** Interestingly, at the beginning of premenopause, progesterone deficiency is especially pronounced, and not estrogen. And by the time of menopause, progesterone is formed in very low doses, and estrogen is only half as much as in childbearing age.

Hormonal background each woman is very susceptible to environmental factors, emotional state and various diseases, so the level of hormones in the same woman is variable.

When to take a blood test for sex hormones?

An analysis for sex hormones in the premenopausal period, that is, with saved menstruation, must be taken at certain periods of the menstrual cycle, accurately indicating the day from its beginning. Usually, FSH and LH are recommended to be taken on the 3-5th day from the onset of menstruation, and estradiol and progesterone on the 21st day. After the onset of menopause, the analysis can be taken any day.

Preparing for a blood test for sex hormones:

• the analysis is given strictly in the morning on an empty stomach, in the evening a light dinner;
• before the analysis, you should stop taking alcohol, coffee and drugs, do not smoke;
• when taking contraceptives, the results are adjusted taking into account their doses;
• the day before blood donation, it is recommended to give up sex and heavy physical exertion;
• before donating blood, you must completely relax, sit quietly for at least 10 minutes.

Ultrasound examination for menopause

With the advent of menopause, women's health problems often come. These are, first of all, various tumor-like formations, both benign and malignant. It is for their detection and observation that ultrasound diagnostics of the pelvic organs is necessary, and annually. In addition, ultrasound helps to diagnose the onset of menopause and determines the possibility of late pregnancy.

Ultrasound signs of the upcoming menopause:

• Ultrasound can detect the presence or absence of follicles in the ovary and their number. The closer to menopause, the fewer follicles, and the less chance of getting pregnant. After menopause, the follicles in the ovaries are not determined.
• The ovaries gradually decrease in size , they lose their echogenicity. After menopause, they may not be detected at all.
• The uterus is shrinking , becomes denser, small fibroids can be observed, which after menopause most often resolve on their own. The location of the uterus in the small pelvis also changes, it shifts somewhat.
Uterine fibroids and its treatment with ultrasound therapy
• Life after menopause - what is it like? Sex and sexual relations. Is it possible to get pregnant with menopause? Nutrition advice for women before and after menopause. Do men have menopause?

Hello, dear readers of the blog site.
The topic of premenopause, menopause, menopause, the fading of a woman's fertility after 45-50 years is quite unpleasant for many. We do not know how to live after 45 years.

Many roads in society are closed to a woman at this age. We see around elderly unrealized women who have problems in the family, with children, with health, with money, with a profession and work. Watching this, young women do not know where to grow old, where to go, what is the essence of older age.

Therefore, many women "cling" to menstruation, become pregnant and give birth after 40-45 years, as if going to the "second round". If only not these terrible words - "menopause" and "menopause".

Everything in the world is cyclical. Periods of the day, year, life are natural. And in the psyche of a woman, all her stages are always present. Girl, Girl, Woman and Old Woman, like the four phases of the moon, are in us at any age. It is important to know them, to own their qualities.

The ability to have children disappears with age. A woman can see the first signs of a decrease in fertility in herself quite early. This can be, for example, if she has a lot of stress, had abortions, if she took hormonal contraceptives, she is in poor health, etc.

Natural Family Planning and Fertility Recognition Methods provide an opportunity to prevent early ovarian failure. A woman, knowing her fertile and infertile days, feels much calmer, she fully owns information about herself. So, can avoid abortions, fear, harm from contraception. Therefore, the age of perimenopause may come much later.

Fertility in premenopause.

Premenopause is a period of fertility decline. Signs of fertility decline can occur at any age. It is always individual. But at the age of approximately 38-40-45 years, as a rule, a decrease in ovarian function begins.

Premenopause is the period from the beginning of the attenuation of ovarian function to the complete cessation of menstruation. It is characterized by a sharp decrease in the ability to conceive and a change in the nature of menstruation.

Menopause is the last independent menstruation in a woman's life.
Postmenopause is the time from the last menstrual period (menopause) to the almost complete cessation of ovarian function.

The cessation of menstruation at the age of 40-45 years is usually regarded as early menopause; older than 55 years - late menopause. The age of 38-39 years is accepted as the lower limit of early premenopause. If a woman begins these symptoms before the age of 38, this is regarded as ovarian failure syndrome.

The female sex hormones, estrogens and progesterone, are responsible for the menstrual cycle, which prepare the uterine mucosa for pregnancy.

But not only the endometrium of the uterus is sensitive to estrogens and progesterone. These are the brain, liver, intestines, heart, musculoskeletal and urinary apparatus and some other tissues. Organs contain receptors sensitive to female hormones.

That is why, with a decrease in the level of female hormones, the so-called "climacteric syndrome" develops, characterized by a violation of the functions of various organs.

The balance between estrogens - female hormones, the synthesis of which in the body decreases, and androgens - male hormones produced by the adrenal glands, is disturbed.

Premenopause, mechanisms of development.

In conditions of deficiency of ovarian hormones, compensatory-adaptive mechanisms develop.
The adrenal glands begin to produce an increased amount of androgens - male sex hormones that turn into estrogens in the subcutaneous fatty tissue.

Violation of autonomic regulation by the hypothalamus provokes increased sweating, dizziness, nausea and hot flashes. These reactions are vascular in nature.

An increase in the synthesis of prolactin by the pituitary often accompanies menopausal syndrome. Because of this, the secretion of estrogen by the ovaries is even more inhibited. In addition, prolactin enhances proliferative processes in the mammary glands and in the uterus. As a result, the risk of uterine fibroids and mastopathy increases significantly.

Neurotic reactions (increased irritability, nervousness, tearfulness, sleep disturbance, suicidal thoughts) occur against the background of the pathology of the internal organs and because of the woman's emotional experiences about her age and condition.

Signs of premenopause.

• Profuse bleeding during menstruation, discharge of blood clots.
• Menstruation lasts a few days longer than usual.
• Minor bleeding between periods.
• A little bleeding after intercourse.
• Reducing the length of time between periods.
• The main sign of the onset of premenopause is a decrease in fertility.
• Reducing the number of ovulations, shortening the luteal phase of the cycle (these are signs of insufficiency of the luteal phase of the cycle).

• The syndrome of luteinization of the unovulated follicle (LUF syndrome) is possible.
• Resistance of the ovaries to the effects of FSH, an increase in its production by the pituitary gland. This stimulation of the ovaries leads to the maturation of several follicles at the same time, none of which reaches full maturity. As a result, a high level of estrogen in the blood, a change in the cervical secretion and the condition of the cervix.
• With a drop in estrogen levels due to the destruction of maturing follicles - abundant irregular bleeding.

I wrote about the syndrome of the unovulated follicle (LUF syndrome) in a separate video course on menstrual cycles. In the same place, I highlighted the issue of insufficiency of the luteal phase, because it is these signs that are the first "bells" that indicate the onset of a decrease in fertility. And we are not talking only about the age of premenopause, it is possible at any time.

Signs of premenopause can occur at any age. If you read literature, get acquainted with these topics, and see a decrease in ovarian function, then you should think about changing your lifestyle, reducing stress. Maybe you should take care of your health.

Observing the signs of fertility and maintaining observation charts of the menstrual cycle at the age of premenopause will allow you to avoid an unplanned pregnancy, see signs of diseases, and feel free in marital relationships. :)

And now - a movie from the video course - Fertility in premenopause. Lesson 1 - The hormonal background of a woman in premenopause.

Sincerely, Elena Volzhenina.

See also:

comments 84

I didn't have any premenopause. Menopause began unexpectedly, the symptoms were pronounced: hyperhidrosis, lack of libido, apathy, weakness. She took cyclim and drank herbs to reduce the severity of symptoms. Great help. But you need to start monitoring your overall health: eat right, take vitamins and exercise. This approach helps me

Elena, hello!

I am almost 42 years old. There were no pregnancies, no abortions. Menstrual cycle from 10 years old. I have not taken OK since I was 28. At the age of 37, the first hormonal failure occurred: in six months, fibroids grew and, against this background, fibrocystic mastopathy sharply worsened. As I now understand, these were the first signs of entering a new phase of my life. But then I was in complete disarray and thought about something completely different - the doctors pressed: give birth urgently or do an operation, and then immediately give birth. I was not ready for either. In the end, I decided to do nothing and observe myoma. She took indinol and epigallate. No one told me to go to an endocrinologist. Three years later, she nevertheless decided on an abdominal operation to remove the fibroids, since it began to grow, and even increased blood supply to the node was revealed. Everything went well, the cycle was restored immediately. The doctor said that in a year you can plan a pregnancy. I refused hormones, wrote out all the same dietary supplements above. But she didn't send me for hormonal tests. Yes, since the appearance of fibroids, the cycle has become shortened and meager. There was a moment before the operation when he disappeared for two months (by the way, all hormonal failures happened in the height of summer). About a year ago, I began to notice excessive sweating in myself, although I had never suffered from it before. I wake up intermittently in the morning sweaty. Now in the heat she haunts me all the time. Fatigue followed. Then I took care of my hormones. On the recommendation of a gynecologist-endocrinologist, she passed the tests and revealed: AMH 0.13, macroprolactin goes off scale 1652, the rest seem to be normal so far. In general, I'm all upset. And I want to know how I can help my body in order to get through this period as smoothly as possible. I do not plan children, I understand that if it happens suddenly, it will be a miracle. I’m definitely not going to experiment with my body in this regard (I decided this even before the operation, until it became clear that the organ would be preserved for me). I do not accept HRT, I watch how my older friend prolongs her female age in this way and I am amazed at her courage. But it’s still a shame terribly (I even cried today), people only remember at the age of 50 that there is a menopause in the world, and I’m barely over forty and hello. Although, of course, you need to thank that only this. Help, how not to fall into bargaining and depression, but to accept your condition and find reasons for joy. Thank you in advance!

Hello. Please tell me. I am 42 years old, a year ago my periods disappeared, there were no two months, on ultrasound the ovarian extinction. My doctor prescribed duphaston, I drank it for 5 months. During this period, menstruation recovered, but an ovarian cyst appeared, she did laparoscopy with hysteroscopy of the rdv. After it, the discharge went on for 14 days, and now they are gone for a month and a week, according to histology, a corpus luteum cyst, the endometrium of the early phase of secretion. I don't feel very well. The doctor says with menstruation to drink Lindinet 20, but they are not. Tell me whether to call again mes.dufastonoi? And whether to drink Lindinet? Thanks in advance.

URL: Question
Good day! I accidentally found your blog, watched the video and reviews of people, decided to ask you for help. Please tell me what tests should be done initially. I am 44 years old, my periods have always been with an interval of 27-28 days. And this month for some reason 2 times, the chest hurt., Severe itching of the skin on the back, which periodically worsens over the course of 2 years. I have suspicions of a hormonal disorder. Last year there was a frozen pregnancy and an arbitrary miscarriage. Thank God everything went without surgery, the monthly period was on time, I didn’t have to go for scraping
i.e. The point is that I want a child with my husband, there’s not much time anyway, but I know they still give birth at that age, that’s for sure abroad. Recommend where should I start the examination ?, thank you very much. It’s just that my husband is young and I wanted to give birth for him, again. I have a 25-year-old son. Thanks for the answer

Good afternoon. I am 47 years old, in the month of October (2017) my periods did not come, then they came in November and every month they came according to the usual pattern, in April there were none again, they came in May, very meager. I went to the gynecologist and passed all the tests, FSH 8.9 LH 7.6, the doctor said that the hormones are normal so far, they did no ultrasound abnormalities. But the state of late is not very good, there is sweating, increased heart rate, irritability. The doctor said that although the hormones are normal, this is premenopause, or rather, its beginning, and prescribed claira and vitamins. At me a question it is expedient to drink a hormonal preparation to support an organism.

Elena, hello! At me a question about protection in a menopause. I am 50 years old, ultrasound signs of menopause (no menstruation for 5 months, the ovaries have decreased to 1.7 x 1.4 x 1.3, the thickness of the m-echo is 2 mm, dryness of the mucous membranes), the gynecologist said that you can not protect yourself. How do you think? I found in the literature that it is necessary to protect yourself for a few more (!) Years.

Fsg-50 and lg-40 at 38 years old - is this a sentence? Monthly not a month and a half. Yesterday I had an ultrasound. ENDOMETRIUM-11 im, 4 Hollywood in the left ovary, on the right cyst. What can be done to start menstruation?

Hello! I am 42 years old. At 37 and 39 years, caesarean. Two children. In May 2016, the first menstruation after childbirth, they are also the last. The youngest was breastfed for 2 years. There were no cycle failures before childbirth. And, suddenly, an early menopause. The gynecologist advises hormones. He says otherwise there are big risks of premature aging. I do not know what to do. And why did menopause begin immediately after childbirth and feeding?

