Vascular collapse symptoms. Vascular collapse - causes, symptoms, treatment
In a woman’s life, there are several periods that are characterized by certain age
anatomical and physiological features. There is no clear boundary between the periods; one period smoothly turns into
another. Age limits may vary slightly depending on climatic conditions,
state of health of organs and systems, state of psychological stability, characteristics of biological and
social factors.
Puberty
Begins at 8-9 years old, ending at 17-18 years old. During this period, the gonads are activated, further
development of the genital organs, secondary sexual characteristics appear, such as enlarged mammary glands,
female-type hair growth, change in appearance. During this period, the first menstruation comes and
the cyclicity of the menstrual cycle is established. At the end of puberty, the body
girls are anatomically and functionally ready for procreation. Puberty provided by women's
sex hormones that are produced in the ovary, and their production, in turn, is subject to cyclic
fluctuations in hormones of the pituitary gland and hypothalamus. The period of puberty is the most responsible period in
a woman’s life, since her further physical and reproductive health will depend on
established menstrual cycle. During this period, the girl’s body is especially sensitive to various
factors such as nutritional errors, frequent infections, intoxication, excessive physical exercise and etc.
Based on this, certain requirements are imposed during this period on parents, school, medical and
social workers. A complete, balanced diet, hardening, and sanitation are of great importance
chronic foci of infection, maintaining psychological balance, prevention bad habits.
Particularly great responsibility falls on the parents, in particular on the girl’s mother, who must, in addition to
everything else, prepare the girl psychologically for the first menstruation, the appearance of sexual feelings and
responsibility for the future.
Puberty - reproductive period
Its duration varies from person to person; on average, it lasts up to 40-45 years. This period is characterized
maturity of all specific functions female body, the most important of which is the ability to
childbirth. Actively functioning ovaries secrete female sex hormones that have protective
properties on the activity of the most important organs and systems - cardiovascular, central nervous system, mineral metabolism and
etc. This is a period of physical, creative activity of women. The most important factors preservation of reproductive
health are general hygiene, sexual hygiene, family planning and somatic preservation
health. The health of women at this age affects the course and outcome of pregnancy, as well as health
future generation.
Menopause
This is a natural, physiological period of cessation of childbearing function. It is divided into sodium phases:
- premenopause(2-5 years before the cessation of menstruation). There is a gradual decline in ovarian function,
menstruation becomes irregular; - menopause- the actual cessation of menstruation;
- postmenopause(5 years after the cessation of menstruation). During this period, the woman’s body is completely
is rebuilt to exist in a new capacity, a period of rest begins.
The menopausal period places increased demands on a woman’s body, as a decrease in
the production of female sex hormones is accompanied by changes in well-being, mood, and the appearance
menopausal symptoms, which often acquire a pathological course.
Estrogen deficiency can be considered as a natural physiological process. But the appearance
menopausal symptoms, such as metabolic-endocrine, psycho-emotional, cardiovascular,
urogenital, significantly worsens the quality of life of women. Change the situation, improve your well-being
Changing a woman’s lifestyle will help. Diet changes need to be made to reduce fat intake and
carbohydrates, increasing the share of fermented milk products, fish, lean meat, vegetables and fruits, vegetable
fats and vitamins. It is recommended to increase as much as possible motor activity, walk and swim more.
Activities to her liking, hobbies, and interest clubs will help a woman during this difficult period. The main thing is not
stay alone, don’t get caught up in age-related changes, don’t succumb to depression.
N.V. Migileva, consultant doctor at Biolit LLC
Throughout her life, a woman must maintain her health, because only a healthy woman can be beautiful and loved. Every age, every period of a woman’s life has its own characteristics. How to save women Health for life?
We often watch with affection how little girls play with dolls. With what pride they roll a toy stroller around the yard, with what tenderness and care they change clothes and put their pet to bed. Behind this simple activity lies not only a game, but also the preparation of the child for a future social role - the role of a mother.
Giving life is one of the most important purposes of a woman on Earth; without this, not only her own life, but the existence of entire countries is also threatened. Motherhood is a great happiness, but not all women get to experience it.
IN Lately The demographic problem in our country is very acute. It's no secret that the birth rate in Russia cannot exceed the death rate. Unfortunately, the number of women able to give birth to a child decreases from year to year. According to experts, the reason is not only economic instability, but also that women’s reproductive health is deteriorating. The incidence among newborn girls has increased 12 times. Gynecological diseases in three-year-old girls account for 3% (in the structure of diseases), and then increase exponentially by the age of 17, reaching 75%. Of these: 26% are deviations of sexual development (premature or delayed development); 30% - inflammatory diseases; 45% - menstrual dysfunction. According to forecasts, by 2015 in Russia there will be 25% of infertile girls. That is, every fourth girl will not be able to conceive and carry a pregnancy to term!
GIVING LIFE IS ONE OF THE MOST IMPORTANT PURPOSE OF A WOMAN ON EARTH, WITHOUT THIS NOT ONLY HER OWN LIFE LOSES MEANING, BUT ALSO THE EXISTENCE OF ENTIRE COUNTRIES IS THREATENED
The decline in reproductive health of modern children and adolescents may be caused by various factors. These include unfavorable ecology, natural and climatic conditions (in particular, in our region - short summer and cold winter), eating disorders resulting in obesity or dystrophy, natural iodine deficiency, low physical activity, thoughtless adherence to fashion (tight trousers, short tops, synthetic fabrics, etc.). The widespread prevalence of bad habits (smoking, drinking alcohol and drugs) among adolescents and young women is cause for concern.
Thus, a decrease in the reproductive health of adolescents contributes to the formation of a vicious circle: sick girl - sick woman - sick mother - sick child. And in order for the expectant mother to be able to give birth to a healthy child, this must be taken care of from the first days of the girl’s birth. On the long journey of developing the reproductive health of a young creature, there are very important stages. This is the time when parents should take the girl’s health especially seriously.
In the sexual development of girls, several periods are distinguished: intrauterine, newborn, “neutral” (from 1 to 7 years), prepubertal (from 8 years to the first menstruation), pubertal (from the first menstruation to 14 years) and adolescence (15-17 years). Each period has its own anatomical and physiological characteristics.
During the INTRAuterine period, the main parts of the reproductive system are intensively developing and are already beginning to function. The development of the female gonads in the fetus and the formation of the female genital organs are determined by the set of sex chromosomes formed after fertilization of the egg. Even before birth, a girl’s hormonal background is formed future woman and it is determined how many times she can become a mother, how many eggs (follicles) her body will produce and until what age the reproductive system will function properly. Already in the 8th week, a special structure of the brain is formed - the hypothalamic-pituitary system, which will subsequently regulate almost the entire functioning of the endocrine system, including the production of sex hormones. By the time a girl is born, 500-700 thousand eggs are laid in the ovaries. This first period of life is very important for the reproductive health of the future girl. Complications of pregnancy in the mother, such as the threat of miscarriage, fetal hypoxia, colds, the presence of somatic diseases, especially smoking and drinking alcohol during pregnancy can have Negative influence on the correct formation of the genital organs and their subsequent full functioning in the baby.
