Age periods of women in gynecology. Physiological processes in a woman’s body at different periods of 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. This is now a promoted strategy, good tone, fashion, and everything less people they refer to their ancestors, who gave birth without any preparation, and are increasingly turning 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 by proper preparation, namely, replenishment of vitamin deficiencies, 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 features female body, his reproductive function 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, physical development female body: body growth in length, physique formation and distribution of fat and muscle tissue throughout female type. Physiological period puberty proceeds 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 puberty(10-13 years old) the 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..

In case of menstrual cycle disorders in children and adolescents, it is imperative to contact special pediatric gynecologists and pediatricians. Timely qualified treatment will in most cases normalize menstrual cycle and thus ensure normal future 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. His physiological mechanism very complicated. In a simplified form, it can be represented as follows. In the subcortical zone of the brain, pulsating secretion of special chemical substances(neurosecrets), which circulatory system enter the anterior lobe of the pituitary gland. 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 hormone production begins corpus luteum progesterone (2nd phase of the cycle). Under the influence estrogen 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, the hormonal function of the reproductive system fades.

The premenopausal period of life is characterized by high social activity of women, due to 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 begins hormonal function ovaries, 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 in the 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 of tubular bones and the most dangerous of them - 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 at 28 daily 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, guided by fimbriae peripheral part 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, temporary endocrine gland- yellow body. 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 does not take place, the corpus luteum is in the stage of 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 produce 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 care in maternity leave threatens deterioration of 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.

To protect yourself both externally and internally, to avoid the discomfort associated with restructuring life values, temporal and spatial resources, a woman is forced to plan to conceive 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.

Varieties natural methods family planning:

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 top part 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 of various systems and organs in 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 barrier contraception.

Intrauterine contraception (IUD). 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 in the early stages of 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, resulting in attachment ovum to the wall of the uterus is impossible. VMC, how 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 and who have permanent partner and not suffering 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 the composition 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 effects on the fetus were 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. Mechanism contraceptive effect mini-pill is that a change in the quantity and quality of mucus contained in the cervix, an increase in its viscosity, a decrease in the penetrating ability of sperm reduces the likelihood of sperm entering the uterus, changes in the endometrium that exclude implantation, and inhibition of the motility of the fallopian tubes. 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 one would touch the 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 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 caption). The presence of IgG antibodies means immunity to these infections and is not an obstacle to pregnancy. The presence of IgM means 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. First time evaluated general state pelvic organs, in 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 a dominant follicle that is 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 (medications, ailments, sleep disorders, menstruation, sex life, stool disorders, etc.) - 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 are factors of early miscarriage.

10. General clinical blood test (hemoglobin, erythrocytes, leukocytes, platelets, ESR, color index, leukocyte formula). Blood from a finger.

11. General analysis urine.

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 (enlargement of the mammary glands, appearance of pubic hair and axillary fossae), the beginning of menstruation (menarche) and the formation 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 highest activity specific functions of the reproductive system aimed at childbearing.

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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Classification of age periods from a biological point of view

There is no single classification, in different time it was compiled differently. The delimitation of periods is associated with certain age when they happen significant changes in the human body.

A person’s life is the periods between key “points”.

Passport or chronological age may not coincide with biological age. It is by the latter that one can judge how he will perform his work, what loads his body can withstand. Biological age may either lag behind the passport number or be ahead of it.

Let's consider the classification of life periods, which is based on the concept of age based on physiological changes in the body:

Age periods

age		period
0-4 weeks		newborn
4 weeks - 1 year		chest
1-3 years		early childhood
3-7 years		preschool
7-10/12 years		junior school
girls: 10-17/18 years old		teenage
boys: 12-17/18 years old
young men	17-21 years old	youthful
girls	16-20 years old
men	21-35 years old	adulthood, 1st period
women	20-35 years
men	35-60 years	mature age, 2nd period
women	35-55 years
55/60-75 years		elderly age
75-90		old age
90 years or more		centenarians

Scientists' views on the age periods of human life

Depending on the era and country, scientists and philosophers proposed different criteria for grading the main stages of life.

For example:

Chinese scientists divided human life into 7 phases. “Desirable,” for example, was the age from 60 to 70 years. This is a period of development of human spirituality and wisdom.
The ancient Greek scientist Pythagoras identified the stages of human life with the seasons. Each lasted 20 years.
The ideas of Hippocrates became fundamental for the further determination of periods of life. He identified 10, each 7 years long, starting from birth.