Hello. I am 50 years old. absence of menstruation for 4 months, the ultrasound doctor said that the size of the uterus had already decreased and this is a picture of menopause. I started my period. What could it be? Before that, I had severe allergies and problems with urinary incontinence when sneezing. I also want to add that for 6 months I took prednisolone pills for 5 days. Thanks in advance.

good day, Elena! I am 51 years old and, as I understand it, I am in the period of premenopause. There were 2 pregnancies that ended in childbirth, there were no abortions. The cycle all my life was in 26-28 days, like clockwork. 2 years ago, the first changes in the cycle began - acceleration, the cycle became shorter after 21-23 days, but the periods were normal in number and duration of 3-5 days, as always. But a year ago - there was another change - the time interval between periods was significantly lengthened - 36-40 days, and it happens that before menstruation there is a brown daub for several days or after menstruation as well. Before the penultimate period, there was already a gap of as much as 58 days, but the menstruation passed normally, and before the last there was also a gap of 58 days, but a completely strange situation had already occurred here - the daub was brown for almost a week, then 3 days of normal menstruation passed, then again a daub for a week , then it seems like everything stopped for a few days and again a daub, but quite plentiful like meager periods - in general, this has already lasted 3 weeks. Help me understand what is happening to me, is this normal for the premenopausal period?

good day, Elena!
I am 58. I was amazed when I read your article about Duphaston.
Help me, please, since the onset of menopause, for 4 years now, the body temperature has not risen above 35.5. Sometimes even 34 and 33.5., hands and feet are cold in winter and summer. the whole body suffers from it. I feel terribly weak and bad. + insomnia, tears and nervous breakdowns. Tablets like Klimadinon do not give any result. I understand that this is due to the thermogenic effect of progesterone, but how can I correct it? The local doctor said, "at your age it happens, it's okay!" What to do??
Thank you.

Good day, Elena. I am 49 years old, three CS ended with 3 children. The fallopian tubes are tied up. The first failures in the cycle began in the summer of 15, when there was an unplanned trip to the sea and there were no periods in July. In August, everything returned and until the fall of 16 it was on schedule. In the fall, very meager discharges began. Odorless and pain free. This lasted until June 16, 17. Although in May there were no discharges at all. And now, from June 16 and already 4 days, discharge began with small and rare clots. I go to a gynecologist and a mammologist once a year. Q: Am I in menopause? Thank you.

good day, Elena!
I am 41 years old, I have 2 children, and I already know for sure that I have (like a year) premenopause, as all the symptoms and AMH indicate. Over the past 2 years, I have been seeing dramatic aging every day. My gynecologist said that I can drink a hormonal drug that will prolong my periods, which are no longer systematic. Do you think it should be done? Thank you in advance for your response!

Elena, hello! Such a situation: I am 42.5 years old. Exactly a year ago, in December, there were two periods (the second time was very poor), then there was a 40-day delay. Since January, everything went smoothly, however, there were heavy periods a couple of times, and scanty in the summer. Previous periods - 40 days late, tested for hormones, FSH and LH are normal, low estradiol - 17.9. The doctor prescribed a month to drink duphaston (from 14 to 26 days), then she said to drink femoston. Noah read - they drink it after 6 months. after the last menstruation, I don’t have menopause yet ... I called another doctor, she advised me to drink logest right away (I drank it for many years before the DHS operation, which was 3 years ago). Today is the 45th day, daubing has begun, the endometrium is 7 mm by ultrasound. What do you advise? Exhausted - to drink duphaston or not, whether to drink logest or phytoestrogens to look for ...

Hello! I am 47 years old. For the last two years, "bells" about age: the pressure has changed from a working 90/60 to 110/70, the cycle "jumps", the nerves "explode" for no reason, the orthopedist recommends to be observed by a gynecologist-endocrinologist in connection with the wave-like loss of bone tissue ... On the advice of one of the gynecologists, she began to drink Menopace Plus, the body reacted with inflammatory, painful acne on the shoulder. Stopped drinking, they passed. I made an appointment with a gynecologist-endocrinologist. What tests do I need to bring to the initial appointment so that something can already be understood according to my condition? I read that FGS is needed, on what day of the cycle should it be taken? Please tell me. (Reception is paid, it’s very far to go, I don’t want to waste time and money)

Elena, good evening! I am 47 years old, 2 pregnancies ended in two children, one operation to remove a polyp, there was nothing else. After 2 pregnancies, heavy bleeding. I was at the gynecologist, they found a polyp, they cut it out as the cause of the bleeding. It didn't get any better. I drink every month tranexamic acid + vitamin e1000 mg. That's how I save myself! I'm waiting for menopause, because heavy periods ruin my life. I live in an embrace with sorbifer durules))) For 5 months now, the cycle has been jumping for 2 weeks, before it was like a watch. Recently I read about the complex, there were only B6 B vitamins ... HE RESTORES THE CYCLE .. Then I called an ambulance, because of palpitations, dizziness, and so on. I immediately threw it away and everything became normal .... Since the cycle began to jump, is it premenopause? What should I do, do nothing?))) wait for menopause? Or run to the doctor?

Good afternoon I am 31 years old Yesterday I went to the doctor and found out the results of my tests. AMH 0.40 said that with such indicators they would not even take IVF. I am naturally in shock. I never gave birth, I didn’t take hormonal pills and I always felt good, my periods were regular. My husband and I have been trying to get pregnant for a year and it didn’t work out, so we turned to the doctor to check my and his health. Tell me where to start??? I began to search the Internet for information and found your article, tell me how to start monitoring fertility? We really want a child with my husband. Thank you!

Hello, Elena! I'm 49. Menstruation is regular. The cycle began to fluctuate a little, 26-28 days. Today, on the 16th day, bleeding began. Not plentiful. It never happened. The day before, the right ovary pulled a little, as if tingling. Was at sea, roasted in the sun. However, as always before. There was some discharge with an unpleasant odor. I made an appointment with the doctor for Saturday. I'm going to work tomorrow, but I'm in a panic. Help advice! Sincerely, Elena.

good day, Elena! I can get your opinion on the following situation: now I am 41 years old, I gave birth to my second child at 38 years old, the first at 21 years old. Up to 35 years, the cycle was 22-24 days (IUD was used as contraception), then oral contraceptives and the cycle was established at 28 days, after the abolition of contraceptives and examination at 38 years, pregnancy occurred immediately, childbirth was normal without complications. After childbirth, menstruation began after 1 year. 7 months, with the continuation of ore feeding, the cycle was established immediately at 28 days. But now, i.e. after 1g1m after the start of menstruation for the second time the cycle is 20 days. last month, on the first day of unexpectedly starting menstruation, an ultrasound scan was performed - the conclusion: "peristent follicles, a gynecologist's consultation is necessary", the next day I went to the appointment - the doctor said that everything was normal according to the ultrasound.

Elena good afternoon. I am 36 years old, I have no children yet and I am not married. June 9, 2016 was the last menstruation, in July they did not come, and in early August I visited a doctor. FSH 96.9 LH 50.3 Prolactin 10.9 estradiol 44.9 progesterone 5.1 testosterone 1.3. I was diagnosed with SIA and prescribed climanorm for 4 months. The doctor said that with such indicators, you can get pregnant only with a donor egg. Help me please! Maybe there is still some percentage of getting pregnant on their own without a donor cell. I hope that my ovaries can still recover, but I don’t know how to help them.

Good day, Elena. I am 45 years old. She gave birth to a second child at 40. In the early stages there was a threat of miscarriage - duphaston was prescribed, she drank for a long time and in large quantities. I breastfed for a long time, about 2 years. When menstruation came after childbirth, they first smeared it for a long time until the 10th day. Then the daub gradually acquired a chaotic character. Menses became very profuse. The last menstruation ended in bleeding. Have made cleaning - the diagnosis glandular and fibrous polyps. Orgametril or busereln injections were prescribed as a treatment. I am very wary of hormonal drugs. But no doctor can advise anything else. Maybe you should take wild yams and he has adjusted the hormonal background?

Hello, I did an ultrasound of the ovaries, the dimensions of the right ovary are 18x10x9 mm, the left ovary is 26x15x13 mm, the volume is 0.85 mm.cube and the volume is 2.56 mm.cube, respectively. Can you please tell me if this is normal or abnormal?

Elena, thank you so much for the very useful information! I am 51 years old. And I began to have the first signs of an approaching menopause. Suddenly, small bleeding began in the middle of the cycle. The cycle is broken. This continues for 2 months. The survey did not reveal anything special. (Follicular cyst, cystic changes of the left ovary). Polycystic ovaries accompanies me for life. But this did not particularly affect my condition - the only thing - menstruation lasted a week and plentifully. Started taking Wild Yam (NSP) (recommended by NSP consulting physician, my gynecologist recommended progesterone) from days 5 to 25 of the cycle, 3 capsules per day with meals. My question is: what if after 25 days menstruation does not occur? How then to take Wild Yam? And if the bleeding starts again on the 14th day? How to take Wild yam in this case, if after bleeding the endometrium will again be like after menstruation? Small pulling pains in the lower abdomen (either on the right or on the left), which I feel only during the day (at night they calm down) is this normal in the period of the oncoming menopause? Thanks in advance for your reply.

Hello! I am 49 years old. Since the beginning of this year, there are signs of premenopause. You say - see if there is ovulation. And how can you track it? I do ovulation tests - they show a weakly positive result on any day of the cycle. Sometimes in the middle of the cycle I feel pain in the lower abdomen, which I take for ovulation. What other ways are there to determine ovulation? Thanks in advance.

good day, Elena. I have such problems: from the age of 38 I was diagnosed with ovarian failure syndrome. The months didn't go by regularly. the smallest interval is 16 days, the largest is 65, JAZZ was prescribed, I drank it for half a year. and refused, her legs began to hurt badly. irritability. now the last months. were February 26th. went to the ultrasound. the left testicle has shrunk. the right one has ovulated. waiting for a month the doctor prescribed normomens.vit.E. and if the months go then Klaira. What do you think, is the treatment appropriate?

I am 43 years old. The pressure of the PA's fears and all those proposing to it has risen sharply. The examination went through everything and completely. Everywhere is the norm. FZG 6.12 by ultrasound is also the norm everywhere. Monthly saved. Attributed to Klaira. I drink 6 packs, the tides are gone PA and the pressure is also gone. But neurosis and anxiety won't let me. I drink gidozypam 0.2 at night. In the morning on valerian. Whether tell or say it is necessary to me to continue a preparation to drink or something another is necessary. Thanks for the early reply.

Hello! I am 47 lkt. Three years ago, heavy menstruation with clots began, a hormonal Mirena coil was put in. Now "catastrophes" do not happen, but somehow everything is irregular and sometimes it just smears, sometimes menstruation goes on. The chest constantly hurts. Hair falls out very much and grows in the wrong places. I passed the tests: thyroid-stimulating hormone -4.1, free thyroxine 0.911, dehydroepiandrosterone sulfate 299.1, free testosterone 3.188. And all this against the background of nervous breakdowns, irritability and thoughts about why I live and what to do. I started to convey, because it turned out - this is the only pleasure. Is it premenopause? What should I take to be calm and in general. Thank you.

Hello, Elena. Please tell me. I am 41 years old. Menstruation has always been regular. January 2016 came as they should. But it's been 2 months now and they're gone. I’m very worried, I don’t know what it is, has the change pause already begun? Lately, my head hurts a lot and my blood pressure rises. I had the flu in February. I was very nervous this winter (problems with my son). Was at the doctor. She prescribed duphaston and vitamin E to drink. No tests were taken. Tell me what's wrong with me?

Hello. I would like to know if I have a changeover or not. I just turned 38 years old. Menstruation was regular until August 2015. Then we went in September. From September to December were regular. No periods since January 2016. Has handed over analyzes FSG - 27.4; LG-18.82; Estradiol-34.8; Prolactin-150. Uzi: there are signs of hr. endocervicitis. Small cystic lesions of the right ovary, cyst of the left ovary, adenomyosis (minor changes). I also have type 1 diabetes. The doctor said if the FSH level is high, it means you are in menopause. Has appointed or nominated that to pass or take place to appoint or nominate reception HRT. What to do? Reading the symptoms of menopause, everything fits. Nervous, I get tired, I want to sleep, sometimes my spine and knees hurt, for several days I sweated once (not now), it seems to me that a light mustache appeared above my lip. My child is 4 years old.

Hello, Elena! I am 44 years old in May, the child is 6 years old. Had a long infertility, the main reason - polycystic ovaries. 7 years ago ovarian fibroma was removed. The child was born via caesarean, a year after laparoscopy. The last six months have been extremely irregular periods. According to the results of the analysis, FSH 55.8, LH 29.83, estradiol<37, пролактин 195. У меня пременопауза? Заранее спасибо за комментарий. С уважением, Валерия.