MOTHERHOOD IS GREAT HAPPINESS, BUT NOT ALL WOMEN HAVE TO EXPERIENCE IT
The second period is NEWBORN (from birth to one year). A newborn girl has internal and external genitalia formed according to the female type. This first year of a girl's life is important for proper hormonal development, despite the fact that the hormonal activity of the ovaries during this period is minimal. The fact is that the cellular apparatus of a girl’s ovary during this period loses up to 10% 
cells that are supposed to produce hormones. This is a normal physiological process, but losses should not exceed the norm! The main factors that increase the death of hormone-producing cells include artificial feeding, frequent illnesses respiratory tract and gastrointestinal tract, allergic conditions. If a large amount of ovarian tissue dies, hormonal deficiency occurs, which will then affect the further sexual development of the child. This can lead to delayed sexual development and subsequently affect the course of pregnancy, childbirth, and even infertility may develop. Therefore, it is very important to preserve ovarian cells expectant mother. To do this you need to exclude unfavorable factors, i.e. the child should grow up healthy, go for walks more often fresh air, be breastfed, hardening and hygienic procedures, age-appropriate massage should be carried out. During this period, parents can be advised to strengthen the baby’s health with FLORENTA. FLORENTA - an extract of young shoots of fir legs - will help the child’s body not only quickly adapt to new living conditions, but also adequately resist infections and stress factors of the outside world. Aqueous extract fir contains a wide range of microelements and vitamin complexes, which is important for proper hematopoiesis and the formation of adequate immunity. Regular use of FLORENTA promotes the proper functioning of the central nervous system and the formation of adequate reflexes (remember that FLORENTA has proven its stabilizing effect on the nervous system in clinical studies in children with perinatal lesion CNS). Taking FLORENTA at such a tender age is calculated based on weight, 1 drop per 1 kg of child’s body weight per dose. This amount of extract is added to boiled water for drinking or in expressed breast milk.
MOMS AND GRANDMOTHERS SHOULD NOT ADVISE THEIR GIRLS TO “PATIENCE.” IT IS NECESSARY TO CONTACT A CHILDREN'S GYNECOLOGIST, SINCE PAINFUL MENSTRUATIONS CAN BE ONE OF THE SYMPTOMS OF SERIOUS GYNECOLOGICAL DISEASES.
PREPUBERTATE PERIOD (from 8 years to the first menstruation). In gynecology childhood the prepubertal period is considered as the 1st phase of puberty (1st phase of puberty). The prepubertal period begins with the development of secondary sexual characteristics and ends with the onset of the first menstruation (menarche). From the onset of secondary sexual characteristics to menarche, an average of 1-3 years pass. According to experts, for the start of menstruation, a girl must reach a minimum weight of 45-46 kg. By the time of puberty, approximately 250-300 thousand eggs remain in the girl’s ovaries. During this period, significant changes occur in the genital organs as a result of activation of the hypothalamic-pituitary region, ovaries and adrenal glands. The hormonal explosion causes rapid growth in the child, which can manifest itself as aching muscles and bones. To alleviate this condition, it is good to do a relaxing massage at night with FLORENTA cream or ARCTIC gel. During this period, secondary sexual characteristics begin to appear: enlarged mammary glands, pubic and armpit hair growth. The first changes in the figure appear: the hips are rounded, the growth of the pelvic bones begins. At this stage, the girl’s body is quite sensitive to the effects of various external factors (frequent colds, chronic tonsillitis, traumatic brain injuries, surgical interventions in the pelvis (appendectomy), violation of daily routine, etc.). The girl’s nutrition during this period should be complete, including the maximum range of vitamins and microelements. And here VITAMIX comes to the rescue again, which contains whey and fruit and berry extracts. It contains everything a growing body needs. Make sure that during this period the girl does not wear tight trousers, this can lead to improper growth and formation of the pelvic bones. Monitor the state of the immune system, gastrointestinal tract and other body systems.
PUBERTY - 2nd phase of puberty (from the first menstruation to 14 years). During this period, the central nervous system, which is involved in the formation and regulation of menstrual function, is labile and vulnerable. The maturation of hypothalamic structures is accelerated, and a close connection is formed between cells that secrete various hormones and control factors. Gradually established circadian rhythm hormone releases. The number of receptors for sex steroids in the cells of all organs of the reproductive system, including the hypothalamus and pituitary gland, increases. Their sensitivity to estrogen changes. 20% of girls experience anovulatory cycles in the first 2 years of puberty. Regular menstruation in some girls is established only in the first 2 years of puberty. It is at this time that secondary sexual characteristics reach full development. By the end of puberty, the formation of a female-type physique ends as a result of the expansion of the pelvic bones and the development of subcutaneous fatty tissue. The timbre of the voice changes, psychological traits characteristic of a woman are formed (shyness, desire to be liked, increased interest in one’s appearance). For the proper development of the body, it is necessary to adhere to a daily routine, normal sleep at least nine hours, staying in the air for at least two hours, doing physical exercise, maintaining personal hygiene and proper nutrition. It is during this period that one can notice any deviations in the development of the girl’s hormonal health. First of all, these are menstrual cycle disorders. For modern teenage girls, hypomenstrual syndrome is more typical, when the interval between menstruation increases, and their intensity and duration decrease. The extreme manifestation of this syndrome is amenorrhea: primary - in the absence of menstruation at 15-16 years of age, secondary - a delay in menstruation for 6 months or more. There is another problem that young girls face - painful sensations during menstruation. varying intensity: from whining discomfort in the lower abdomen to debilitating pain, accompanied by nausea, vomiting, and a pronounced decrease in performance. Mothers and grandmothers should not advise their girls to “be patient.” You need to contact pediatric gynecologist, because the painful menstruation may be one of the symptoms of serious gynecological diseases. And after consultation, add to therapeutic measures reception of CLIMATON. Yes, yes... we were not mistaken. We are talking about phytocomplexes CLIMATON and CLIMATON-PLUS, which were originally developed to alleviate the symptoms of menopause in women. However, many years of experience in use and clinical observations have proven that CLIMATONES containing hormone-like substances of the cuff herb (phytoestrogens). help normalize hormonal levels and even out the menstrual cycle in a growing body. Motherwort, which is part of CLIMATONES, will relieve tension and calm the nervous system, normalize vascular tone, and St. John's wort, being a natural antidepressant, will restore a joyful feeling of life. In addition, CLIMATON and CLIMATON-PLUS have anti-inflammatory and antispasmodic effects. Do not forget that CLIMATON-PLUS is intended for girls prone to hypotension, and CLIMATON - for those prone to hypertensive conditions. If a girl is bothered by pain, swelling or discomfort due to the intensive growth of mammary gland tissue and reaction to hormonal changes, you can use the “MAMAVIT” gel, which will relieve tension and pain, increase skin elasticity and normalize capillary blood flow in the breast tissue. Of course, we should not forget about other systems. Needs to be supported correct work liver, since the processing of all sex hormones occurs in it, and here true friend and GEPATOSOL will become your assistant.
YOUTH PERIOD begins at the age of 15. There is a significant activation of the reproductive system both in the central (pituitary) and peripheral (ovaries) parts. The formation of the mature functioning of the reproductive system ends with the transition to ovulatory menstrual cycles. During this period, a stable hourly rhythm of hormone secretion is established, the formation of secondary sexual characteristics ends, a stereotype of menstrual function is formed, and the girl’s body becomes completely ready for pregnancy. Often young girls begin to worry about their overly rounded figures and begin to abuse diets. This is fraught with consequences. Severe weight loss can cause persistent menstrual irregularities, and sometimes a complete absence of menstruation. IN daily diet Girls should definitely eat foods containing vitamin D, phosphorus and calcium. Proper calcium metabolism is necessary for the formation of the pelvis, which, in turn, is very important for bearing the fetus and safe birth. During this period, in addition to the above products, it is worth paying attention to the new products of the Biolit company from the marine series, namely CALCIUM-BIOLIT. The sufficient content of calcium and phosphorus with high bioavailability allows us to recommend this therapeutic and prophylactic agent for the proper formation of the bone skeleton and ligamentous apparatus, as well as for improving the condition of the skin, hair and nails.
WEIGHT LOSS CAN CAUSE PERSISTENT DISRUPTION OF THE MENSTRUAL CYCLE, AND SOMETIMES A COMPLETE ABSENCE OF MENSTRUATION.
