woman’s body. During puberty, menstruation appears, i.e., the menstrual cycle is established. The start and end times of puberty are subject to individual fluctuations and also depend on climatic and living conditions. In the republics middle zone In our country, most girls begin menstruation at the age of twelve or thirteen. In the southern regions puberty begins and ends earlier than in the northern ones, but not earlier than ten years of age. Menstruation after 16-17 years is called delayed (menstruatio tarda). Delayed puberty is caused by chronic debilitating diseases, intoxication, overwork, poor nutrition, etc. Delayed sexual development is often a manifestation of general or sexual infantilism. Much less often, menstruation occurs before the age of 10 (6-8 years). This phenomenon is called premature menstruation (menstruatio praecox). Precocious puberty is observed more often with dysfunction of the hypothalamic-pituitary system, adrenal glands and ovaries (tumors), as well as with other pathological processes(hereditary diseases, metabolic disorders, etc.). During the 3rd period of puberty, final sexual differentiation occurs and a normal two-phase menstrual cycle is established. In girls with an asthenic constitution, menstruation begins earlier, with a picnic constitution - a little later. Most often, the first menstruation occurs during the winter months. Simultaneously with the formation of ovarian function during puberty, thyroid-stimulating and adrenocorticotropic influences on the development of the female reproductive system intensify. In this case, there is a friendly influence of the hormones of the thyroid gland and the cortex of the adrenal glands, which have common mechanisms of central regulation with the ovaries. By the end of this period, all organs and systems of the female body reach functional maturity and the woman’s body is capable of reproductive function.

Puberty period begins at 18 and lasts until 45-47 years. At puberty they reach maximum activity all specific functions of the female body aimed at childbirth. Puberty period - childbearing, active life period. The most significant characteristic of the state of the reproductive system is the presence of a two-phase menstrual cycle and correct rhythm menstruation

Transitional (menopausal) period occurs at the age of 45-47 years and lasts 2-3 years. During this period, the maturation of follicles and the intrasecretory function of the ovaries gradually fades away: the woman enters a new period of life - the period of physiological cessation of menstrual function. At that time average duration the menstrual cycle increases and the frequency of defective biphasic and anovulatory cycles increases. There are two stages in the menopause: the stage of climacteric changes and the stage of menopause. The stage of menopausal changes lasts from 2 to 3 years. Changes in menstrual function at this stage occur according to the hypoestrogenic type, with rare and more scanty bleeding. The main features of ovarian function are a gradual transition to a single-phase cycle and disruption of the menstrual rhythm. Subsequently, menstrual function ceases and the second stage of the menopause begins - menopause. The time of onset of menopause is individual and varies within a fairly wide range (46-50 years). The basis for identifying the second stage was numerous observations indicating the continuing hormone-producing function of the ovaries for several years after menopause.

Menopause on average lasts from 2 to 5 years after the cessation of menstrual function. Thus, menopause- this is a period characterized by the reverse development of the female reproductive system - involution with the gradual cessation of the menstrual and then the hormone-producing function of the ovaries.

Menopause can occur physiologically and pathologically. The physiological menopause passes without any painful disturbances, menstruation becomes scanty and rare and, finally, stops altogether. Pathological menopause is often very difficult and is expressed by a disorder of menstrual function in the form of acyclic uterine bleeding and angioneuroses resulting from dysfunction of the endocrine, nervous and vascular systems. Menopausal angioneurosis is manifested by increased excitability, dizziness, rush of blood to the vessels of the head, sudden sensation of heat, fluctuations blood pressure and others. Violations of the transition period in mild form, as a rule, are observed during physiological menopause. This is due to the weakening of nervous (mainly inhibitory) processes and age-related restructuring of the gonadotropic function of the subtubercular region and pituitary gland, leading to disruption of cyclic processes in the ovaries, as well as to the cessation of menstrual function. In the normal state of the female body after the cessation of menstruation sexual desire is preserved for a long time due to the fact that the body contains sufficient quantity estrogen and other hormones. Working capacity is not reduced. Aging occurs significantly later than onset menopause. When pathological condition female reproductive system or any common diseases In the body, the onset and duration of menopause are different. With fibromyoma and adenomyosis of the uterus, menopause occurs at more late age(after 55 years). This condition is called late menopause (climax tarda). Cases of early menopause (climax praecox) at the age of 40 years and earlier are less common. Early menopause usually associated with severe infectious diseases, infantilism, mental trauma, malnutrition, tumors of the central nervous system. The postmenopausal period (menopause) lasts from 47-50 to 57-59 years. General and local changes appear in the body. General changes are expressed in the visible aging of the body: a tendency towards obesity, the appearance of wrinkles on the face, a decrease in libido; local - in the gradual atrophy of the uterus and mammary glands, cessation of menstruation. Ovarian function fades gradually. Atrophy of the genital organs is observed much later than the cessation of menstruation.

Senile (senile) period— the last period of a woman’s life lasts from 59-60 years until the end of her life. This period is characterized by general senile changes throughout the body and decreased ability to work. The genital organs atrophy: the uterus and fallopian tubes become sharply smaller, the ovaries shrink and thicken, the vagina narrows, its mucous membrane becomes thin, easily vulnerable, and its folding disappears. Senile colpitis often develops. Atrophy also extends to the external genitalia: the subcutaneous fat layer becomes flabby, pubic hair thins, becomes short and thin. Thus, the senile period is characterized by physiological rest of the reproductive system and age-related hypotrophy of the genital organs. Signs of estrogenic influences often found in older women are, obviously, the fact of excretion steroid hormones adrenal cortex or development of an ovarian tumor.