Hello, I'm 53 years old. Until June, my periods went regularly. Then
bleeding began, curettage began. Myoma is not very large. I did all the ultrasound tests. Hyperplasia seems to have gone. I drank wild yam. weeks, then again mucus with blood. Five years ago, I removed myoma. The pressure jumps, the condition is bad. I was in the hospital, they gave injections and that’s it, only the blood became thick. What should I do to remove the fibroids or wait for the menopause, the doctor says that the age is such that the menopause should come. And everything will pass by itself. Thank you!

Hello, Elena! I am 49 years old. Last month I was 10 days late and my period lasted only 1 day. My chest hurt. When it was time for my period, it turned out that the cervix was in the position of ovulation, so I was already prepared that my period would come late. This month, the middle of the cycle has already passed (day 19) and there is still no ovulation (discharge is dry and the cervix is ​​closed, the temperature is 36.5). Could it be premenopause? For some reason I became very irritable. Is it from premenopause? I'm getting on my nerves ... I'm afraid to completely break loose (I decided to lose weight and count calories) and give up everything. I do not know what is the reason and how I can restore emotional balance. Thanks in advance for your reply. And thanks for your site!

Hello. I have a question for you. I am almost 44 (February 20 will be 44) for 11 days now my period has been delayed. Pregnancy is excluded, because I have not been sexually active for a year. before that everything was fine. The menstrual cycle is 25-28 days, passed regularly, without any complications. What could it be? I'm already worried because I still plan to have children.

Hello. I have multiple large nodular uterine fibroids. 41 years old Menstruation was profuse, but lately there have been delays. Previously, the cycle was regular. I had my period in July and then in September. And that's it. In October there is another delay. What could it be. Thank you

Elena, hello! I am 47 years old, the birth was 5 years ago, the third. Breastfed for 2 years. Looks like it's going through menopause now. Menstruation (or bleeding) is regular but very heavy. Ultrasound showed the thickness of the endometrium on the 7th day of the cycle 12 mm. On day 5-1 with a 27-day cycle, FSH is 15, estrogen is 5, the rest of the hormones are normal. According to my observations, ovulation has not been the last 2 months. Well, FKB 2nd category. The doctor diagnoses premenopausal hyperpolymenorrhea and endometrial hyperplasia and sends for hysteroscopy. Hormones I can not drink because of the tendency to thrombosis. Plus last year I began to quickly gain weight, which I can not get rid of. The doctor prescribes mastodinone, estravel, selzinc, toxidont may, gemafemin. After two weeks of taking the breast hurts terribly, it seems that ovulation was. I haven't had a hysteroscopy yet. Did I understand correctly that it is necessary to compensate for estrogen with progesterone? The treatment is scheduled for 3 months, but I do not feel a positive effect on the body. Is a hysteroscopy necessary in this case?

Elena, thank you so much for your knowledge and kindness! God bless you!
Elena, if possible, comment on my situation, please.
I am 38 years old, for about 2 years I have not been able to get pregnant (first pregnancy). Husband sailor 1 month/1 month Regular normal menstrual cycle is 26-28 days.
We turned to a reproductive specialist. She liked the result of the ultrasound (on the 1st day of the cycle): the ovaries are working normally. Then another examination was made, I don’t remember the name: both tubes are passable, others are also fine, but a polyp in the uterine cavity. It was removed immediately.
Hormones: LH 9.3, FSH 20.2. The rest are normal. It was concluded: Premenopause. I found information that LH and FSH are stress hormones as well. A few days before taking hormones, I trained, the day before I went to a Russian bath, and before the analysis I drank black coffee. In the next cycle I retaken according to the rules. As a result: LG 4.7, FSH 9.1. For the second month I will drink DHEAx150mg, so the analysis will already be biased (as the reproductologist told me). She also said that overwork is nonsense and these hormones in fairly young women under no circumstances jump like that. Is it so??
Thanks a lot!!

Hello, Elena. I'm 29 and already in menopause. Menstruation began at the age of 13 and immediately were irregular 3-5 times a year. Of course, I can't even get pregnant. Is it possible to put a cross on me already? Went to doctors. Saw contraceptive, hormonal and even clostilbegit 2-3 times. Is there any chance for me to become a mother?

good day, Elena! Tell me, please, is it possible to talk about premenopause at the age of 33, if there are such symptoms: for the last 3 months there has been a reduction in the days of menstruation from 7 to 5, a decrease in the amount of blood, a decrease in libido, frequent urge to urinate, sometimes discomfort during sex, I suspect because of the dryness of the vaginal mucosa. What should I do and what examination should I start first? Thanks for your reply.

Hello, Elena!!! I accidentally found your site when I was looking for information about duphaston. Starting today, I started keeping a calendar. I am 44 years old. I really want to get pregnant. I went to the doctor for a consultation, there was a daub. She said the neck is soft, sent for an ultrasound, and prescribed duphaston. I drank it for 6 days, the menstruation came on cancellation (at the same time, I think that I extended the cycle by several days). It was very bad. When my period came, on the second day there were unbearable pains in both ovaries, I even called an ambulance. Now the menstruation is over, and the chest hurts terribly, as before menstruation. To be honest, I have a panic that I knocked down the entire hormonal balance. I don’t want to go to this doctor anymore, but I’m going through the tests that she prescribed. I want to take your advice. Is it better to collect all the tests first? Again, it's scary to delay, because realizing that time does not work for me, age ... Help!?

Elena, hello. The signs of premenopause described by you are one to one with my condition. I am 50 years old. When to expect an increase in the time between periods. It's been a year since menstruation. the cycle was reduced to 21 days. Used to be 28 regularly. And the duration, as it was 6-7 days, remained. There is multiple myoma: one of the nodes is up to 2.5 cm. I compensate for the decrease in hemoglobin by taking Sorbifer for several days. The condition of premenopause is definitely not hereditary. My mom ended it all at 45. The gynecologist in the clinic says that everything is individual. And someday it will all end. And when? Not even irregularity!

Good day, Elena. I am 45 years old and last period was 9 months. back, then (after 10 days) - bleeding, which was stopped by injections. At 43, I had a birth, I finished feeding the baby 10 days ago (I fed the last six months 1-2 times a day). After weaning, she immediately began to drink menopause, as she suffers from insomnia and hot flashes. But I have a strong sexual desire from him, so I stopped drinking it for three days. Result: Today I fell asleep only at 5 am. I drink motherwort. I walk before going to bed, with a child. Until half past nine. And I can't sleep! During the day I go sleepy, broken, I fall asleep when I can and for as long as I can. Please advise me how to improve my sleep.

Elena, good afternoon. I just started to study your methodology, because we really want a child. I have two children, already adults, I turned 45 in August. I want to get pregnant at the age of 41, I have a new husband, we are happy, but there are no common children. Once I got pregnant, but ST was 42. I went to the doctor because hot flashes began to torment me, my breasts were very painful. She advised me to get pregnant on cancellation. I drank Lindinet-30 for three months, my periods were clear, but after the abolition they stopped going at all. G said, if it doesn’t work out over the summer, then only IVF or donor UC. I just rule it out. October is already in the yard, and months. everything is not. I feel normal, the hot flashes have become less, as soon as I started drinking cyclodinone, I have been drinking for 3 months, there are practically none. But the ovaries began to tingle periodically, one or the other, what does this mean? In July I went for an ultrasound, the ovaries are not empty in them, 4-5 eggs each, but I understand that this is very small, I reassure myself that at least they are not empty. The uzistka said that in such a situation it is impossible to get pregnant. Please advise me something. I'm just like a squeezed lemon. I really don't want cleaning. I still hope for a miracle, I really believe. How can I get my period back and do I need to return it. I'm afraid of breakthrough bleeding. Thank you in advance. Thank you for your hard work in the field of fertility.

good day, Elena! Please tell me. I am 42 years old. I have been trying to get pregnant for a long time. On ultrasound they said that I have ovarian failure - a small number of follicles. Adenomyosis 0-1 st. When measuring basal temperature, almost all the time it stays at 36.6-36.8. Occasionally there are jumps to 37.1 on 18 dts and by the 25th it goes down. The cycle is about 30 days. Menstruation lasts no more than 4 days. Used to be up to 7. Menstruation has been irregular all my life, started at the age of 16, was provoked by Norkolut, in my opinion. Please advise what kind of research I need to do? Which doctor should I contact? I really want a baby.

Elena, thanks for your work!
Please explain, if possible, my situation.
I am 47 years old. Until about 38-39 years of age, menstruation was scanty, rare (with interruptions of up to three months), irregular. By the age of 40, for some reason, it began to approach the norm. During this time, the intervals between menstruation have decreased and now - a cycle of 28-30 days, of medium profusion, is practically the norm. I donated blood for hormones, everything is normal, except for FSH, which is 11.3 (according to the laboratory - the upper limit of normal). What does this mean? Is this kind of premenopause?
Recently, often stress (the last 5-6 years, due to problems with mom and daughter). I am married, my relationship with my husband is wonderful and active). I began to sleep little, more than 6 hours does not work, I can burst into tears at any moment. What to trace? what to watch in this case?

Elena, thanks for the useful information. Recently, I began to be interested in the topic of premenopause, and you have found everything in an accessible, understandable language for me and acceptable schemes for supporting the body. I am 46 years old, the uterus was removed a year ago (multiple fibroids), the neck was left, the cysts were removed. There was a history of adenomeosis and heavy bleeding, so the operation. Some semblance of menstruation has disappeared, there are small spotting during intercourse. She began to feel dryness of the mucous membranes. The skin also began to lose elasticity, and all this is somehow abrupt)) Now they have prescribed Klimaninon to drink for 1 year. Histology is normal. I was surprised that they did not ask me to take hormones. As I understand it, you need to drink progesterone-like drugs in parallel with phytoestrogens? Maybe something else to do? Thank you in advance!

I join - Thank you so much for the information about premenopause!
I also have a question for you, Elena.
I am 46 years old, already several periods (since March of this year) have become more abundant and longer. The usual cycle is 28-3 days. I turned to a gynecologist, I did an ultrasound - on the 10th day, the uterus is -5 cm, the contour is even. Myoma nodes are located - 8x10mm and 15x15 mm interstitially, 16x15 mm deforms the walls of the uterus. The thickness of the M-echo is 12 mm, the contour is not even, the endometrium is not homogeneous, with hypoechoic inclusions. The cervix is ​​without features. Ovaries are normal.
KLA - and OAM are normal.
A gynecologist with heavy menstruation advised to drink a tincture of water pepper, and if the bleeding does not stop for more than 5 days, go to the hospital.
My question is, how many cycles can I take hemostatic agents? How to evaluate - too abundant discharge or is it more or less the norm in my premenopause? When is it necessary to do a second ultrasound? What is the best day? I would be very grateful for an answer.

• Svetlana, just removing the symptom, heavy menstrual-like bleeding is unreasonable. Because the reason for them is the predominance of estrogen, the lack of progesterone. More rare ovulation and a decrease in estrogen synthesis in the ovaries lead to the fact that low estrogen levels, but acting for a long time, lead to the so-called relative hyperestrogenism. That is, there are few of them, but their action is long, without compensation by progesterone. Read in my tutorials how estrogens work and how progesterone works. Estrogens cause the division of endometrial cells, an increase in the thickness of the endometrium, and progesterone - filling these cells with secrets. And then the cycle is completed, menstruation comes. But in the absence of progesterone, there is a constant, subtle cell division. This is the cause of fibroids, endometrial polyps, bleeding, etc.
  To compensate for such conditions, progesterone-like herbs are needed in a constant mode. For example, I like wild yam (NSP). It must be drunk constantly, one capsule at night. If the symptoms of hyperestrogenism are pronounced, then 2-3 capsules a day for several months, and then switch to 1 capsule. If necessary, over time, if there are symptoms of a decrease in estrogen (dry mucous membranes, etc.), then you can add estrogen-like herbs, for example, sage - just drink it periodically like tea.
  One way or another, you need to keep maps of self-observation, and select herbs for yourself, and maybe good homeopathy, in order to keep the whole system in balance. Otherwise - curettage, hospitals, and other delights of life. It is very important to deeply understand what is happening. If there are questions, ask.

Elena! First of all - Many thanks to you for publishing your experience and knowledge!
And the question is: is there a way to reduce the abundance of menstruation in premenopause? I see, directly during menstruation, when the discharge is very plentiful.
Thank you!

The cause of itching and burning during menopause is a decrease in estrogen levels. A low concentration of this hormone in the blood negatively affects the condition of the mucous membrane of the genital organs. Its blood circulation worsens, the processes of regeneration of damaged cells slow down. The mucous membrane becomes thinner and atrophies.

The glands that produce mucus are underactive, which causes dryness. The consequence of this is an increase in acidity in the vagina and a change in the composition of the microflora. The development of opportunistic microorganisms leads to inflammation of the thinned vaginal mucosa - atrophic vaginitis. Itching and burning are the first manifestations of this disease.

How to reduce itching and burning during menopause?