A young woman enters PUBERTY, which lasts an average of 30-35 years. A woman's hormonal background is what largely determines her entire life. And the general hormone here is estrogen. If its amount in the body is normal, the woman will feel great and look much younger than her peers. With estrogen deficiency, a woman does not feel well and does not look too good. It would seem that in order to always feel good, one must strive to increase the amount of female hormones. However, this is a double-edged sword. On the one hand, a woman looks youthful beyond her years, on the other, an excess of estrogen leads to infertility, menstrual dysfunction, and the formation of tumor processes. Another female hormone, produced by the ovaries - progesterone - is responsible for mood stability, primarily in the second half of the menstrual cycle. If progesterone levels are low, women experience pain in the mammary glands and periods become painful. Such women are more susceptible to mood changes, depression, and irritability in the second phase of the menstrual cycle. If there is a lack of progesterone, pregnancy either does not occur or ends in miscarriage. Unfortunately, every year the question of hormonal disorders during middle age of a woman and - alas! - even youth. Disruption of estrogen production in a young woman’s body can be due to many reasons: for example, serious illnesses internal organs(liver, kidneys, thyroid gland, ovaries), prolonged sexual abstinence, difficult or early childbirth, inflammatory processes in the reproductive system and simply severe stress. This disorder can manifest itself as chronic fatigue, apathy, depression, lack of sexual desire, obesity or, conversely, sudden weight loss, headaches, dry and sagging skin, painful periods, and the development of mastopathy. With a lack of female sex hormones, male hormones “take over” and the so-called hyperandrogenism develops, which manifests itself increased growth hair on the arms, legs, chest, back, the appearance of a mustache and beard, irregular periods, a tendency to acne.
Many women complain of premenstrual tension or premenstrual syndrome. PMS is not just irritability, bad mood or a tendency to tears, but a whole complex of symptoms such as headache, joint pain, allergic manifestations, absent-minded attention, intolerance and aggression, the feeling that the whole world is against you, awkwardness in movements and a tendency to injury, weight gain, insomnia. About 70% of women of childbearing age are susceptible to PMS, and about 10% of them suffer from PDD (premenstrual dystrophic disorder).
And again CLIMATONS come to the rescue! With all these problems, CLIMATON and CLIMATON-PLUS in the composition complex therapy significantly alleviate the condition of women and contribute to more rapid recovery normal hormonal levels. The complex of herbal extracts of these remedies will help the body cope with a stressful situation, quickly and adequately respond to changes in the external world and internal fluctuations. REISHI-KAN can become a good friend for a woman. The extract of the legendary Reishi mushroom has a powerful immunomodulatory effect, primarily restoring the body's antitumor shield. In conditions modern life this is very important - after all, according to statistics, more than 60% modern women have neoplasms of the reproductive system organs (mastopathy, fibroids, cystic formations etc.). REISHI-KAN normalizes the functions of the endocrine system (primarily the thyroid gland and gonads), restores blood pressure and tone of the heart muscle, protects the liver and improves kidney function. Reishi mushroom extract contains unique ubiquinones for their anti-aging effect, better known to us under the name coenzyme Q10! REISHI-KAN is a source of vitamins, micro- and macroelements, and also a source of good mood, excellent performance and good sleep! If a woman is diagnosed with diseases such as mastopathy or fibroids, the development of which is also associated with hormonal imbalance, “MAMAVIT” gel and TOXIDONT-MAI are added to the complex therapy. Their use is also justified for the prevention of these diseases. For several decades, Biolit products have been helping to protect a woman during the most active period of her life.
Next comes a relatively short period - CLIMACTERIC. Its duration ranges from six months to 2-3 years. Then comes the time from the persistent disappearance of menstruation to 53-55 years, which is usually called menopause. And then, the woman enters the postmenopausal period. Menopause is not a pathology, not a disease requiring treatment. This is an absolutely physiological process, another “step” in a woman’s life. The process occurs over many years - menstrual and reproductive functions decrease and eventually disappear. At this time, a woman experiences severe hormonal changes. The consequence is changes in all organs of the female body. The most typical manifestations menopause are “hot flashes”, which can appear after 40 years. In addition, menopause is accompanied by a lot of unpleasant symptoms: headaches and dizziness, tremor (shaking), insomnia, chronic fatigue, as well as disorders of the nervous system, as a result of which a woman becomes irritable, whiny, and depressed. During this period, it is necessary to observe a work-rest regime, maintain physical activity, avoid stress. Today, the Biolit company has developed therapeutic and prophylactic agents that help, if not completely get rid of unwanted manifestations menopause, then significantly reduce them. These are all the same CLIMATONES! It is precisely in order to color the autumn of a woman’s life with bright colors and add sunshine to it that these two non-hormonal herbal remedies were developed. CLIMATON and CLIMATON-PLUS can significantly reduce, and with regular use, completely smooth out the neurovegetative manifestations of the menopause. It is during this period of life that a woman’s risk of developing hypertension, atherosclerosis, diabetes, thyroid and genitourinary diseases. To prevent osteoporosis, periodically use CALCIUM-BIOLIT. Be sure to remember about the therapeutic and prophylactic drug REISHI-KAN, which will prolong the youth of the body and cope with impending problems.
THE CLIMACTERIC PERIOD IS NOT A PATHOLOGY, NOT A DISEASE REQUIRING TREATMENT. THIS IS AN ABSOLUTELY PHYSIOLOGICAL PROCESS, ANOTHER “ONE STEP” IN A WOMAN’S LIFE.
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Physiological periods in a woman’s life. Planning a pregnancy
Introduction
1.2 Puberty
1.3 Menopause
2. Menstrual cycle
3. Planning pregnancy
3.1 Methods of contraception
3.2 Planning for conception
Conclusion
Introduction
Throughout life, women distinguish between several periods. They are characterized by certain age-related anatomical and physiological characteristics. These are the following periods:
1) childhood;
2) puberty;
3) puberty;
4) climacteric.
Strategy of modern medicine - preventive medicine, the strategy of modern obstetrics is a planned, prepared pregnancy. Now this is a promoted strategy, good form, fashion, and fewer and fewer people refer to their ancestors, who gave birth without any preparation, and more and more people turn to doctors for help in a situation that does not yet exist, for planning a future pregnancy.
It has long been proven that most complications that develop during pregnancy can be prevented. proper preparation, namely, replenishment of vitamin deficiency, examination, diagnosis possible diseases, conditions, predispositions, and their correction.
There are conditions whose harmful effects can be completely eliminated if identified in advance: for example, lack of immunity to rubella. There are conditions that cannot be completely eliminated, but diagnosing them before pregnancy allows the attending physician to predict possible expected complications, be prepared for them and prescribe their correction in time - literally from the first days of the delay, before contacting the doctor, the woman begins taking medications that allow her to maintain pregnancy in the early stages. Thus, the characteristics of the female body and its reproductive function are very interesting and important to study. The purpose of our work is to study the physiological periods in a woman’s life and the features of pregnancy planning.
1. Periods of a woman’s life associated with reproductive function
1.1 Puberty of a girl
conception pregnancy menopause menstrual
Puberty takes about 10 years. Its age limits are 7(8)--17(18) years. During this time, in addition to the maturation of the reproductive system, the physical development of the female body ends: body growth in length, the formation of a physique and the distribution of fat and muscle tissue according to the female type. The physiological period of puberty occurs in a strictly a certain sequence. During the puberty period (7-9 years), a growth spurt is observed, the first signs of a female figure appear: the hips become rounded, the female pelvis begins to form, and the vaginal mucosa thickens. In the 1st phase of puberty (10-13 years), mammary glands begin to enlarge and pubic hair begins to grow. This period ends with the first menstruation - menarche (at about 13 years of age), which coincides with the end of rapid growth body length. In the 2nd phase of puberty (14-17 years), the mammary glands and sexual hair complete their development, the last to finish is the hair growth of the armpits, which begins at the age of 13. The menstrual cycle becomes normal (two-phase), body growth stops in length and the female pelvis is finally formed William G. Masters, Virginia E. Johnson, Robert K. Kolodny Basics of sexology. Per. from English - M.: Mir, 1998. - P.24-42..