Periods of life according to Pythagoras

The ancient philosopher Pythagoras, considering the stages of human existence, identified them with the seasons. He identified four of them:

Spring is the beginning and development of life, from birth to 20 years.
Summer is youth, from 20 to 40 years.
Autumn is the heyday, from 40 to 60 years.
Winter - fading, from 60 to 80 years.

The periods of human life according to Pythagoras had a duration of exactly 20 years. Pythagoras believed that everything on Earth is measured by numbers, which he treated not only as mathematical symbols, but also endowed them with a certain magical meaning. Numbers also allowed him to determine the characteristics of the cosmic order.

Pythagoras also applied the concept of “quaternary” to age periods, because he compared them with eternal, unchanging natural phenomena, for example, the elements.

Periods (according to Pythagoras) and their benefits are based on the idea of eternal recurrence. Life is eternal, like seasons changing each other, and man is a part of nature, lives and develops according to its laws.

The concept of “seasons” according to Pythagoras

Identifying the age intervals of a person’s life with the seasons, Pythagoras focused on the fact that:

Spring is the time of beginning, the birth of life. The child develops, absorbing new knowledge with pleasure. He is interested in everything around him, but everything is still happening in the form of a game. The child is blossoming.
Summer is the period of growing up. A person blossoms, he is attracted by everything new, still unknown. Continuing to blossom, a person does not lose his childish fun.
Autumn - a person has become an adult, balanced, the former gaiety has given way to confidence and leisureliness.
Winter is a period of reflection and summing up. The man has gone most of the way and is now considering the results of his life.

The main periods of people's earthly journey

Considering the existence of an individual, we can distinguish the main periods of a person’s life:

youth;
mature age;
old age.

At each stage, a person acquires something new, revises his values, and changes his social status in society.

The basis of existence is made up of periods of human life. The characteristics of each of them are associated with growing up, changes in the environment, and state of mind.

Features of the main stages of personality existence

The periods of a person’s life have their own characteristics: each stage complements the previous one, bringing with it something new, something that has not yet happened in life.

Youth is characterized by maximalism: the dawn of mental and creative abilities occurs, the basic physiological processes of growing up are completed, and the appearance, well-being. At this age, a system is established, time is valued, self-control increases, and others are re-evaluated. A person decides on the direction of his life.

Having reached the threshold of maturity, a person has already reached certain heights. In the professional sphere, he occupies a stable position. This period coincides with the strengthening and maximum development social status, decisions are made thoughtfully, a person does not avoid responsibility, appreciates the present day, can forgive himself and others for mistakes he has made, and realistically evaluates himself and others. This is the age of achievement, conquering peaks and obtaining maximum opportunities for your development.

Old age is more associated with losses than with gains. A person ends his working life, his social environment changes, and inevitable physiological changes appear. However, a person can still engage in self-development, in most cases this happens more on a spiritual level, on development inner world.

Critical points

The most important periods of human life are associated with changes in the body. They can also be called critical: hormonal levels change, which causes changes in mood, irritability and nervousness.

Psychologist E. Erickson identifies 8 crisis periods in a person’s life:

Teenage years.
A person's entry into adult life- thirtieth birthday.
Transition to the fourth decade.
Fortieth birthday.
Midlife - 45 years.
Fiftieth anniversary.
Fifty-fifth anniversary.
Fifty-sixth birthday.

Confidently overcoming “critical points”

Overcoming each of the presented periods, a person moves to a new stage of development, while overcoming the difficulties that arose along the way, and strives to conquer new heights of his life.

The child breaks away from his parents and tries to independently find his own direction in life.

In the third decade, a person reconsiders his principles and changes his views on the environment.

Approaching their fourth decade, people try to gain a foothold in life, to rise in career ladder, begin to think more rationally.

In the middle of life, a person begins to wonder whether he is living correctly. There is a desire to do something that will leave a memory of him. Frustration and fear for your life appear.

At the age of 50, a slowdown in physiological processes affects health; age-related changes. However, the person has already correctly placed life priorities, his nervous system works stably.

At 55 years old wisdom appears and a person enjoys life.

At 56 years old, a person thinks more about the spiritual side of his life and develops his inner world.