• Avoid scented panty liners and toilet paper.
• For intimate hygiene, use only water, discard soap and intimate gels saturated with aromatic additives.
• For washing underwear, soap without additives or a hypoallergenic powder intended for newborns is suitable. Rinses and other additional detergents are undesirable.
• Do not give up intimate life. Regular sex normalizes the condition of the vaginal mucosa. Lubricants and mucosal moisturizers can be used to reduce discomfort.
• Consume at least 1.5 liters of fluid per day. A banal lack of water can also cause dry mucous membranes.
• Enrich your diet with healthy fats. Estrogen production requires fatty acids, so include oily fish, dairy products, nuts and seeds, and vegetable oils in your diet.
• Hormone replacement therapy helps to restore the normal concentration of estrogen and eliminate all the symptoms of menopause, including discomfort in the genitals.

What are the first symptoms of menopause after the age of forty?

Menopause or menopause is an inevitable period in the life of every woman. But some of its symptoms appear a little earlier than others. Women may experience the first symptoms of menopause in their 40s.

The first symptoms of menopause after the age of 40 are:

• Changes in the menstrual cycle. For most women, menstrual bleeding becomes less heavy and can last up to 7 days. The intervals between them are lengthening: instead of 25 days, they can increase to 35-40. Some women, on the other hand, suffer from recurring uterine bleeding.
• excessive sweating may accompany hot flashes or be an independent symptom associated with a change in hormonal balance.
• tides- redness of the skin of the face, neck and chest, accompanied by a wave of heat and increased sweating. The attack often occurs in the afternoon and lasts 1-5 minutes. This phenomenon is experienced by 70% of menopausal women. The appearance of hot flashes is explained by the reaction of the thermoregulatory center to a decrease in estrogen levels.
• Headache are usually associated with tension in the nervous system, which is caused by a decrease in the level of female hormones. In this regard, the mimic muscles of the face and neck tense up and spasm. This leads to clamping of sensitive nerve roots and, in addition, disrupts the outflow of venous blood from the skull. The increase explains recurrent headaches and migraine attacks.
• Forgetfulness and distraction. Changes in the hormonal background lead to a decrease in the release of mediators that provide communication between neurons. As a result, women note a slight decrease in attention and memory impairment.
• Mood swings. Sudden changes in the level of hormones affect the nerve cells of the limbic system of the brain, while the production of endorphins - "hormones of happiness" - decreases. This is associated with the occurrence of depression, tearfulness and irritability.


• Cardiopalmus- the result of hormonal stimulation of the autonomic nervous system.
• Dryness of the mucous membrane of the vagina. The condition of the female genital organs is closely related to the level of estrogen. Their deficiency slows down all processes in the mucous membrane, including the production of vaginal secretions.
• Frequent urination. Sex hormones are responsible for the tone of the bladder and the state of its sphincters. Therefore, as menopause approaches, women notice that the urge to urinate has become more frequent. Also, with age, the muscles of the pelvic floor weaken, on which the work of the bladder depends. The weakness of the sphincter leads to the fact that when coughing, sneezing, laughing, a small amount of urine may involuntarily be released.
• Decreased sex drive to a sexual partner. A woman's sexual activity is directly dependent on the level of hormones secreted by the ovaries, so as menopause approaches, it decreases.

It is believed that from the moment these symptoms appear until the last menstruation, 1-2 years pass.

Menstruation during menopause

Menstruation during menopause does not disappear at once, the last menstruation is preceded by a number of changes that can alarm a woman. During premenopause, bleeding from the genital tract becomes irregular, this condition can last 1-2 years.

The following changes are considered normal:

• The menstrual cycle either lengthens or shortens.
• The volume of bleeding may either increase or decrease.
• Menstruation is absent for 1-2 months, and then resumes again.

When to See a Doctor

• Profuse menstrual bleeding. It becomes necessary to change the gasket every hour or more often.
• Discharge of blood from the vagina after intercourse.
• The appearance of blood clots on the pad.
• Bloody discharge between periods.
• The duration of bleeding increased by 3 days. This has been observed over several cycles.
• Several menstrual cycles shorter than 21 days.
• Absence of menstruation for 3 months.

Is it possible to get pregnant during menopause

Climax is a long process consisting of several stages, which can last from 2 to 8 years. The answer to the question: "Is it possible to get pregnant during menopause?" depends on the stage at which the woman is. As long as sex hormones provoke the maturation of the follicle in the ovaries, pregnancy is possible. Fertilization can occur even if menstrual bleeding has become irregular or has stopped for several months.

Unfortunately, it often happens that turning to a gynecologist about the absence of menstruation, 45-year-old women are surprised to find out that this is not menopause, but pregnancy. In order not to be in such a situation, it is necessary to protect yourself within 2 years after the last menstruation. In the future, the woman enters the postmenopausal period, when, due to changes in the body, pregnancy is no longer possible.

It is difficult to say at what age a woman loses her ability to reproduce. Many cases are described when women over 55 became mothers in a natural way. And this despite the fact that they had early symptoms of menopause. Even more are those who managed to get pregnant at this age after ovarian stimulation with hormone therapy. However, statistics say that such mothers have a significantly increased chance of giving birth to a child with Down syndrome - the risk is 1:10.

To summarize: a woman can become pregnant during menopause, but this is associated with health risks for both mother and child.

How to stop the menopause

Menopause is a natural period in a woman's life. Although menopause is associated with feelings and unpleasant symptoms, it nevertheless performs a protective function - in this way, nature took care of the woman, depriving her of the opportunity to become pregnant. After all, bearing a child in adulthood can cause serious harm to women's health.

You can't stop the climax. Even hormone therapy is not able to do this. It is only intended to maintain health in a normal state, when the natural production of sex hormones decreases in the body. The same can be said about the phytohormones contained in medicinal plants and homeopathic remedies. Their reception can improve the condition of a woman, but will not cancel menopause.

The moment of the onset of menopause largely depends on heredity, and it is impossible to change the program embedded in the genes. If the mother had an early menopause, then most likely her daughter will face the same fate.

The only thing you can do is not bring menopause closer with your wrong actions. The work of the glands that synthesize sex hormones largely depends on lifestyle and bad habits. For example, women who smoke enter the menopause phase 2 years earlier than their peers. Based on this, gynecologists have developed tips that will help delay the onset of menopause.

• Do not drink alcohol and drugs, do not smoke.
• Lead an active lifestyle, play sports.
• Have a regular sex life.
• Eat properly . The menu should contain fresh vegetables and fruits daily, as well as sources of essential fatty acids: fish, nuts and seeds, oils.
• Live in an ecologically clean area.
• Take vitamins and minerals.
• Avoid stressful situations.
• Strengthen immunity.

If you suffer from unpleasant symptoms of menopause, then consult a gynecologist-endocrinologist. He will select replacement therapy, which will relieve the manifestations of menopause and slow down the aging process.

How to relieve menopause

Hormone replacement therapy for menopause

The doctor individually selects hormonal drugs, based on the results of ultrasound and tests. Do not take the funds that were recommended to your friends. Incorrect dosage of hormones can cause weight gain and uterine bleeding. At the same time, you should not refuse the treatment prescribed by the doctor. After all, a lack of female hormones can lead to hair loss, bone fragility and male-type obesity, as well as to atherosclerosis and its consequences - heart attack and stroke.

Used as hormone replacement therapy combined preparations: estrogen + progesterone (designed to protect the endometrium of the uterus):

• Divisek;
• indivina;
• Premarin;
• Pausegest;
• Tibolone;
• Klimonorm.

The drugs are taken 1 tablet 1 time per day at the same time. The duration of admission is 1-2 years. Some pharmaceutical companies produce hormonal preparations in the form of a patch: Klimara.

If a woman's uterus is removed, then they take estrogen-based drugs.

• Estrovel;
• Cimicifuga.

Attention! There are a number of contraindications for prescribing hormone replacement therapy for menopause, so before you start using drugs, you need to be examined. Absolute contraindications are:

• enalozide;
• Enalapril;
• Arifon retard;
• Kapoten.

sedatives herbal preparations:

• Valerian tincture;
• Motherwort tincture;
• Phytosed.

Daily regime

• Active recreation and sports. Physical activity improves blood circulation and metabolic processes in tissues, and also serves as a prevention of osteoporosis.
• Healthy sleep normalizes the functioning of the nervous system and improves skin condition.

Diet

• Frequent meals in small portions 4-5 times a day.
• Drinking mode. 1.5-2 liters of water will improve the condition of the skin and mucous membranes.
• Foods rich in calcium will prevent osteoporosis, hair loss and brittle nails.
• Vegetables and fruits are a source of fiber. They will relieve constipation, which can lead to prolapse of the uterus. They also contain antioxidants that slow down the aging of the skin and the cardiovascular system.
• Vegetable and animal fats in moderation are necessary for the synthesis of hormones.

What folk remedies for hot flashes with menopause can be used?

Some medicinal herbs contain phytoestrogens - substances similar to female sex hormones. Their consumption can compensate for estrogen deficiency and reduce the frequency of hot flashes.

Sage tea. 2 tablespoons of dry chopped sage herb pour 400 ml of boiling water. Insist 30 minutes. The infusion is filtered and consumed throughout the day in small portions, preferably on an empty stomach. The course of treatment is 14 days. In season, doctors recommend adding fresh sage leaves to salads and main dishes.

Infusion of hawthorn. A tablespoon of dried blood-red hawthorn flowers pour a glass of hot water. Incubate for 15 minutes in a water bath. Infuse for 20 minutes, then strain. Boiled water to bring to the original volume. Consume ½ cup 3 times a day half an hour before meals. The course of treatment is 21 days.

Herbal collection for menopause

• Linden flowers;
• Peppermint leaves;
• fennel fruit;
• Wormwood grass;
• Buckthorn bark.

Mix dried and chopped ingredients in equal proportions. 2 tbsp mixture pour 0.5 liters of boiling water. Warm up in a water bath for 15 minutes. Let it brew for 45 minutes, then strain. Drink before meals one glass in the morning and in the evening for 3 weeks. Then take a break for 7 days and repeat the treatment.

Replace tea and coffee with decoctions of chamomile, lemon balm or linden. These herbs do not contain caffeine, so they do not cause high blood pressure, which can cause hot flashes.

G. Savelyeva, Academician of the Russian Academy of Medical Sciences, Professor, V. Breusenko, Doctor of Medical Sciences, Professor, Yu. Golova, Candidate of Medical Sciences, Russian State Medical University

The period of a woman's life after the cessation of menstruation is called postmenopausal. Postmenopause - absence of menstruation for more than 12 months.

Menopause, characterized by loss of cyclic ovarian function, corresponds to the last menstrual period, the date of which is established retrospectively. In the modern population of women, there continues to be a trend towards an increase in the average age of menopause, which is approaching 52-53 years.

In the last decade, close attention has been paid to the course of the postmenopausal period. Since 1977, the Department of Obstetrics and Gynecology of the Russian State Medical University has been intensively studying the physiology and pathology of the postmenopausal period (more than 3,500 observations).

Postmenopausal symptoms. climacteric disorders.

The postmenopausal period is characterized by general involutional processes in the body, against which age-related changes occur in the reproductive system.

It is known that the change in the hormonal function of the ovaries begins long before the last menstruation, the cessation of the cyclic function of the ovaries coincides with menopause. In postmenopausal women, estrogen secretion decreases, while the least active of them, estrone, becomes the main one, which in postmenopause is formed from androstenediol, mainly secreted by the adrenal glands and, to a lesser extent, by the ovaries. The concentration of this hormone in the blood plasma of postmenopausal women is 3-4 times higher than that of estradiol.

On the one hand, estrogen deficiency, which is part of the involutional processes in a woman's body after menopause, can be regarded as a natural physiological process, on the other hand, it plays a pathogenetic role in the occurrence of many disorders, including menopausal ones.

• Neurovegetative, metabolic-endocrine, psycho-emotional manifestations of climacteric syndrome,
• urogenital disorders,
• osteoporosis

appear in a certain chronological sequence and significantly impair the quality of life of a postmenopausal woman.

The frequency of menopausal syndrome varies depending on age and duration of the postmenopausal period.

If in premenopause it is 20-30%, immediately after menopause - 35-50%, then 2-5 years after menopause it drops to 2-3%.

Individually, the climacteric syndrome can vary both in duration (from 1 year to 10-15 years) and in the severity of manifestations. Frequency characteristic manifestations of climacteric syndrome(assessment on the scale of the modified menopausal index) is presented as follows:

• hot flashes - 92%,
• sweating - 80%,
• increase or decrease in blood pressure - 56%,
• headache - 48%,
• sleep disorders - 30%,
• depression and irritability - 30%,
• asthenic manifestations - 23%,
• sympathetic-adrenal crises - 10%.