For menstrual cycle disorders in children and adolescents, it is necessary to mandatory contact special pediatric gynecologists and pediatricians. Timely qualified treatment will in most cases normalize the menstrual cycle and thus ensure normal reproductive function. Puberty occurs between 16 and 18 years of age, when a woman’s entire body is fully formed and ready for conception, pregnancy, childbirth and feeding a newborn.
1.2 Puberty
Puberty, or the reproductive period, takes about 30 years --s 16--18 to 45 years old. During this period, a woman has a two-phase menstrual cycle. Its physiological mechanism is very complex. In a simplified form it can be represented in the following way. In the subcortical zone of the brain, pulsating secretion of special chemicals (neurosecrets) occurs, which enter the anterior pituitary gland through the circulatory system. Special cells of this gland internal secretion Two types of so-called gonadotropic hormones are produced: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones, entering the blood, act on the ovary, stimulate the growth of the follicle, in which sex hormones (estrogens) begin to be produced and the maturation of the egg occurs. An increase in the production of LH and FSH in the middle of the menstrual cycle (2nd - 15th day) leads to rupture of the follicle and the release of the egg into the abdominal cavity (1st phase of the cycle). At the site of the follicle; The corpus luteum appears, in which the production of the corpus luteum hormone progesterone begins (phase 2 of the cycle). Under the influence of estrogenic hormones in the uterine mucosa, restoration and growth of epithelial cells of the functional layer of the uterine mucosa occurs (1st phase of the cycle). After ovulation and the start of production of the corpus luteum hormone (progesterone), glands appear in the uterine mucosa, which are filled with secretions (2nd phase of the cycle, 15-28 days).
If fertilization does not occur, then the corpus luteum withers, decreases, and then stops the production of progesterone. This leads to the death of the functional layer of the uterine mucosa, and it begins to be rejected - menstruation begins. At this time, as a result of changes in the concentration of ovarian sex hormones in the blood, the next process of production of neurosecrets in the anterior lobe of the pituitary gland, the development of a new follicle and the maturation of the next egg in the ovary begin again. All these complex processes occur regularly in the body healthy woman throughout the entire period of puberty. The menstrual cycle is cyclical changes in a woman’s reproductive system from the 1st day of the previous menstruation to the 1st day of the next menstruation. The normal duration of the menstrual cycle is 21-35 days. Menstruation is the discharge of blood from the genital tract at the end of each two-phase menstrual cycle. The normal duration of menstruation is 2-7 days.
1.3 Menopause
Currently, the following terms are accepted instead of the terms “menopause” and “menopause”:
premenopausal period - from 45 years to the onset of menopause;
menopause is a period of absence of menstruation. The last menstrual period occurs on average at the age of 50.8 years;
perimenopausal period -- postmenopausal period and 2 years after menopause;
The postmenopausal period begins after menopause and lasts until the end of life.
By the age of 45, a woman’s reproductive capacity fades, and by the age of 55 - hormonal function reproductive system.
The premenopausal period of life is characterized by high social activity women, conditioned by accumulated life experience, knowledge, etc. At the same time, at this age the body’s defenses decrease, non-infectious morbidity increases, and body weight gradually increases against the background of pronounced changes in the reproductive system. A gradual decrease in the hormonal function of the ovaries begins, which is characterized by the onset of menopause. As a result of dysfunction of the ovaries, bleeding occurs from the altered mucous membrane of the uterus.
In postmenopause, a progressive decline in ovarian hormonal function continues. At the same time, involution processes occur not only in the organs of the reproductive system, but also in all other organs and systems. The uterus becomes smaller, the vaginal mucosa becomes thinner, folding decreases, and vaginal dryness appears. Happening atrophic changes V bladder, urethra, muscles pelvic floor. This leads to stress urinary incontinence, prolapse of the walls of the vagina and uterus. Metabolism changes significantly with excessive deposition of subcutaneous fat. Blood clotting increases due to a decrease in the production of estrogen hormones, bone loss of calcium and a decrease in bone substance begin. All this leads to severe consequences: osteochondrosis, fractures tubular bones and the most dangerous of them is a fracture of the femoral neck. For various complications of the menopausal period, as well as for the purpose of their prevention, it is necessary to contact an obstetrician-gynecologist. Modern medicine has highly effective means that can reliably prevent the complications listed above and ensure a high quality of life for pre- and postmenopausal women.
2. Menstrual cycle
The menstrual cycle is a physiological process of cyclical changes in the functions of the female reproductive system, which are externally manifested by regular uterine bleeding (menstruation, in common parlance - menstruation) William G. Masters, Virginia E. Johnson, Robert K. Kolodny Basics of sexology. Per. from English - M.: Mir, 1998. - P.54-59..
During the menstrual cycle, a woman’s body prepares for conception and pregnancy. If conception does not occur, this process is repeated again.
The first menstruation (menarche) appears in girls during puberty. Menstruation stops with the onset of menopause, as well as during pregnancy and with certain diseases.
The duration of the menstrual cycle is determined from the first day of menstruation to the first day of the next and is 21-36 days, usually 28 days. Menstruation (uterine bleeding) lasts from 3 to 6 days.
The leading role in the regulation of the menstrual cycle belongs to the central nervous system (cerebral cortex, pituitary gland, hypothalamus and other structures).
In the ovaries, during the first phase of the menstrual cycle (in the first 14 days of a 28-day cycle), the follicle grows and matures. The growing vesicle releases estrogens (female sex hormones). Under the influence of estrogens, growth (proliferation) of the uterine mucosa also occurs. On days 14-16, the follicle bursts, and a mature egg capable of fertilization emerges from its cavity, that is, ovulation occurs.
Ovulation occurs under the influence of gonadotropic hormones of the pituitary gland and estrogens. Since during the first phase, that is, before ovulation, the follicle matures, it is called follicular. Since growing follicles secrete a large number of estrogen, this phase is also called the estrogenic phase. And since proliferation of the uterine mucosa occurs under the influence of estrogens, the term proliferative is also applied to the first phase.
During each cycle, many thousands of follicles mature, but only one of them reaches ovulation. Thus, in each menstrual cycle, as a rule, one egg is available for fertilization. However, on average, in one in 200 cycles, two follicles mature simultaneously so that two eggs can be fertilized, resulting in fraternal twins.
The egg migrates from the ovary to the abdominal cavity and is guided by the fimbriae of the peripheral part of the fallopian tube into its lumen. Due to the peristaltic movements of the fallopian tube from the abdominal end to the uterine end (similar to intestinal peristalsis), the egg moves in the fallopian tube into the uterine cavity. If there are sperm in the lumen of the fallopian tube, fertilization of the egg occurs.
Meanwhile, the burst follicle collapses, a small blood clot remains in its emptiness, and the rupture site is closed. From the luteal cells of the granular layer of the follicle, which have yellow, a temporary endocrine gland develops - the corpus luteum. Luteal cells multiply intensively, and the corpus luteum hormone progesterone is released. The corpus luteum usually functions for 14 days, that is, the second half of the menstrual cycle.
Influenced higher level progesterone after ovulation, cryptoid glands develop in the uterine mucosa. In this state, the uterus is most prepared for pregnancy.
Progesterone acts on the body temperature regulation centers, causing an increase in basal temperature by approximately 0.5 oC. With the end of the functioning of the corpus luteum, the basal temperature decreases.
There is a distinction between the corpus luteum of menstruation and the corpus luteum of pregnancy in the case of fertilization of the egg. With the onset of pregnancy, the corpus luteum continues to function throughout pregnancy (corpus luteum of pregnancy) and the entire period of lactation (corpus luteum of lactation).
Thus, the second phase of the menstrual cycle, which is associated with the formation of the corpus luteum in the ovaries and glands in the uterus, is called luteal or secretory.
If fertilization has not taken place, the corpus luteum is in the stage reverse development, the maturation of a new follicle begins, and rejection of the mucous membrane and associated bleeding (menstruation) occurs in the uterus.