In the specialized medical literature, there are reports of pregnancy in a six-year-old girl with premature sexual development and in a 113-year-old woman, who was apparently distinguished by the special preservation and activity of the endocrine system.

Of course, such cases belong to the category of casuistic, that is, exceptional, falling out of social patterns. But even within the limits of the laws, individual fluctuations are very large, and therefore it is impossible to say with absolute accuracy from what age and ending with what age a woman is able to become pregnant and give birth to a child.

There are six periods in the development of the female body. This is the period of childhood (up to 8 years), the period preceding puberty (prepubertal - 8-11 years); period of puberty (puberty – 12-18 years); childbearing (reproductive – 19-45 years); transitional (menopause 45-55 years): period of withering (postmenopause - after 55 years).
Their change is determined by the changes that occur in the gonads, in the cerebral cortex, its subcortical structures (hypothalamus), and in the leading endocrine gland - the pituitary gland.

The female sex glands are the ovaries. An egg matures in them, capable of merging with a male reproductive cell - a sperm - to give rise to a new life. But the maturation of the egg occurs only if there is a clear interaction between the functions of the ovary and the mechanisms that regulate its activity. In its most general form, it goes like this: the hypothalamus produces hormones that stimulate the pituitary gland, and pituitary hormones awaken the activity of the ovaries.

In the first years of a girl's life, the regulatory systems and especially the ovaries are almost inactive. This period is rightly called “rest of the reproductive system.” Only within a few days after the birth of a girl, under the influence of placental and maternal hormones, she may develop the phenomenon of the so-called sexual crisis (bloody discharge from the vagina, engorgement of the mammary glands).

Only in the prepubertal period does the formation of the complex system hypothalamus - pituitary gland - ovaries begin. For some time, her activities proceed chaotically, with many disruptions and dissonances. The reproductive cell, as a rule, does not yet mature, but under the influence of hormones produced by the pituitary gland and ovaries, signs of puberty appear - a female physique is formed, and the mammary glands develop. From 11 to 15 years of age, girls experience a period rapid growth, it seems to “stretch out”, from 15 to 19 years the processes of fatty tissue deposition predominate; The girl doesn’t stretch out so much as she gets fatter and takes shape.

From the moment the first menstruation appears, and this can happen from 11 to 16 years, puberty begins (that is, the period of puberty). Now a clearer relationship is being established between the hypothalamus, pituitary gland and ovaries. Menstruation gradually becomes regular. The time of onset and course of puberty is influenced by external and internal factors. Internal factors include hereditary and constitutional factors, health status and body weight; to external – climatic (illumination, geographical location, altitude), nature of nutrition (content of proteins, vitamins, fats, carbohydrates, microelements in food).

The normal menstrual cycle has two phases. The first is characterized by the maturation of the egg and its release from the ovary - ovulation; in the second phase, if fertilization does not occur, the ovaries and uterus return to their original state. Such cycles are called ovulatory. In girls during puberty, they alternate with anovulatory periods, when there is menstruation, but the egg does not mature.
By the way, healthy women of childbearing age also experience anovulatory cycles for some time after childbirth or abortion.
If a girl has already started menstruating and the egg matures at least occasionally, then pregnancy is possible. And yet, the female body is finally formed only by the age of 17-18, and then pregnancy and childbirth become within its capabilities. It is conventionally believed that by this time the period of puberty ends.

However, the most favorable first pregnancy and first birth occur between the ages of 19 and 29 years, and repeat ones - up to 40 years. During this age period, women in labor experience fewer complications, which means that children are born healthier and stronger.
This does not mean that it is absolutely impossible to give birth for the first time after 29 years or again after 40. But in such cases, a preliminary consultation with a doctor and especially careful observation during pregnancy, and often advance hospitalization for childbirth, are necessary.

The period of flowering of the female body lasts up to 45 years. Then, and sometimes much earlier or later, a transitional stage begins when the relationship between the pituitary gland and the ovaries is again disrupted. The ovaries produce less hormones, decrease in size, and the uterus also decreases in size. Menstruation becomes irregular, ovulatory cycles alternate with anovulatory ones.
A delay in menstruation during this period is most often one of the signs of the onset of menopause. But it can also mean the beginning of pregnancy. Of course, the older the woman, the less likely the egg is to mature. However, this possibility cannot be completely ruled out.

I would like to remind you once again: menstrual irregularities at any age are a reason to immediately consult a doctor!

Being late may result in serious complications. After all, it is known that termination of pregnancy after 12 weeks is unsafe, and at such a time it is done only for special medical reasons. But it’s not easy to decide to give birth at this age, and is it worth it?

Pregnancy in a woman who has passed this age period is fraught with complications - after all, activity of cardio-vascular system and the function of the liver and kidneys is no longer as perfect as in younger years. In addition, tissues lose their elasticity, labor weakness develops more often, and expulsion of the fetus becomes more difficult.
Of course, they will always be on guard and will provide necessary help. But all their efforts will not bring complete success if the child suffered in the prenatal period. It has been noticed that older parents (this means not only the mother, but also the father) have an increased risk of having a child with various developmental defects. And therefore, when deciding to have a later child, first consult with an obstetrician-gynecologist and a medical genetic consultation specialist.

People often ask: how long should you protect yourself? It seems that the answer follows from all of the above: until persistent menopause has occurred, that is, there has been no menstruation for at least a year.

I wouldn’t want, of course, for the decline of reproductive function to be perceived as a decline of the body in general. No, that's a long way off! A woman even during menopause is still full of strength, energy, and attractiveness. It must be said that sexologists believe that prolongation intimate life at this age it helps to prolong the activity of the endocrine system and maintain general tone.

Sevostyanova Oksana Sergeevna