Hormonal adjustment affects the state and function of many organs and systems, in which estrogens and gestagens, which have a wide range of biological effects, can have certain effects on the cardiovascular, bone and joint systems, brain, genitourinary tract, skin and its appendages, etc. .d. Various symptoms associated with ovarian failure are observed in more than 70% of women.

Urogenital disorders usually appear in the 2-5th year of postmenopause in 30-40% of women; in the elderly, according to a more in-depth study, their frequency can reach 70%. The occurrence of urogenital disorders is due to the development of atrophic and dystrophic processes against the background of a deficiency of sex hormones in estrogen-sensitive structures of the urogenital tract, which have a common embryonic origin (urethra, bladder, vagina, ligamentous apparatus, muscular and connective tissue component of the pelvic floor, vascular plexuses).

This explains the simultaneous increase in the clinical symptoms of atrophic vaginitis, dyspareunia, a decrease in the lubrication function, an increase in cystourethritis, pollakiuria, and urinary incontinence. In postmenopause, genital prolapse often progresses, which is based on a violation of collagen biosynthesis and its deposition in fibroblasts against the background of hypoestrogenism; this is due to the fact that fibroblasts have estrogen and androgen receptors.

One of the consequences of an estrogen-deficient state in postmenopausal women is catastrophic an increase in the incidence of cardiovascular disease due to atherosclerosis: up to 40 years in women, the incidence of myocardial infarction is 10-20 times less than in men, and after the extinction of ovarian function, the ratio gradually changes and by the age of 70 is 1:1.

It is believed that prolonged estrogen deficiency in the elderly leads to the onset of the disease. Alzheimer's. The role of hypoestrogenism in the development of this pathology is confirmed by the prophylactic effect of estrogens used in postmenopausal women for replacement purposes.

An estrogen-deficient state after menopause leads to osteoporosis in 40% of cases, while bone tissue remodeling is characterized by reduced synthesis of bone matrix by osteoblasts and enhanced processes of bone tissue resorption by osteoclasts. The rate of bone loss after menopause increases dramatically and is 1.1-3.5% per year, by the age of 75-80 years, bone loss can approach 40% of the level (peak) at the age of 30-40 years. 10-15 years after menopause, the frequency of bone fractures reaches 35.4% among women who have lived to 65 years. The insidiousness of the situation lies in the fact that osteoporosis develops gradually and asymptomatically, and clinical symptoms appear already with a significant loss of bone mass.

Expressed osteoporosis characterized by pain, micro- and macrofractures with minimal trauma, curvature of the spine (kyphosis, lordosis, scoliosis), and decreased growth. Since in the first 5 years after menopause, bones with a predominance of a trabecular, lattice structure are predominantly affected (later the lesion of the tubular bones of the skeleton joins), fractures of the spine, radius in a typical place chronologically appear earlier than fractures of the femoral neck. X-ray examination does not solve the problem of timely diagnosis, since the bone changes detected during it occur when bone loss reaches 30% or more. Diagnosis of osteoporosis, in addition to clinical manifestations, is based on densitometry. Currently, risk factors for osteoporosis are known, which make it possible to outline the circle of women in need of prevention of this pathology:

• age (risk increases with age);
• gender (women have a higher risk than men; they make up 80% of patients with osteoporosis);
• early onset of menopause, especially before the age of 45;
• race (the greatest risk is in white women);
• slender physique, small body weight;
• reduced calcium intake;
• sedentary lifestyle;
• smoking, alcohol dependence;
• family history of osteoporosis;
• polymorphism of the gene responsible for the synthesis of the vitamin D receptor.

The only pathogenetically substantiated and effective method for correcting menopausal disorders is hormone replacement therapy (HRT), but the ratio of those who need HRT and those who receive it is not in favor of the latter (Fig. 1).

On the one hand, this is a consequence of insufficient education of the population, on the other hand, changing perceptions about the risks associated with HRT. So, with long-term HRT, the risk of breast cancer increases, while estrogens play the role of promoters in carcinogenesis. In recent years, there has been evidence of an increase in the incidence of cardiovascular complications (thrombosis, thromboembolism, heart attacks, strokes) with the use of HRT, with the most dangerous being the 1st year of taking the drugs.

Changes in the uterus and ovaries during the postmenopausal period

With the introduction of new technologies (ultrasound, dopplerography, hydrosonography, magnetic resonance imaging, hysteroscopy, histochemistry, etc.), it became possible to objectively assess the condition of the internal genitalia in women of different ages, in particular in the postmenopausal period.

The most pronounced involutive processes after menopause occur in the reproductive organs. The uterus, being a target organ for steroid sex hormones, after menopause loses up to 35% of its volume due to atrophic processes in the myometrium, which are most intense in the first 2-5 years after menopause. After 20 years of menopause, the size of the uterus does not change.

With a short duration of postmenopause, echographically, the myometrium is characterized by an average echogenicity, which increases with an increase in the duration of menopause; multiple hyperechoic areas appear, corresponding to fibrosis of the myometrium.

Postmenopause is characterized by a significant depletion of blood flow in the myometrium (according to the Doppler study) with the registration of the latter in the peripheral layers of the myometrium.

Myoma nodes that have arisen even in premenopause also undergo involution - their diameter decreases, and nodes with initially increased echo density (fibroma) undergo the smallest changes, and the diameter of nodes with medium or low echogenicity (leiomyoma) decreases as much as possible.

Along with this, the echo density increases, especially the capsules of the nodes, which can lead to the effect of attenuating the echo signal and make it difficult to visualize the internal structure of the nodes and the uterus. It also becomes difficult to identify small fibroid nodes as their size decreases and echo density changes (close to that of myometrium). Interestingly, against the background of HRT, the echographic picture of the nodes is restored in the first six months.

A rare variant of age-related changes that occur with uterine myoma is cystic degeneration of the node (subserous localization), echographically characterized by many cavities with hypoechoic contents.

In the study of blood flow in myoma nodes that have undergone atrophy, intranodular registration of color echo signals is not typical, perinodular blood flow is poor.

In the presence of interstitial and interstitial-submucous nodes, atrophic processes in the uterus after menopause can lead to an increase in centripetal tendencies and an increase in the submucosal component of the node.

With the submucosal location of the nodes in postmenopause, bleeding is possible. At the same time, echography does not allow to adequately assess the M-echo, which is difficult to differentiate from the node capsule and determine the cause of bleeding (submucosal node? concomitant pathology of the endometrium). Diagnostic difficulties allow to resolve hydrosonography (Fig. 2) and hysteroscopy.

The growth of the size of the uterus and (or) myomatous nodes in postmenopause, if it is not stimulated by HRT, always requires the exclusion of hormone-producing pathology in the ovaries or uterine sarcoma. For sarcoma, in addition to the rapid growth of the node or uterus, a homogeneous "cellular" echostructure of the average level of sound conductivity is characteristic with the presence of increased echogenicity of thin strands corresponding to the connective tissue layers.

Doppler study showed diffusely increased blood flow throughout the tumor (medium resistant). However, it should be noted that uterine sarcoma is a rare pathology in postmenopausal women, and the risk factors for this pathology have not been elucidated.

The endometrium after menopause ceases to undergo cyclic changes and undergoes atrophy. Age-related changes affecting the uterus as a whole cause a decrease in the size of its cavity - longitudinal and transverse. With ultrasound, a decrease in the anteroposterior size of the M-echo to 4-5 mm or less and an increase in its echogenicity are regular.

Pronounced processes of endometrial atrophy during prolonged postmenopause may be accompanied by the formation of synechia, which are displayed as small linear inclusions in the M-echo structure of increased echo density and are easily diagnosed with hysteroscopy. The accumulation of a small amount of fluid in the uterine cavity, visualized by sagittal scanning in the form of an anechoic strip against the background of atrophic thin endometrium, is not a sign of endometrial pathology and occurs as a result of narrowing (infection) of the cervical canal, which prevents the outflow of the contents of the uterine cavity.

Hyperplastic processes of the endometrium occur against the background of an increased concentration of estrogens (classical and non-classical steroids), which realize a proliferative effect by acting on estrogen receptors in the endometrial tissue. The frequency of detection of estrogen and progesterone receptors, as well as their concentration, vary depending on the type of endometrial pathology and decrease as endometrial proliferative processes progress: endometrial glandular polyps - glandular fibrous polyps - glandular hyperplasia - atypical hyperplasia and endometrial polyps - cancer.

Hyperestrogenemia in postmenopausal women may be due to:

• excessive peripheral conversion of androgens to estrogens in obesity, especially visceral obesity, which is characterized by the highest enzymatic potential that provides aromatization;
• the presence of hormone-producing structures in the ovary (tecomatosis, tumors);
• liver pathology with impaired inactivation and protein-synthetic functions (decrease in the synthesis of proteins - carriers of steroid hormones, leading to an increase in the bioavailable fraction of hormones);
• pathology of the adrenal glands;
• hyperinsulinemia (in diabetes mellitus), leading to hyperplasia and stimulation of the ovarian stroma.

Hyperestrogenemia is currently considered as the main, but not the only cause of endometrial proliferative processes. The significance of immune disorders in this case, as well as the role of urogenital infection, are discussed.

In postmenopausal women, endometrial hyperplastic processes (both benign and malignant) can be clinically manifested by bloody discharge from the genital tract, but are often asymptomatic.

The latter serves as a prerequisite for the late diagnosis of precancerous and cancerous endometrial processes. Therefore, postmenopausal women without clinical manifestations should undergo a screening examination using ultrasound twice a year, and, if necessary (in risk groups for endometrial cancer), endometrial aspiration biopsy. Among women who do not have complaints, with ultrasound screening, the incidence of endometrial pathology in postmenopausal women is 4.9%.

In postmenopause, there is a wide range of intrauterine pathology: endometrial polyps (55.1%), its glandular hyperplasia (4.7%), atypical hyperplasia (4.1%), endometrial adenocarcinoma (15.6%), endometrial atrophy with blood discharge (11.8%), submucosal uterine fibroids (6.5%), adenomyosis (1.7%), endometrial sarcoma (0.4%).

Sonographic signs of endometrial polyps are local thickening of the M-echo, the presence of inclusions of increased echogenicity in its structure (Fig. 4), sometimes with visualization of color echo signals of blood flow in the projection of the inclusion. Diagnostic difficulties may occur with endometrial glandular polyps, which, due to their soft consistency, take on a flattened leaf-like shape and have a sound conductivity close to that of the uterine mucosa. Endometrial hyperplasia is characterized by a thickening of the M-echo of more than 4-5 mm with the preservation of clear contours, the frequent presence of small liquid inclusions in the structure of the M-echo (Fig. 5).

In endometrial cancer, the echographic picture is polymorphic. With ultrasound signs of endometrial pathology, hysteroscopy and separate diagnostic curettage of the uterine mucosa are required, followed by a histological examination. Hysteroscopy is the method of choice for diagnosing intrauterine pathology in postmenopausal patients: a visual assessment of the uterine cavity in 100% of cases makes it possible to identify the nature of endometrial changes and control the completeness of removal of the pathological focus.

According to the morphological study, in postmenopause, benign (fibrous, glandular-fibrous, glandular polyps, glandular hyperplasia), precancerous proliferative processes of the endometrium (atypical hyperplasia and polyps), and endometrial cancer are isolated. However, the prognosis for hyperplastic processes correlates not only with the type of endometrial pathology, but also with the proliferative potential of the endometrial tissue. A high risk of recurrence, progression and malignancy is characteristic of morphological forms of endometrial precancer - its atypical hyperplasia and polyps, in which, according to the study of chromatin of interphase nuclei (morphodensitometry), there is a high proliferative activity of cells (Fig. 6).

Prospective observations, receptor status studies, and morphodensitometry show that the concept of postmenopausal endometrial precancer should be supplemented by the clinical forms of this process, which include glandular hyperplasia and recurrent glandular endometrial polyps.

An in-depth examination of patients with recurrent forms of endometrial proliferative processes shows that the cause of relapses is the hormone-producing structures of the ovaries, both tumor and non-tumor (tecomatosis) in nature.

For a correct assessment of changes in the ovaries, it is necessary to know the normal echographic picture of the ovary and its dynamics in postmenopause (involutive changes in the ovaries are regular, reflected in a decrease in the size and volume of the organ, a change in the echostructure - according to ultrasound); the dynamics of changes is presented in the table.

The volume and structure of the ovary after menopause (see table) are subject to significant individual fluctuations, which is consistent with the data on the atrophic and hyperplastic (stromal hyperplasia) morphological type of the ovary after menopause and explains individual fluctuations in the level of steroid hormones during this period of a woman's life. In the atrophic type of the ovary, a significant decrease in their size and volume, a decrease in sound conductivity and the presence of hyperechoic areas are revealed, which corresponds to the prevalence of the connective tissue component.