During the menstrual cycle, cyclic changes occur in the cervix (in the first phase, cell growth is observed and mucus secretion increases, in the second phase it decreases), in the vagina (in the first phase, epithelial cells grow, in the second phase they exfoliate), in the mammary glands (in the first phase, the development of the tubular system and expansion of the gland lobules, in the second phase, the formation of lobules, an increase in the volume of the gland).
3. Planning pregnancy
3.1 Methods of contraception
Planning is usually understood not as a simple determination of formal deadlines, but as preparation, implementation of a number of activities and further monitoring of their implementation. Since in our case the plan is not to release any products, but to produce offspring, it is necessary to include the state of the emotional and motivational sphere of the parent couple Bandler R., Grinder J., Satir V. Family therapy. - Voronezh: NPO "MODEK", 1993. - P.72-89..
Over the past century, the state of society has contributed to the inclusion of women in active social and professional life. Most women in the West are busy building a career and developing financial independence from a man, which in turn has led to a shift in the timing of a woman’s first pregnancy to 30 years.
More and more common married couples, where the main source of income is concentrated in the hands of women, and going on maternity leave threatens to worsen their financial situation. Often a woman delays conceiving a child due to her reluctance to spoil relations with higher management, who are interested in a full-time employee, or under the threat of losing her job, she is forced to leave maternity leave much earlier than the deadline established by law.
In order to protect herself both externally and internally, to avoid the discomfort associated with the restructuring of life values, time and spatial resources, a woman is forced to plan the conception of a child. But planning should not replace making the actual decision to have a child. Today, maternal values have largely lost ground, and the voices of adults are increasingly being heard declaring their reluctance to have a child.
Pregnancy can be avoided by abstaining from sexual intercourse during the period of the menstrual cycle when a woman might become pregnant. With this method of contraception there is no need to use medicines, and therefore no side effects, except pregnancy, which in this case can occur in 10 - 15% of cases.
Benefits of natural contraception:
no health risk;
no side effects;
involving men in family planning;
Possibility of use for pregnancy planning.
Difficulties you will have to face:
low contraceptive effectiveness (9-25 pregnancies per 100 women during the 1st year of use);
contraceptive effectiveness depends on the couple's motivation and willingness to follow instructions;
the need to abstain during the fertile phase to avoid conception;
Daily record keeping is required;
the presence of a vaginal infection may make it difficult to interpret changes in cervical mucus;
a thermometer is required for some methods;
does not protect against sexually transmitted diseases, incl. HIV infection AIDS.
Who should not use natural family planning methods:
women whose age, number of births or health conditions make pregnancy unsafe;
women with an unsteady menstrual cycle (breastfeeding, immediately after an abortion);
women with irregular menstrual cycles;
women whose partner does not want to abstain from sexual intercourse on certain days of the cycle.
Types of natural family planning methods:
the calendar (rhythmic) method is the least effective;
basal body temperature method;
cervical mucus method;
the symptothermal method (a combination of the two methods listed above) is the most effective.
Calendar method of family planning. To avoid getting pregnant, abstain from sex during your fertile period (the period of time during which a woman can become pregnant). If, on the contrary, you want to conceive a child, the fertile period is the period when conception is most likely (in 10 - 20% of cases it can occur at another time).
There are three phases in the menstrual cycle:
absolute sterility;
relative sterility (conception may or may not occur);
fertility (the most favorable phase for conception).
The relative sterility phase lasts from the last day of menstruation until ovulation. Ovulation occurs approximately two weeks from the start of the cycle (usually on the 11th, 12th or 13th day of a 28-day cycle). It should be remembered that with a 28-day cycle, ovulation is possible between the 8th and 20th days.
The fertile phase begins from the moment of ovulation and ends 48 hours after it. For practical reasons, it is believed that the fertile phase lasts 6 - 8 days (+ due to the inaccuracy of calculations, due to the fact that sperm that have entered the cervical mucus are capable of fertilization within 5 days).
The phase of absolute sterility begins 48 hours after ovulation and continues until the end of menstruation.
Chemical contraceptives (spermicides). Spermicides are substances that neutralize sperm and prevent sperm from entering the uterus. The main requirement for spermicides is the ability to destroy sperm in a few seconds. Spermicides are available in the form of creams, jellies, foam aerosols, melting suppositories, foaming suppositories and tablets. For contraception, some women use douching after sexual intercourse with solutions that have a spermicidal effect: acetic, boric or lactic acid, lemon juice, mixed with water. Considering the data that 90 seconds after sexual intercourse, sperm are detected in the fallopian tubes, douching with a spermicidal drug cannot be considered a reliable method of contraception General practical and family medicine/ Ed. M. Cohen. - Minsk, 1997. - P.188-194..
Spermicides can be used with condoms, diaphragms, caps, or alone. Spermicides are injected into the upper part of the vagina 10-15 minutes before sexual intercourse. For one sexual act, a single use of the drug is sufficient. With each subsequent sexual intercourse it is necessary additional introduction spermicide.
Since spermicides act for a very short period of time and do not affect a woman’s ability to conceive, fertilization after their use is possible already during the next sexual intercourse. If pregnancy occurs while using spermicides, this can lead to the formation of malformations. various systems and organs of the fetus due to the possible penetration of sperm damaged by spermicides into the egg. It should be noted here that to increase the reliability of spermicides, they are recommended to be used in combination with other means of barrier contraception.
Intrauterine contraception (IUC). The mechanism of action of intrauterine contraceptives is as follows: under the influence of the IUD, the endometrium (inner lining of the uterus) is traumatized, the tone of the uterine muscles increases, which leads to the expulsion of the embryo into early stages implantation The IUD increases contractions of the fallopian tubes and uterus, so the fertilized egg enters the uterus prematurely. The endometrium is not prepared to receive a fertilized egg, as a result of which the attachment of the fertilized egg to the wall of the uterus is impossible. The IUD, as a foreign body, causes so-called aseptic inflammatory changes in the endometrium (without the participation of bacteria, due to damage to the inner layer of the uterus by the spiral), which prevent the attachment and further development of the embryo. Such inflammation disappears without a trace after removal of the IUD. The addition of copper and silver to the IUD enhances the spermatotoxic effect (the effect of sperm destruction).
The IUD is the optimal means of contraception for healthy women who have given birth, have a permanent partner and do not suffer from any inflammatory diseases genitals, that is, it is most likely that it is with the help of this method of contraception that the family plans to have a second child.
After removal of the IUD, the ability to conceive is usually restored very quickly, but it is recommended to refrain from conceiving for 2-3 cycles to restore the functioning of the uterus and fallopian tubes and, therefore, reduce the risk of spontaneous miscarriage and ectopic pregnancy.
Before planning to remove the IUD, you must contact a gynecologist 2-3 weeks in advance to get tested to determine the degree of cleanliness of the vagina. In this case, you will have time to carry out anti-inflammatory therapy before the IUD is removed. The actual removal of the IUD is carried out on the 2-3rd day of menstruation, when the cervix is slightly open and removal of the IUD is most painless. During the procedure, the cervix is exposed in special gynecological speculums; the doctor uses the same instruments during a routine examination. An IUD that has threads is usually removed by pulling on the threads. If the threads are not visible for one reason or another, then hospitalization is necessary to remove the IUD. Pregnancy occurs after removal of the IUD within a year in 90% of women.
If pregnancy occurs while using an IUD and the woman wishes to continue the pregnancy in the presence of threads, the IUD should be removed. If the IUD threads are not detected and pregnancy is diagnosed, the IUD is not removed. It should be noted that there has been no increase in the incidence of malformations or any damage to the fetus if the pregnancy is carried to term with an ICH.
Hormonal contraception. Hormonal contraception is based on the use of synthetic analogs of natural ovarian hormones and is highly effective remedy pregnancy prevention.
Depending on the composition and method of use, hormonal contraceptives are divided into several types.
Combination drugs are the most common oral contraceptives due to their high reliability, reversibility of action, reasonable cost and good tolerability. Such drugs contain two types of female sex hormones - estrogens and gestagens. Mechanism of action oral contraceptives(OK) is based on the blockade of ovulation, implantation, changes in the movement of sperm and the function of the corpus luteum, which remains in the ovary at the site of the released egg and normally provides normal development fertilized egg.