On Doppler examination, there are no color echoes of blood flow, and often there is no clear visualization of the ovary. With the hyperplastic type of the ovary, the decrease in linear dimensions occurs slowly, the average level of sound conductivity of the ovarian tissue is characteristic, the presence of small liquid inclusions (often irregular and star-shaped) is possible. With a short duration of postmenopause, such inclusions are due to the preservation of the follicular apparatus, 5 years after the onset of menopause, only single follicles are histologically determined in the ovaries, and the inclusions visualized by echography may correspond to inclusion cysts. With a hyperplastic type of ovary, visualization of single color echo signals of blood flow is possible, mainly in the central part of the ovary.

It is believed that with the hyperplastic type of the ovary, hormone production in postmenopause, mainly androgenic, is preserved to a greater extent. This is confirmed by the data of a histochemical study with the determination of the enzyme of steroidogenesis 3-b-steroid dehydrogenase, indicating that the main site of hormone production after menopause is the ovarian stroma, and not the follicular apparatus.

When screening women who have no complaints about changes in the genitals, the frequency of ovarian pathology detected by echography is 3.2%. Among all tumors of the female genital area, ovarian tumors occupy the 2nd place; benign tumors account for 70-80%, malignant - 20-30%. In postmenopause, cancer awareness is especially necessary, since this period is the peak of the incidence of malignant tumors.

However, both in malignant and benign tumors, there are a number of prerequisites for late diagnosis of ovarian formations. In 70% of cases, an asymptomatic course of the disease is observed, and only in 30% there is a meager and non-pathognomonic (with benign tumors and early stages of ovarian cancer) symptoms. Even with a complicated course of the disease (tumor rupture, torsion of the leg), pain in the elderly, as a rule, is not expressed. Timely diagnosis of ovarian pathology is difficult due to frequent obesity, prolapse of the genitals, intestinal atony, adhesive process.

A combination of transabdominal and transvaginal ultrasound is a highly informative method for diagnosing formations of the uterine appendages. Doppler echography, along with the determination of tumor markers, is the main method of preoperative oncoexamination; the diagnostic accuracy is 98%. In malignant neoplasms, signs of vascularization are detected in 100% of cases, while the blood flow curves are characterized by low resistance (IR<0,47). Доброкачественные опухоли чаще имеют скудный кровоток, выявляемый в 55-60% случаев, характеризующийся высокой резистентностью. Для доброкачественных процессов характерно одностороннее поражение яичников (60%), двустороннее наблюдается лишь в 30% случаев; при злокачественном поражении выявляется обратное соотношение.

In postmenopausal women, epithelial tumors are the most common, but almost any histological variants can occur: simple serous cystadenoma (59%), papillary serous cystadenoma (13%), mucinous cystadenoma (11%), endometrioma (2.8%), Brenner tumor ( 1%), granulosa cell tumor (3%), thecoma (3%), fibroma (1.7%), mature teratoma (5%).

A feature of postmenopausal ovarian diseases is their frequent combination with endometrial pathology - every 3rd patient has one or another intrauterine pathology. Most often, glandular fibrous polyps (49%) and blood discharge against the background of endometrial atrophy (42%) are combined with ovarian tumors, less often - glandular hyperplasia of the endometrium (7.7%) and endometrial cancer (1.5%). The high incidence of endometrial pathology in ovarian tumors can be explained by the existence of the so-called "ovarian tumors with a functioning stroma", when there is hyperplasia of theca cells capable of hormone production in the tumor stroma. From these positions, changes in the uterine mucosa, on the one hand, are a secondary process, on the other hand, in the pathology of the ovary and endometrium, there are often multiple common risk factors.

Thus, in the postmenopausal period, against the background of regular involutive processes (in the body as a whole and in the reproductive organs), benign and malignant neoplasms of the genitals often occur, timely diagnosis and prevention of which require regular dispensary observation. Ultrasound is the most important screening method for genital pathology.

Female appendages are important organs of the reproductive system that are necessary for conceiving a child. With the onset of menopause, their average statistical parameters change, due to the extinction of the functioning of the appendages. The norm of the ovaries in menopause and the sizes have certain values, according to which doctors determine whether a woman is healthy or has a pathology.

The size of the ovaries during menopause is determined by an ultrasound examination, which a woman should undergo 1-2 times a year as a preventive measure to exclude inflammatory and infectious processes in the pelvic organs. When conducting an examination, it is not the parameters that are taken into account, but the volume of the examined appendages, since this information may indicate a benign or malignant formation.

With the onset of menopause, serious changes occur in the body of a woman that affect the appendages. The normal size of the ovaries in women according to ultrasound during menopause should be as follows:

• length - 19–24 mm;
• width - 11–14 mm;
• thickness - 8–11 mm;
• volume - 2–4 cm3.

Such sizes of ovaries in postmenopause are the norm. They can fluctuate within 3 mm in the first few years after menopause. Fluctuations in parameters are associated with the periodic development of a pair of follicles in these phases.

The results obtained by examination using ultrasound cannot be the only basis for determining an accurate diagnosis.

Increase

The size of female paired appendages depends on many factors. The female body is a complex mechanism. Menopause does not come immediately, it lasts up to several years, until menstruation does not stop at all.

If a woman has critical days at least several times a year and an examination was carried out at that time, then the sizes can differ significantly. The volume of the appendages depends on the day of menstruation, the use of oral contraceptives and the use of hormone-containing medications.

Pathologies

If the size of the ovaries exceeds the norm, then the woman has a pathological change that requires a diagnosis and treatment. An increase in the volume of the appendages may indicate the presence of the following diseases of the reproductive system:

• cystic formations;
• metastases;
• malignant or benign tumors;
• congenital pathologies of the size or structure of the ovaries.

Enlarged appendages can signal serious disorders in the body. Additional diagnostics and, if necessary, treatment is necessary.