After stopping taking OCs, ovulation (the release of an egg from the ovary in the middle of each menstrual cycle) is quickly restored and more than 90% of women are able to become pregnant within two years. It is worth mentioning a complication that rarely occurs after taking oral contraceptives. This is the so-called “post-pill” amenorrhea - the absence of menstruation and the possibility of conception for 6 months after stopping taking OCs. Such amenorrhea occurs in approximately 2% of women and is especially characteristic of the early and late reproductive periods (that is, it occurs in young girls or premenopausal women) or for women who have a hidden pathology, the manifestation of which was provoked by taking OCs.
It has been reliably proven that hormonal contraceptives, regardless of the duration of their use, do not affect a woman’s fertility (ability to bear children) and do not cause infertility. After stopping taking OCs, most women regain their ability to conceive fairly quickly.
* in most cases, fertility is restored after 2-3 months;
* Availability regular cycle will facilitate the calculation of the correct gestational age;
* hormones included in hormonal contraceptives change the vitamin and mineral balance in the body, preventing, for example, the absorption of vitamin C, some trace elements and folic acid and at the same time promoting excess absorption of vitamin A, which can negatively affect the development of the unborn child.
It does not follow from the above, however, that if pregnancy occurs immediately after taking OCs or even if they were taken during the conception cycle, this increases the risk of pregnancy pathology or birth defects. Therefore, such cases are not an indication for termination of pregnancy. Women who used OCs did not experience an increased incidence of spontaneous miscarriage, ectopic pregnancy, or fetal abnormalities. In those in rare cases When a woman accidentally took OCs during early pregnancy, their damaging effect on the fetus was also not revealed. Moreover, it has been shown that taking OCs in women with reduced fertility increases the likelihood of conception immediately after their discontinuation.
Mini-pills contain 300-500 mcg of gestagens in one tablet and do not significantly limit ovarian function. The mechanism of the contraceptive action of the mini-pill is that changes in the quantity and quality of mucus contained in the cervix, increasing its viscosity, reducing the penetrating ability of sperm reduce the likelihood of sperm entering the uterus, changes in the endometrium that exclude implantation, and inhibition of fallopian tube motility. Reception begins on the 1st day of the menstrual cycle and is carried out daily on a continuous basis.
Taking mini-pills, as well as combined OCs, should be stopped 2-3 months before the planned pregnancy.
Long-acting drugs contain only gestagens (an example of such a drug is Depoprovera). Drug injections are given once every 1-5 months. Subcutaneous implants are capsules that are inserted subcutaneously into the upper arm and release hormones daily, providing contraception for 5 years. An example is Norplant, which consists of 6 cylindrical capsules, which are injected subcutaneously into the forearm of the left hand under local anesthesia. There are intrauterine contraceptives containing levonorgestrel in the rod, which is released daily throughout the year (an example of such a drug is Mirena).
Restoration of the ability to conceive after discontinuation of long-acting contraceptives may occur only after several months (up to 1.5 years). Therefore, these contraceptives are recommended only for women who are not planning a pregnancy in the near future.
Barrier methods. Such contraceptives are a mechanical barrier to sperm (condoms, caps, diaphragms).
Barrier contraceptive methods are less effective than most oral contraceptives and intrauterine devices; For some patients, their use is impossible due to an allergy to rubber, latex or polyurethane.
The vaginal diaphragm and cervical cap are used for contraception alone or in combination with spermicides. The diaphragm is a dome-shaped rubber cap with a flexible rim, which is inserted into the vagina before sexual intercourse so that the posterior rim is in posterior fornix vagina, the front would touch pubic bone, and the dome would cover the cervix. Operating principle barrier contraceptives consists of blocking the penetration of sperm into the cervical mucus. They are applied and act only locally, without causing changes in the body; therefore, these methods of contraception can be discontinued immediately before planned conception.
Barrier agents do not affect fertility in any way. Therefore, as an optimal contraceptive For the time that, according to doctors’ recommendations, should pass between stopping the use of any of the contraceptives described above and conception, it is recommended to use barrier contraception.
Voluntary surgical contraception(sterilization). Female sterilization is a surgical blocking of the patency of the fallopian tubes in order to prevent the fusion of the sperm with the egg. This is achieved by ligation, the use of special clamps or rings, or electrocoagulation of the fallopian tubes.
Male sterilization, or vasectomy, involves blocking the vas deferens to prevent sperm from passing through.
After surgical sterilization, pregnancy is possible only with the use of auxiliary reproductive technologies, such as in vitro fertilization, etc.
3.2 Planning for conception
Now let’s try to figure out how adequate planning occurs in a family that wants to have a child and has made the appropriate decision. First, it’s worth understanding that there will never be a best time to have a child, so it’s best to simply settle on “suitable enough.” It is advisable not to be guided by the stereotypes offered in abundance by others, and not to adapt to anyone (girlfriends, sisters, other relatives). But it is necessary to take into account the information about your own health that you receive from your doctor. The moment of conceiving a child is a decision of two adults who are psychologically ready to have a child and can be responsible for his well-being Varga A.Ya. Systemic family psychotherapy. - St. Petersburg: Rech, 2001. - P.147-152..
Thus, the first stage of pregnancy planning includes familiarization with the health status of both parents and the elimination of those diseases that may lead to unfavorable development of the fetus. Simple and obvious, but in practice exceptions sometimes prevail over the rule. It is worth giving an account of yourself and your mental state, because pregnancy is stressful state both for the body and for the psyche, which can aggravate problems that were previously managed to cope with.
Next, an important component is to determine the necessary resources. This stage is experienced by parents very differently. For some it is a pleasant pastime, for others it is a heavy burden. Generally speaking, this is worth making a holiday out of, because this is a unique opportunity to experience the joyful moments of possessing something that you may have been deprived of in your infancy and childhood, which appears through identification with your unborn child.
Speaking about resources, first of all, the issue of time and space must be resolved. A mother should always have enough time for her child and the child should have his own place, his own space. This is also a rule that is not particularly difficult to implement at the planning stage. Setting aside a place for a child and its equipment can become a space for the parent couple’s shared dreams, and perhaps memories of their own childhood.
The second important stage is a medical examination. Sometimes women do not want to be examined, citing the fact that nothing bothers them and they feel good. But the trouble is that most pregnancy complications become complications of pregnancy, and before it, even if they exist in the form of test deviations, they do not manifest themselves subjectively. For example, antibodies to the Rh factor, formed in Rh-negative women after pregnancy with a Rh-positive fetus. You can only find out about them by taking a test; they cannot bother you in any way.
Some do not follow the instructions and enter pregnancy with an initial deficiency necessary substances. Taking vitamins during pregnancy is of course necessary, but if the first, most important weeks of embryo development occur in a state of deficiency of these substances, their further intake will not help eliminate the complications that have developed.
First, before conception, you need to conduct an examination:
1. Going to the dentist or therapist
2. Examination by a gynecologist, colposcopy
3. Blood type, Rh factor for both spouses
If a woman positive Rh factor, no problem. If a woman negative Rh factor- antibodies to the Rh factor (even if the man is also negative). If they are positive, pregnancy is currently impossible and needs to be corrected.
4.TORCH complex. Antibodies to rubella, toxoplasma, herpes, CMV, chlamydia - quantitative analysis (with titer). Availability IgG antibodies means immunity to these infections, and is not an obstacle to pregnancy. The presence of IgM indicates an acute stage; planning in this case must be postponed until recovery. If there are no IgG antibodies to rubella, you need to get vaccinated and then protect yourself for another 3 months.
5. Tests for infections: regular smear, PCR for latent infections - for both.
6. Ultrasound of the pelvic organs - at least 2 times per cycle: after menstruation and before menstruation. The first time, the general condition of the pelvic organs is assessed; the second, the presence of the corpus luteum and transformation of the endometrium, indicating that ovulation has occurred. An intermediate third ultrasound on the eve of expected ovulation is ideal - to detect dominant follicle ready to ovulate.
7. Basal temperature chart. From 6 to 7 am, at the same time, without getting out of bed, mercury thermometer 5 minutes in the rectum. All deviations from this regime and special circumstances (medicines, ailments, sleep disorders, menstruation, sex life, bowel disorders, etc.) should be noted in a special column.
8. Hemostasiogram, coagulogram - features of blood clotting
9. Determination of lupus anticoagulant, antibodies to human chorionic gonadotropin, antibodies to phospholipids - factors of early miscarriage.
10. General clinical analysis blood (hemoglobin, red blood cells, leukocytes, platelets, ESR, color index, leukocyte formula). Blood from a finger.
11. General urine analysis.
Conclusion
The childhood period for girls lasts from birth to 7-8 years. It is called the “neutral” or “rest period”. However, during this period certain changes occur in the reproductive system, which indicate its, although low, but certain functional activity. During childhood, there is a low content of sex hormones, and there are no secondary sexual characteristics.
The period of puberty takes about 10 years; its age limit is considered to be 7 (8) - 16 (17) years. The period of puberty is characterized by activation of the gonads, further development of the genital organs, the formation of secondary sexual characteristics (enlarged mammary glands, the appearance of pubic and axillary hair), the onset of menstruation (menarche) and the formation of menstrual function.
The first ovulation is the culmination of puberty, however, it does not yet indicate puberty. Maturity occurs around the age of 16-17, when not only the reproductive system, but also the entire body has finally formed and has become capable of conceiving, bearing a pregnancy, giving birth and feeding a newborn.
The period of puberty (childbearing, or reproductive) lasts about 30 years - from 16-17 to 45 years. It is characterized by the highest activity of specific functions of the reproductive system aimed at fertility.
The main guarantee of successful pregnancy planning is not to turn this activity into work, into debt, into a hitherto unfulfilled task, into an unrealized area of life, into a family responsibility, into trying to fit into some time, age, zodiac interval, into a problem. The birth of a child, in any case, is a miracle beyond human control, and it should be treated as such.
List of used literature
1. Bandler R., Grinder J., Satir V. Family therapy. - Voronezh: NPO "MODEK", 1993.
2. Varga A.Ya. Systemic family psychotherapy. - St. Petersburg: Rech, 2001.
3. General practice and family medicine / Ed. M. Cohen. -- Minsk, 1997.
4. William G. Masters, Virginia E. Johnson, Robert K. Kolodny Fundamentals of Sexology. Per. from English - M.: Mir, 1998.
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The human body is a complex physiological systems, the normal operation of which ensures his existence as an individual. Currently, there are 12 systems in the human body: central nervous, reproductive, endocrine, musculoskeletal, lymphatic, immune and peripheral nervous, respiratory, circulatory, hematopoietic, digestive, excretory and skin. All systems consist of various organs, functionally connected to each other, and represent a single whole that exists in constantly changing conditions environment, performing all vital functions, the quality of which determines the level of health of the human body. Normal operation These systems ensure the existence of the individual and his life activity. In addition, nature has endowed the human body with a unique mechanism of self-regulation and self-healing; it is also called the natural self-organizing system of the human body. The principle of self-regulation is that the body, using its own mechanisms, changes the intensity of the functioning of organs and systems according to its needs in various living conditions. Thanks to this, a person is able to endure significant loads and restore his health.
When any of the body systems is disrupted, disorders occur that are often incompatible with life. But there is a system that is not involved in life support processes, but its importance is extremely great - it ensures the continuation of the human race. This is the reproductive system. Like all body systems, the reproductive system is established and begins to develop during fetal development. This system is unique: if all other vital systems are formed and function from the moment of birth to death, then the reproductive system works only during a certain period of time - during the heyday of all vitality. Genetically, this period is programmed for the age of 15-49 years.
The optimal age for the implementation of the basic functions of the reproductive system is considered 20-40 years, when a woman’s body is fully prepared for conceiving, bearing, giving birth and feeding a child.
The normal functioning of this mechanism depends on the coordinated interaction of the hypothalamus, pituitary gland, ovaries and endometrium, which ensures the regularity of menstruation every 21-35 days, which makes it possible to judge regular ovulation and, in general, the functional viability of the reproductive system. Any disease of the tissues and organs of the reproductive system or organs of the endocrine system can cause disturbances or absence of ovulation, which is manifested by irregular uterine bleeding.
Functionally, all organs and systems of a woman’s body are closely interconnected: activation of the activity of one body system necessarily entails activation of the activity of others. For example, during pregnancy, all organs and systems of the mother’s body work with increased load, the quantity and quality of which increases with the duration of pregnancy, which ensures its normal course, fetal development and prepares the woman’s body for childbirth and lactation. Exceeding the functional capabilities of the mother's body leads to a pathological course of pregnancy or its termination. On the other hand, modern traditional medicine cannot completely cure many diseases, since it is not possible to immediately influence all body systems. For example, the optimal conditions for maintaining pregnancy are not well known, therefore, if there is a threat of premature termination, they use standard methods treatments provided for by the protocol, without correction of other body systems, the function of which, as a rule, is involved to a greater or lesser extent. As a result, treatment may not be effective. Therefore, for an accurate diagnosis and development of the correct treatment tactics, it is necessary to have a clear understanding of the functional state of both the reproductive system and other organs and systems.
The female reproductive system is represented by an anatomical and functional system that ensures the reproduction of the body. Anatomically, it is a collection of female internal and external genital organs located in the pelvic area, between the rectum and bladder in the lower abdomen. The internal female genital organs are: ovaries, the fallopian tubes, uterus and vagina, external - pubis, labia majora and minora, vestibule of the vagina, clitoris, large glands of the vestibule of the vagina, hymen. The female reproductive system is characterized by four specific functions: menstrual, sexual, reproductive and secretory, the normal implementation of which ensures the continuation of the human race.
The functional state of a woman’s reproductive system is largely determined by age-related anatomical and physiological characteristics, depending on which they are distinguished following periods woman’s life: antenatal, childhood, puberty, puberty, menopause (premenopause, menopause, perimenopause and postmenopause). The boundaries between periods are very arbitrary and vary depending on individual development conditions, hereditary, biological and social factors. Modern interpretation of existing age-related problems of reproduction, establishment of cause-and-effect relationships in the formation of somatic, reproductive health and quality of life in the puberty, reproductive and menopausal periods makes it possible to develop a strategy for managing a woman from her intrauterine development to old age. Correction of identified disorders, based on determining the relationships between the body systems responsible for its reproductive system, allows us to re-imagine the pathogenesis of many diseases and disorders of the reproductive system, improve its condition at different age periods, and reduce reproductive losses.
I have just returned from a large international forum of doctors and scientists that took place in St. Petersburg. It discussed issues of improving the diagnosis and treatment of chronic myeloid leukemia. We have now achieved that the life expectancy of such patients has increased fourfold; people cured of this serious disease are already living, enjoying life and working in Russia... Along with domestic clinicians, hematologists from Houston (USA) and Turin spoke at the forum (Italy), Mannheim (Germany).
I remember my conversations with sick teachers medical institute, professors. What can I say, it’s difficult to work with them! It is difficult to talk and act with them, as with all other patients... What else is characteristic of a sick doctor psychologically? Often such a patient completely forgets not only the effect of the drugs, but also the time of taking them, although he himself has prescribed them several times in his life.
During the inspection, we also first of all pay attention to Special attention skin. Normal skin and its changes in various diseases are presented in some detail in textbooks and monographs. Here I would just like to provide some information that will be of interest to doctors of various specialties and will allow them to understand why the skin undergoes changes. It is known that the skin is a full-fledged organ that complements and duplicates the functions of various internal organs. It actively participates in the process of respiration, excretion, and metabolism.