What happens in the case of the appearance of single follicles before and during menopause. ovary after menopause Menopause and menopausal syndrome: what happens in a woman's body? Harbingers, hot flashes, symptoms and manifestations, diagnosis of menopause (menopause). Diseases associated with menopause (uterine fibroids, endometrial hyperplasia, and others) Thank you Climax- this is the depletion of the female sex glands - the ovaries, which every woman inevitably experiences. And although menopause is a completely physiological process, and not a pathology, every woman feels different symptoms, requires observation by her gynecologist and treatment. All the rich symptoms of menopause are the result of a deficiency of female sex hormones, which play a huge role in a woman's life. There is probably not a single organ in the female body that does not involve sex hormones. Therefore, during menopause, changes affect the entire body as a whole, including appearance, psycho-emotional state and sexual life. What happens in a woman's body? Ovaries with menopause The ovaries undergo irreversible changes during menopause. As it has already become clear, at all stages of menopause there is a change in their functions. The activity of the ovaries decreases premenopausal and stops completely postmenopausal. In addition to functions, the ovaries change their shape, size and structure. At the initial stages, the ovaries slightly decrease in size; a small number of follicles can still be found in them. After the onset of menopause, they seem to wrinkle, their size decreases several times, follicles are not defined in them, and the ovarian tissue is gradually replaced by connective tissue - that is, tissue devoid of any function. Changes in the uterus and endometrium with menopause The uterus also responds to hormonal imbalances. During a normal menstrual cycle, physiological changes constantly occur in it, necessary to prepare for the fixation of the fetal egg. Particular changes occur in the inner layer of the uterus - the endometrium, it is updated monthly, rejected during menstruation and thickened after ovulation. And all this under the influence of estrogens and progesterone. Involution in the uterus and in the fallopian tubes with menopause: Premenopausal the uterus increases somewhat in size, but becomes less dense. After menopause the uterus decreases in size several times. Myometrium , or the muscular layer of the uterus gradually atrophies, in postmenopause it is replaced by connective tissue - that is, it loses contractile functions. Even at the beginning of the climax uterine endometrium , or its inner layer gradually becomes thinner, by menopause it is also replaced by connective tissue - the inner cavity of the uterus overgrows. Cervix is also shortened, the cervical canal connecting the uterus with the vagina is significantly narrowed or completely overgrown. It also disrupts the functioning of the mucous glands located on the neck, which reduces the amount of vaginal mucus, or "lubrication". The fallopian tubes gradually atrophy, their patency disappears, they also overgrow with connective tissue over time. Weakened ligaments and muscles that support the uterus with appendages in the pelvis. As a result, the risk of prolapse of the vagina and uterus increases. How does menopause affect the vagina and vulva? Female hormones are responsible for the elasticity, firmness and moisture of the vagina, which is necessary for a normal sexual life and fertilization. With the extinction of the ovaries and estrogen deficiency, changes also occur in the vagina that bring women unpleasant discomfort. Changes in the vagina with menopause: Gradual loss of elasticity and firmness of the vagina, thinning of its walls, as a result - it narrows and stretches poorly during sexual intercourse, bringing pain to the woman. Decreased secretion of vaginal secretions, or "lubrication". The vagina becomes dry, poorly lubricated during sexual arousal. The acidity of the vaginal mucus changes, which reduces local immunity, leads to a violation of the microflora (dysbiosis, thrush) and increases the risk of infection with sexually transmitted diseases. Fragility of the vessels that feed the vaginal wall is noted, which can be manifested by spotting. With menopause, the appearance of the external genitalia also changes: the labia majora become flabby due to the loss of adipose tissue in them; labia minora gradually atrophy; thinning pubic hair. Processes in the mammary glands The condition of the mammary glands directly depends on female sex hormones. They constantly undergo changes associated with the menstrual cycle and lactation. With menopause, as in the genitals, changes also occur in the mammary glands (involution, or reverse development), because there are few sex hormones, there is no menstrual cycle, and breastfeeding is no longer useful. Physiological involution of the mammary glands with menopause: 1. Fat involution - replacement of the glandular component of the mammary glands with adipose tissue, which does not carry specific functions. 2. fibrous involution - replacement of glandular tissue with connective tissue. In this form, the reverse development of the mammary glands can be complicated by the formation of tumors and cysts, which are usually benign in nature, but always have a risk of malignancy. This process is called "fibrocystic involution". 3. Fibrofat involution The mammary gland is made up of fat and connective tissue. What does the mammary gland look like after menopause? In premenopause, the mammary glands may thicken, swell, and slightly increase in size. After menopause, the mammary glands become soft, sag, change their size, in overweight women they increase in size due to excess fat, and in thin women, on the contrary, they decrease, they can completely atrophy. The nipple also changes, it sags, decreases in size, turns pale. Skin in menopause. What does a woman look like after menopause? Female hormones are the beauty of a woman, beautiful skin, hair, toned face and figure, attractiveness. And the saddest thing that happens during menopause is the appearance of age-related changes, that is, aging. Of course, the pace of aging is different for every woman. Everything is very individual. Some girls are already covered with wrinkles at 30, while other ladies at 50 even look very young. But with the onset of menopause, everything becomes very noticeable, because changes in the skin cannot be avoided. What changes in appearance can appear in women after menopause? 1. Wrinkles, skin laxity. In the skin, the processes of formation of its own collagen, elastin and hyaluronic acid worsen, that is, the skin frame becomes loose and flabby. As a result - wrinkles, dry skin, sagging of the contours of the face and body. 2. Tired appearance, morning swelling. Under the influence of a lack of hormones and cardiovascular problems, the microcirculation of the skin is disturbed, which worsens the metabolic processes in it. The skin suffers from a lack of oxygen and nutrients, harmful compounds accumulate in it. Subsequently, the skin fades, turns pale, has a tired look. Red spots may appear associated with dilated blood vessels (rosacea). Morning swelling on the face and limbs is also associated with poor circulation. 3. Skin inflammation. Sex hormones regulate the work of the sebaceous and sweat glands, which protect the skin from negative environmental factors. Therefore, with a deficiency of female hormones, the skin becomes sensitive, easily irritated, various inflammatory dermatological problems appear. Seborrheic dermatitis may appear, as well as blackheads and acne, with which we are accustomed to associate adolescence. 4. Age age spots are more embarrassing for many than wrinkles and sagging skin. They cover not only the body, but also the face. Causes of age spots after menopause: Violation of pigment metabolism, which probably involves sex hormones. In this case, the extra pigment melanin is not "utilized", but accumulates in the skin. The protective layer of the skin is weakened, so it is more susceptible to sunlight, which stimulates the production of excess melanin. By menopausal age, problems often appear with the liver, which is also involved in the exchange of pigments. Many experts believe that age spots are manifestations of atherosclerosis, and since this pathology often progresses with menopause, there are more and more spots. Age spots on the skin can be in the form of ordinary dark spots that merge with each other (chloasma), freckles, which are more located on the hands, and also in the form of plaques (keratoma, xanthelasma), which are dangerous for the risk of malignancy. 5. Increased hair loss - they thin, become drier, stiffer, brittle, devoid of shine and natural color. Who has not yet turned gray before, gray hair appears. Thinning eyelashes and eyebrows. 6. May be noted hair growth in unwanted places , for example, antennae, individual hairs on the cheeks, back. 7. Shape changes associated with weight gain, sagging skin, redistribution of fat throughout the body. In addition, over time after menopause, posture changes and even a person’s height decreases, which is associated with age-related changes in the bones. Why is menopause dangerous for bones? Throughout life, there is a constant renewal of bone tissue, or, as experts call this process - remodeling. In this case, the bone tissue is partially absorbed and a new one (osteogenesis) is formed in its place. Remodeling is planned at the genetic level and is regulated by many metabolic processes and hormones, including sexual ones, this is a very complex process. Without a sufficient amount of estrogen during menopause, bone formation is disrupted, while the bone is gradually destroyed. Also, as a result of menopause, the absorption of calcium and phosphorus, minerals that are responsible for bone strength, is disrupted. Such changes in the skeletal system lead to the slow destruction of bone tissue, or osteoporosis, to increased bone fragility and various degenerative processes in them. Menopause, heart and blood pressure Estrogens in childbearing age protect a woman from the development of cardiovascular diseases. But as soon as their level drops, the risk of developing atherosclerosis, arterial hypertension with all the consequences increases several times. How does a deficiency of sex hormones affect blood vessels? With menopause, the metabolism of fats is disturbed. Excess fat, namely cholesterol, is deposited not only on the sides, but also on the walls of blood vessels, that is, atherosclerosis develops. Atherosclerotic plaques gradually increase and narrow the lumen of blood vessels, which leads to impaired blood circulation, increasing the risk of heart attack and stroke. Climax affects the processes of narrowing and dilation of blood vessels. These processes are necessary for the adaptation of the body during physical or emotional stress. Normally, vascular tone is regulated by the autonomic nervous system, and with a lack of estrogen, this regulation is disrupted, which leads to spontaneous vascular spasms or, conversely, to a decrease in vascular tone. This is manifested by jumps in blood pressure, the development of arterial hypertension, aggravation of atherosclerosis, the development of arrhythmias and coronary heart disease. Increases blood clotting. Estrogens thin the blood, and when they are deficient, the blood becomes thick, prone to the formation of blood clots and atherosclerotic plaques. As a result, an aggravation of the course of atherosclerosis, circulatory disorders and an increased risk of heart attacks, strokes and thromboembolism. Menopause and thyroid gland Thyroid and ovarian hormones are always interconnected. As with thyroid diseases, the reproductive function of a woman is disrupted, and with menopause, malfunctions in the thyroid gland can occur. It's all about the hormones of the central nervous system that regulate the function of these organs, namely follicle-stimulating and luteinizing hormone (FSH and LH) and thyroid-stimulating hormone (TSH). They are very similar in their chemical structure. During the restructuring of the body at the beginning of menopause, the level of FSH and LH increases, they react to the lack of sex hormones and try to “spur” the ovaries to produce them. And with stress, which occurs during menopause, the thyroid gland may begin to perceive FSH and LH instead of TSH, which is more often manifested by an increase in its functions and the release of a large amount of hormones. This imbalance of thyroid hormones leads to metabolic disorders and requires urgent specific treatment. Climax and nervous system The nervous system during menopause suffers the most. In addition to the fact that female hormones are involved in various "nervous processes", menopause and aging for a woman is always stress, both somatic (bodily) and psycho-emotional. This is what exacerbates the development of nervous disorders. What happens in the nervous system with the onset of menopause? Sex hormones affect the autonomic nervous system , which is responsible for the work of all internal organs, blood vessels and the adaptation of the body to various environmental factors, that is, to all internal processes. With an imbalance of estrogens and progesterone, the work of the autonomic nervous system is disrupted, as a result, a rich symptomatology of menopause: these are hot flashes, and a violation of vascular tone, the work of the heart and other organs. Influence of female hormones on the central nervous system. In the brain, the processes of excitation and inhibition of the nervous system are disturbed, this is manifested by increased emotionality, depression, emotional outbursts, sleep disturbance and other mental disorders. In addition, the lack of sex hormones affects brain structures such as the pituitary and hypothalamus, which are responsible for the production of many hormones, including serotonin, norepinephrine and endorphins - hormones of happiness. Mental disorders exacerbated by depression into which the woman "drives" herself. She realizes that she is getting old, it seems to her that she has become ugly, that she did not have time, did not achieve much. Besides, suffers and sex life , which, as you know, is an integral part of inner peace and satisfaction. Yes, and survive hot flashes and other unpleasant symptoms of menopause is also difficult. Symptoms and manifestations of menopause in women Deficiency of sex hormones during menopause affects many systems, organs and processes in the body. All these violations cannot pass without a trace, therefore, with the onset of menopause, various symptoms appear that bring discomfort and some women are driven to despair. Symptoms and manifestations of menopause are very individual. We are all unique, every fifth woman does not feel any changes in her health at all. Menopause is more easily tolerated by people who lead a healthy lifestyle, have interesting hobbies, are in demand in the family and are ready to adequately meet their interesting mature age. Harbingers Experts believe that the harbingers of menopause appear already at the age of 30-40 years or even earlier, long before the onset of premenopause, and these are: problems with conceiving and bearing a child or reduced fertility after 30 years; hormone-dependent gynecological diseases, for example, endometriosis, ovarian cysts; diseases of the mammary glands, mastopathy; menstrual irregularities, heavy or scanty periods, menstrual cycles without ovulation. All these conditions are associated with an imbalance of female sex hormones and require mandatory treatment by a gynecologist-endocrinologist. The onset and first signs of menopause, menstrual irregularities Beginning menopause is always characterized by menstrual irregularities. Against the background of a failure of menstruation, other symptoms associated with a lack of estrogen gradually develop. All these manifestations are combined in climacteric syndrome, which each woman manifests very individually. Usually, one of the first symptoms of menopause are hot flashes and impaired psycho-emotional state. The menstrual cycle is completely dependent on the hormones that are produced by the ovaries and the central nervous system (releasing hormones, LH and FSH). At the very beginning of menopause, the female cycle does not stop yet, but obvious failures are already noticeable, menstruation becomes irregular and completely unpredictable. Also, most menstruation passes without ovulation, that is, without the maturation of the egg. In what form, and with what regularity menstruation will go, traditionally depends on individual characteristics. But it is possible to define some options for menstrual irregularities in premenopause: 1. Cycle lengthening (more than 30 days), scanty menstruation . This is the most common type of menstrual irregularity before menopause. In this case, the period between menstruation can be several months, and after 2-3 years menopause occurs, that is, the complete cessation of menstruation. 2. Abrupt cessation of menstruation one can say in one day. It doesn't happen very often. In this case, the development of two variants of the course of menopause is possible: a woman crosses this stage in her life almost without any discomfort, or menopause is more difficult, which is due to the fact that the body does not have time to adapt to a sharp change in hormonal levels. Why do hot flashes appear during menopause? The mechanism of tidal development is so complex and multicomponent that it has not yet been fully studied. But many experts believe that the main mechanism for the development of hot flashes is the “suffering” of the central and autonomic nervous system from a lack of sex hormones. Modern research has proven that the main trigger in the development of hot flashes is the hypothalamus, a structure in the brain whose main function is to regulate the production of most hormones and control thermoregulation, that is, to maintain normal body temperature under the influence of various environmental factors. With menopause, in addition to the ovaries, the hypothalamus is also rebuilt, because it disrupts the production of releasing hormones that stimulate the pituitary gland and then the ovaries. As a result, thermoregulation is also disturbed as a side effect. In addition, menopause affects the functioning of the autonomic nervous system, sweat glands and the cardiovascular system. Obviously, the complex of all these reactions of the body to the lack of sex glands manifests itself in the form of attacks of hot flashes. What are the symptoms of hot flashes during menopause? 1. Not all women feel the harbingers of the tides, many attacks are taken by surprise. Before the onset of the tide, tinnitus and headaches may appear - this is due to a spasm of the cerebral vessels. 2. Throws into the heat - many describe the abrupt onset of the tide, the head and upper body seem to be doused with boiling water, the skin becomes bright red, hot to the touch. At the same time, the body temperature rises above 38 o C, but it will soon return to normal. 3. There is increased sweating, drops of sweat immediately appear, which quickly flow down in streams. Many women describe that their hair and things become so wet that "at least wring it out." 4. General well-being is disturbed - heartbeat accelerates, headache, weakness appear. Against this background, nausea and dizziness may appear. Severe attacks of hot flashes can even lead to short-term fainting. 5. The feeling of heat is replaced by chills - due to the fact that the skin becomes wet with sweat and thermoregulation is disturbed, the woman freezes, muscle tremors begin, which can persist for some time. After an attack, muscles may ache due to muscle tremors. 