I never finish a questioning or conversation with a patient without finding out at least approximately the state of relationships in the family. Polypharmacy is the scourge of modern medicine and the clinic of internal medicine. On rounds, we often see how patients are prescribed 13-16 drugs, often with mutually exclusive pharmacological properties.
Having studied hundreds of diagnostic errors, our team became convinced that during the diagnostic process, practicing doctors violate even the most basic rules of logic. For example, they incorrectly use the methods of analogy, induction, and deduction.
And now, both in clinics and in hospitals, I myself have heard such “respectful and sweet” addresses from medical workers (and even students who take an example from their elders!!!), such as “darling”, “grandmother”, “darling” ", "darling", "darling", "grandmother", "grandfather", "grandfather", "woman", "man", "old man", "daddy", "mother", "father", "mother", “young lady”, “man”, “aunt”, “uncle”, etc. Many of these words are offensive to patients, full of contempt, and, as a rule, hurt the pride of patients and their relatives.
He rarely listened to the end of a report about a patient, often immediately asking questions clarifying the nature of the course of the disease and the characteristics of life. It’s amazing that he could say out loud: “Something is not clear to me here. There’s something missing in the medical history.” And he began to collect and figure out these “missing links” himself.
In a woman’s life, we can distinguish periods that are characterized by certain age-related anatomical and physiological characteristics: 1) childhood; 2) puberty; 3) period of puberty; 4) menopause; 5) menopause and 6) postmenopausal period. Childhood is a period of life up to 8 years, in which the specific functions of the ovaries do not appear, although estrogens are synthesized. The uterus is small. The cervix is longer and thicker than the size of the uterus; fallopian tubes are tortuous, thin, with a narrow lumen; the vagina is narrow, short, the vaginal mucosa is thin up to 7 years, the epithelium is represented by basal and parabasal cells. The external genitalia are formed, but hairline absent. During the first year of life, the size of the uterus decreases (by the end of the 1st year, the weight of the uterus is 2.3 g, its length is 2.5 cm). Subsequently, the weight of the uterus increases, and by 6 years it weighs 4.0 g. The ratio of the length of the cervix to the body of the uterus at the end of the 1st year is 2:1, by 5 years - 1.5:1, at 8 years - 1, 4:1. Gonadotropin-releasing hormone (GT-RH) is produced in the hypothalamus in very small quantities. The pituitary gland produces and releases FSH and LH. Gradual education begins feedback. However, the hypothalamic-pituitary-ovarian system is characterized by immaturity. The immaturity of the hypothalamic nuclei is manifested by the high sensitivity of the anterior pituitary gland and the neurosecretory nuclei of the mediobasal hypothalamus to estradiol. It is 5-10 times higher than in women reproductive age, and therefore small doses of estradiol inhibit the release of gonadotropins by the adenohypophysis. By the age of 8 years of life (the end of childhood), the girl has formed all 5 levels of the hypothalamic-pituitary-ovarian (HPT) system, the activity of which is regulated only by a negative feedback mechanism. Estradiol is released in very small quantities, follicle maturation occurs rarely and unsystematically. The release of GT-RG is episodic, synaptic connections between adrenergic and dopaminergic neurons are not developed, and the secretion of neurotransmitters is insignificant. The release of LH and FSH by the adenohypophysis is in the nature of individual acyclic emissions.
The period of puberty (puberty) lasts from 8 to 17-18 years. During this period, the reproductive system matures and the physical development of the female body ends. Uterine enlargement begins at age 8. By the age of 12-13 years, an angle appears between the body and the cervix, open anteriorly (anteflexio), and the uterus takes a physiological position in the pelvis, deviating anteriorly from the wire axis of the pelvis (anteversio). The ratio of body length to cervix becomes 3:1.
In the first phase of puberty (10-13 years), enlargement of the mammary glands (thelarche) begins, which is completed by 14-17 years. By this time, hair growth (pubis, armpits), which began at the age of 11-12 years. In the vaginal epithelium, the number of layers increases, cells of the superficial layer appear with pyknosis of the nuclei. The vaginal microflora changes, lactobacilli appear. The process of maturation of hypothalamic structures is underway, a close synaptic connection is formed between cells secreting liberins (GT-RH, somatoliberin, corticoliberin, thyroliberin) and neurotransmitters. A circadian (daily) rhythm of GT-RG secretion is established, the synthesis of gonadotropins is enhanced, their release becomes rhythmic. An increase in the secretion of LH and FSH stimulates the synthesis of estrogens in the ovaries, the number of receptors sensitive to sex steroid hormones in all organs of the reproductive system increases. Achievement high level estradiol in the blood stimulates the release of gonadotropins. The latter completes the maturation of the follicle and the ovulation process. This period ends with the onset of the first menstruation - menarche.
In phase II of puberty (14-17 years), the maturation of the hypothalamic structures that regulate the function of the reproductive system is completed. A circhoral (hourly) rhythm of GT-RG secretion is established, the secretion of LH and FSH by the adenohypophysis increases, and the synthesis of estradiol in the ovaries increases. A positive feedback mechanism is formed. The menstrual cycle becomes ovulatory. The timing and course of puberty is influenced by internal and external factors. TO internal factors include hereditary and constitutional factors, health status, body weight; to external - climatic conditions (illumination, geographical location, altitude), nutrition (content of proteins, vitamins, fats, carbohydrates, microelements in food).
The period of puberty (reproductive period) takes a period of time from 16-17 to 45 years. The function of the reproductive system is aimed at regulating the ovulatory menstrual cycle. By the age of 45, the reproductive system fades away, and by the age of 55, the hormonal activity of the reproductive system fades away. So the duration functional activity The reproductive system is genetically encoded for the age that is optimal for conceiving, bearing and feeding a child.
Menopausal period (premenopausal) - from 45 years to the onset of menopause. According to the hypothesis put forward in 1958 by V. M. Dilman and developed in his subsequent works (1968-1983), during this period, aging of the hypothalamus is observed, which is manifested by an increase in the threshold of its sensitivity to estrogens, phasing out pulsating rhythmic synthesis and release of GT-RG. The negative feedback mechanism is disrupted, the release of gonadotropins increases (increased FSH levels from 40 years of age, LH from 25 years of age). Disturbances in the function of the hypothalamus aggravate disturbances in the gonadotropic function of the pituitary gland, folliculogenesis and steroidogenesis in the ovaries. The formation of catecholamines in brain tissue increases. Probably, age-related changes occur in the receptor apparatus - a decrease in estradiol receptors in the hypothalamus, pituitary gland and target tissues. Impaired transmission of nerve impulses is associated with age-related degenerative changes in the endings of dopamine and serotonergic neurons of the hypothalamus and suprahypothalamic structures. The process of oocyte death and atresia of primordial follicles accelerates, the number of layers of granulosa cells and theca cells decreases. A decrease in the formation of estradiol in the ovaries disrupts the ovulatory release of LH and FSH, ovulation does not occur, and the corpus luteum does not form. The hormonal function of the ovaries gradually decreases and menopause occurs.
Menopause is last menstruation, which occurs on average at the age of 50.8 years.
The postmenopausal period begins after menopause and lasts until the woman's death. In the postmenopausal period, the level of LH increases by 3 times, and FSH by 14 times compared to secretion during the reproductive period. In deep postmenopause, the formation of dopamine, serotonin, and norepinephrine decreases. The main route of estrogen synthesis becomes extraovarian (from androgens), and estrone becomes the main estrogen: 98% of it is formed from androstenedione, secreted in the ovarian stroma. Subsequently, only 30% of estrogens are formed in the ovaries, and 70% in the adrenal glands. 5 years after menopause, single follicles are found in the ovaries; the weight of the ovaries and uterus decreases. By the age of 60, the weight of the ovaries decreases to 5.0 g, and the volume to 3 cm3 (at reproductive age, the volume of the ovaries is on average 8.2 cm3).
Literature
Obstetrics: Textbook for medical schools. 4th ed., add./E. K. Aylamazyan