6. Violation of the psycho-emotional state - during the tide, an acute attack of fear and panic occurs, a woman may begin to cry, may feel short of breath. After that, the woman feels devastated, oppressed, and a pronounced weakness develops. With frequent hot flashes, depression can develop. It is these symptoms that are described by women who have experienced severe attacks of hot flashes. However, not everyone tolerates the menopause. Hot flashes can be short-term, lighter, without disturbing the general and psycho-emotional well-being. Often, ladies feel only increased sweating and heat. Some women experience nocturnal hot flashes in their sleep, and only a wet pillow indicates a past attack. Many experts believe that the severity of hot flashes directly depends on the psychological state of the woman, but there are a number of factors that often provoke the development of hot flashes. Irritant factors that provoke hot flashes: Stuffiness: poorly ventilated area, large crowds, high humidity on a hot day. Heat: prolonged exposure to the sun, out-of-season clothing, space heating with fireplaces and other heat sources, bath or sauna. Anxiety: stress, emotional distress, nervous exhaustion, fatigue and lack of sleep. Food and drinks: hot, spicy, sweet, too spicy food, hot and strong drinks, coffee, strong tea and overeating. Smoking, namely the very addiction to nicotine. Often the flush appears during a long break between cigarettes and with a strong desire to smoke. Poor quality clothes , poorly permeable to moisture and air, leads to overheating of the body, and wearing such things can provoke a rush. In principle, if a woman avoids the effects of these factors, she can control hot flashes, and if good emotions are added to all this, then menopause will go much easier. How long do hot flashes last during menopause? The attacks of hot flashes themselves can last from a few seconds to several minutes, this is very individual. There may be no such attacks per day, or maybe several dozen. Individually, and how much time they generally have to endure. Statistics show that almost all women experience hot flashes for at least 2 years (from 2 to 11 years). But some "lucky women" have to experience these hot flashes for many years after menopause and even for life. The duration and severity of hot flashes largely depend on when they began: with early menopause and a long period of premenopause, hot flashes last longer. What do tides affect? Psycho-emotional state of a woman, self-confidence. Immunity - violation of thermoregulation reduces the body's ability to adequately respond to infections and other external factors. There may be fears of leaving the house so that people do not see her in this state. Prolonged depression against the background of severe hot flashes is not only a manifestation of psychological problems, but also increases the risk of developing other pathologies, such as psoriasis, diabetes, arterial hypertension, and many "mental" diseases. Some women have such a hard time with hot flashes that they even have to resort to emergency medical services. It must be remembered that hot flashes and menopause itself are a normal reaction of the body, which is not any pathology, all the more something shameful and shameful. Moreover, many modern women are not only not shy about this, but are also ready to discuss it. It is important to prepare for menopause in advance, change your lifestyle, get everything from life, especially positive emotions, listen to your body. All this will not only alleviate the symptoms of menopause, but will also allow you to move on to a new stage of life with ease and dignity. climacteric syndrome As already mentioned, the climacteric syndrome in each woman proceeds differently. It represents a huge complex of symptoms and manifestations from various organs and systems. Many of these symptoms are still experienced by most women, to varying degrees and severity. Violation of the menstrual cycle and hot flashes are essential components of menopause. Other manifestations may be absent or unrecognized, often ladies associate poor health with fatigue or other diseases. Symptoms depend on the phase of menopause. So, in premenopause, more vivid symptoms are observed, but after menopause, the risk of developing many diseases increases, which are often not associated with the manifestations of menopause. Symptoms of the period of premenopause - from the first manifestations of menopause to 2 years of complete absence of menstruation Symptoms How do they appear? tides sudden feeling of heat; profuse sweating; skin redness; increase in body temperature; chills; severe weakness and disruption of the heart; psychoemotional disorders. excessive sweating may accompany hot flashes and be a separate manifestation of estrogen deficiency; often occurs at night; many women, because of this symptom, have to change clothes several times a day and use the most "powerful" antiperspirants. Increased body temperature fever may be associated with hot flashes or manifest as a separate symptom; during high tides, the temperature may exceed 38 o C; prolonged subfebrile condition or temperature up to 37 o C can be observed. Discomfort in the mammary glands swelling and puffiness; drawing pains in the chest; changes cease to depend on the phase of the menstrual cycle. Insomnia And drowsiness hard to sleep at night; during the day you constantly want to sleep; often women in menopause have bad dreams that are so vivid and realistic that they keep negativity for the whole day. Headache may be pronounced or aching; often develops for no apparent reason, at any time of the day, including in the morning and at night; often has the character of a migraine (acute pain in one half of the head); difficult to treat with conventional analgesics. Weakness, increased fatigue this symptom accompanies almost all women in menopause; often weakness and fatigue occurs already in the first half of the day, both after mental or physical exertion, and without it; working capacity decreases, memory, concentration and attention worsens, absent-mindedness appears. Irritability , tearfulness, anxiety and a lump in the throat even the most restrained women can break down on loved ones over trifles, often this symptom is accompanied by a fit of hysteria; ladies become touchy and impressionable, it seems to them that no one understands them; constant or sudden anxiety, many have bad "forebodings" of impending disaster, all this is accompanied by pathological fears; "pessimism" prevails over "optimism", and negative emotions over positive ones; a woman may stop enjoying life as much as before, but what is interesting is that in the postmenopausal period, love and joy for life not only return, but also become much stronger than in her youth. Depression, chronic stress this is the result of not only a lack of hormones, but also an unwillingness to realize the fact of the onset of menopause; "fuel is added to the fire" nervous exhaustion due to fatigue, poor sleep, lack of sex, hot flashes and other manifestations of menopause. Feeling the heartbeat Most often, there is an increase in heart rate or tachycardia. Tachycardia usually occurs spontaneously and resolves on its own. Urination disorder increased risk of developing cystitis. Sex, fertility and perimenopause decreased sex drive (libido); there is a slight dryness in the vagina; sexual intercourse may become painful (dyspareunia); natural pregnancy is still possible. Other manifestations the first signs of skin aging: dryness, shallow wrinkles, decreased skin tone, etc.; fragility of hair and nails appears; blood cholesterol may increase; some women begin to gain weight. Postmenopausal symptoms - 1 year after the last menstrual period and for the rest of life Symptoms How do they appear? Hot flashes, sweating and psychoemotional disturbances hot flashes usually become less frequent and easier, after a few years, most women have hot flashes completely; irritability, tearfulness, fatigue persist, but every month and year it becomes easier; insomnia and weakness persist for several more years, and some women do not get enough sleep for a long time. Excess weight many women gain weight, which is associated with a sedentary lifestyle, a slowdown in metabolism, and also with the fact that the body is trying to make up for the lack of estrogen due to its production by adipose tissue; the type of the figure also changes, there is a redistribution of fat in the abdomen and upper shoulder girdle, the skin sags, the posture changes. muscle weakness lack of hormones leads to weakening and flabbiness of muscle tissue, muscles sag, and their performance is significantly reduced; "Pumping muscle" with the help of sports becomes much harder than at a younger age. Vaginal dryness pain during intercourse; feeling of discomfort while wearing tight underwear and clothes; high risk of developing thrush and other inflammatory processes of the vagina. Vaginal discharge, itching and burning vaginal discharge is normal after menopause if it is: transparent, odorless and colorless, its amount is scarce and most importantly, it does not cause any discomfort and itching; the presence of itching, burning and unusual discharge indicate the presence of inflammatory and other problems, are not a normal condition, an appeal to a gynecologist is required; yellowish, odorless discharge, itching and discomfort during sexual intercourse indicate vaginal dysbiosis - the most common condition of the genital organs after the onset of menopause; cottage cheese discharge with a sour smell indicates vaginal candidiasis (thrush); secretions with a specific odor indicate the attachment of various pathogenic infections, including sexually transmitted ones; brown and bloody vaginal discharge may be associated with increased fragility of the vessels of the vaginal mucosa, in which case blood appears to a greater extent after intercourse, but also blood from the vagina can be a sign of tumors in the uterus and appendages, including malignant ones. Urination disorder the urge to urinate is significantly increased; a very high risk of developing urethritis and cystitis, as a result - the risk of developing inflammation of the kidneys (pyelonephritis); some women may experience urinary incontinence, especially when exercising, and the saying "you can stop laughing" is not so funny anymore. Sex and fertility libido continues to decline, although some women, on the contrary, have a special interest in sex, one that was not even in their youth; pain increases during sex due to vaginal dryness and poor elasticity of its walls; natural pregnancy is no longer possible. Skin, hair and nails there is a noticeable aging of the skin, it becomes dry, flabby, sags, deep age wrinkles appear, and not only on the face; the natural blush disappears, the skin of the face grows dull, looks tired, there are problems with acne, acne; often there are swelling of the eyelids; the hair splits, becomes thin, dull, turns gray, and there is also an increased loss of hair, over time the braid becomes much thinner; growing nails for a beautiful manicure is becoming increasingly difficult, they are brittle, often lose their color. High risk of developing various diseases osteoporosis - deformation of bone tissue; cardiovascular pathologies (arterial hypertension, atherosclerosis, arrhythmia, angina pectoris and others); diseases of the uterus and appendages (myoma, ovarian cysts, polyps, oncological diseases), prolapse of the vagina and uterus; pathologies of the mammary glands (mastopathy, cancer); diabetes mellitus, pathology of the thyroid gland and adrenal glands; diseases of the nervous system (vegetative-vascular dystonia, strokes, mental disorders and diseases); diseases of the digestive system (cholelithiasis, constipation, hemorrhoids); urinary tract infections and others. Diseases with menopause One of the manifestations of menopause after menopause is the risk of developing various diseases. This does not mean that all women in the period of menopause should suddenly begin to suffer from all diseases. Everything largely depends not so much on the level of hormones as on lifestyle, genetic predisposition and many environmental factors. In addition, many of these diseases can develop without menopause at a younger age. Yes, and men who are not so dependent on estrogens also suffer from these ailments. But many scientific studies have proven that it is the deficiency of sex hormones that is the trigger for the development of many of the "age-related" pathologies. Let's consider some of them. Diseases associated with menopause: Disease Factors and causes that increase the risk of developing the disease Main symptoms What is dangerous? How to reduce and prevent manifestations of the disease? Osteoporosis- a decrease in bone density, a lack of calcium, phosphorus and other minerals in them, leads to the gradual destruction of bone tissue. heredity; smoking; alcohol; sedentary lifestyle; excess weight; rare exposure to sunlight; unbalanced diet; diseases of the digestive and endocrine systems. bone pain, especially "for the weather"; movement disorder in some joints; weakness, decrease in physical strength, sluggishness; spinal deformity, manifested by a violation of movements and posture, pain and a decrease in growth; deformation of the fingers and toes and other bones; fragility of nails, diseases of the teeth and hair loss. Pathological bone fractures that can occur even with the slightest injury and simply unsuccessful movements. Fractures are difficult to grow together and can permanently chain a woman to a bed. Violation of cerebral circulation as a result of osteochondrosis of the cervical and / or thoracic spine. Right way of life; food rich in calcium and phosphorus; moderate sunbathing; moderate physical activity, the correct mode of work and rest; fight against excess weight; avoid falls, injuries, awkward movements; hormone replacement therapy with sex hormones reduces the manifestations of osteoporosis; taking calcium supplements: Calcium D3, Ergocalciferol and many others. Uterine fibroids is a benign tumor of the uterus associated with an imbalance of sex hormones. Myoma can be of different sizes, single or multiple. It often occurs against the background of menopause, and after the onset of menopause, small myomatous nodes are able to resolve on their own. Abortions and operations on the uterus; lack of childbirth; endometriosis; irregular sex life; chronic stress; early menarche (first menstruation); excess weight; abuse of animal food; alcohol abuse; heredity; late pregnancy can exacerbate the growth of fibroids. Prolonged, frequent and profuse menstruation; bleeding that is not associated with the monthly cycle; an increase in the volume of the abdomen; frequent urge to urinate; constipation; pain during intercourse. Uterine bleeding, including massive. Pelvioperitonitis associated with torsion of the leg of the myoma node requires surgical intervention. Cancer is the malignancy of a tumor. Replacement hormone therapy; healthy lifestyle; regular sex; prevention of venereal diseases; fight against excess weight; regular follow-up with a gynecologist. ovarian cysts- benign cavity formations. With menopause, dermoid, endometrioid and other types of non-functional cysts often occur, as well as polycystic ovaries. Endocrine diseases of the thyroid gland, adrenal glands, brain; abortions and operations; inflammatory diseases of the pelvic organs; sexually transmitted infections; genetic predisposition; taking contraceptives and hormone replacement therapy with sex hormones. Pain in the abdomen, in the lower abdomen or in the lower back, aggravated by physical exertion and sexual intercourse; violation of urination and constipation; asymmetric enlargement of the abdomen; spotting spotting; painful menstruation in premenopause. Cancer - non-functional cysts have a high risk of malignancy. Cyst rupture, ovarian rupture, and torsion of the cyst pedicle are conditions that require urgent surgical treatment. Annual examination by a gynecologist and timely treatment of gynecological problems; if necessary, surgical treatment; prevention of venereal infections; healthy lifestyle and "no" to carcinogens. Uterine bleeding- spotting from the vagina of a different nature, associated or not associated with menstruation. In premenopause, bleeding is often associated with hormonal changes in menopause and menstrual irregularities; endometriosis; uterine fibroids; uterine polyposis; pathology of the cervix; polycystic and other ovarian cysts; spontaneous abortions. Options for uterine bleeding in the premenopausal period: prolonged and heavy menstruation (more than 6 pads per day and more than 7 days); periodic spotting spotting, not associated with menstruation; the presence of large blood clots, lumps during or between periods; frequent periods (more than every 3 weeks); spotting that appears after intercourse; prolonged spotting of varying intensity (more than 1-3 months). After the onset of menopause, any spotting should alert. Cancer. Uterine bleeding can be a sign of serious illness, including cancer. Anemia - with prolonged and heavy bleeding, lead to loss of blood. Hemorrhagic shock - can develop with massive uterine bleeding, requires urgent resuscitation, surgery and transfusion of blood products. Timely access to a doctor to determine the causes of bleeding and their correction; food rich in protein and iron; control over the amount of blood lost. Mastopathy- a benign tumor of the mammary glands. Involution of the mammary glands associated with hormonal changes; early onset of menstruation and early puberty; various diseases of the uterus and appendages, especially inflammatory ones; lack of lactation or a short period of breastfeeding; no pregnancy before the age of 30; abortions and miscarriages; stress; excess weight; taking contraceptives and other hormonal drugs in large doses; endocrine pathologies. Pain in the chest of a pulling, dull, aching character; the presence of seals in the mammary glands of various sizes; change in the shape and size of the mammary glands; a feeling of swelling and swelling in the glands; any discharge from the nipples. Breast cancer - against the background of menopause, the risk of tumor degeneration increases. Regular preventive examination of the mammary glands (self-examination, ultrasound or mammography); healthy lifestyle; timely treatment of inflammatory diseases of the genital organs; refusal of abortions; breastfeeding for more than 6 months; the dose of hormonal drugs should be selected individually by a doctor. Diseases of the cardiovascular system: arterial hypertension; atherosclerosis; cardiac ischemia; arrhythmia; heart failure. genetic predisposition; regular intake of drugs containing aspirin; control of blood pressure; timely access to a doctor and compliance with his recommendations. Diseases associated with menopause can be prevented not only by hormone replacement therapy, often recommended during severe menopause, but also by the right lifestyle and regular examinations by your gynecologist. Menopause is one of the causes of panic attacks in women (opinion of a psychotherapist) - video Menopause diseases: obesity, diabetes mellitus, uterine prolapse, thrombosis, Alzheimer's disease - video Menopause diagnostics Menopause is not a disease and, it would seem, why diagnose it, because everything is clear anyway - hot flashes, menstrual irregularities, the onset of menopause and the body getting used to living on small doses of sex hormones. But there are situations when it is simply necessary to know whether menopause has begun, and at what stage it is. Why do we need menopause diagnostics? differential diagnosis of menopause and other diseases; identification of complications and diseases associated with menopause; examination before prescribing hormone replacement therapy and contraceptives. What is included in the examination plan for menopause? 1. Analysis of life history and complaints (time of onset of menarche, presence of pregnancies, abortions, regularity of the menstrual cycle, etc.).
Estradiol, pg/ml	Progesterone, nmol/l	FSH(follicle-stimulating hormone), honey/ml	LG(luteinizing hormone), honey/ml	LH/FSH index
Reproductive period before menopause: 1. Follicle maturation phase (1-14th day of the menstrual cycle).	less than 160	up to 2.2	to 10	less than 15	1,2-2,2
2. Ovulation (14-16th day).	over 120	to 10	6 – 17	22 – 57
3. Luteal phase (16-28th day).	30 – 240	over 10	up to 9	less than 16
premenopause	Female sex hormones gradually decrease**, menstrual cycles are observed without ovulation.		over 10	over 16	about 1
Postmenopause	5 – 30	less than 0.6	20 - 100 and above	16 - 53 and above	less than 1