Doctors say that if you are prepared and know about the critical periods of life, then overcoming them will happen calmly and painlessly.

Conclusion

A person decides for himself by what criteria he divides his life periods, and what he means by the concept of “age”. It could be:

Purely external attractiveness, which a person seeks to prolong by all available means. And he considers himself young as long as his appearance allows it.
The division of life into “youth” and “the end of youth.” The first period lasts as long as there is an opportunity to live without obligations, problems, responsibility, the second - when problems and life difficulties appear.
Physiological changes in the body. A person clearly follows changes and identifies his age with them.
The concept of age is associated with the state of the soul and consciousness. A person measures his age by his state of mind and inner freedom.

As long as a person’s life is filled with meaning, the desire to learn something new, and all this is organically combined with the wisdom and spiritual wealth of the inner world, the person will be forever young, despite the weakening physical capabilities of your body.

The functional state of a woman’s reproductive system is largely determined by the periods of life, among which it is customary to distinguish the following:

Antenatal (intrauterine) period;
- neonatal period (up to 10 days after birth);
- childhood period (up to 8 years);
- period of puberty, or puberty (from 8 to 16 years);
- period of puberty, or reproductive (from 17 to 40 years);
- premenopausal period (from 41 years to the onset of menopause);
- postmenopausal period (from the moment of permanent cessation of menstruation).

Antenatal period.Ovaries. In progress embryonic development The gonads are the first to develop (starting from 3-4 weeks of intrauterine life). By 6-7 weeks of embryo development, the indifferent stage of gonad formation ends. From the 10th week, female gonads are formed. At week 20, primordial follicles form in the fetal ovaries, which represent an oocyte surrounded by compacted epithelial cells. At week 25, the tunica albuginea of the ovary appears. At 31-32 weeks, granular cells of the inner lining of the follicle differentiate. From 37-38 weeks the number of cavity and maturing follicles increases. By the time of birth, the ovaries are morphologically formed.

Internal genital organs. Fallopian tubes, uterus and upper third vaginas originate from the paramesonephric ducts. From 5-6 weeks of embryo development, the development of the fallopian tubes begins. At 13-14 weeks, the uterus is formed by the fusion of the distal sections of the parameso-nephric ducts: initially the uterus is bicornuate, but later acquires a saddle-shaped configuration, which is often preserved at the time of birth. At 16-20 weeks, the cervix differentiates. From the 17th week, the labia develop. By 24-25 weeks, the hymen is clearly visible.

Hypothalamic-pituitary system. From 8-9 weeks of the antenatal period, the secretory activity of the adenohypophysis is activated: FSH and LH are determined in the pituitary gland, fetal blood and in small quantities in amniotic fluid; during the same period, GnRH is identified. At 10-13 weeks, neurotransmitters are detected. From the 19th week, the secretion of prolactin by adenocytes begins.

Newborn period. At the end intrauterine development fetus high level maternal estrogens inhibit the secretion of gonadotropins from the fetal pituitary gland; a sharp decrease in the mother’s estrogen content in the newborn’s body stimulates the release of FSH and LH by the girl’s adenohypophysis, which provides a short-term increase in the function of her ovaries. By the 10th day of a newborn’s life, manifestations of estrogenic effects are eliminated.

Childhood period. Characterized by low functional activity reproductive system: the secretion of estradiol is insignificant, the maturation of follicles to the antral occurs rarely and unsystematically, the release of GnRH is inconsistent; receptor connections between subsystems are not developed, the secretion of neurotransmitters is poor.

Puberty period. During this period (from 8 to 16 years), not only the maturation of the reproductive system occurs, but also the physical development of the female body is completed: body growth in length, ossification of the growth zones of tubular bones, the physique and distribution of fat and muscle tissue according to the female type are formed.

Currently, in accordance with the degree of maturity of the hypothalamic structures, three periods of maturation of the hypothalamic-pituitary-ovarian system are distinguished.

First period- prepubertal (8-9 years) - characterized by increased secretion of gonadotropins in the form of individual acyclic emissions; estrogen synthesis is low. A “jump” in body length growth is noted, the first signs of feminization of the physique appear: the hips are rounded due to an increase in the amount and redistribution of adipose tissue, the formation of the female pelvis begins, the number of epithelial layers in the vagina increases with the appearance of intermediate-type cells.

Second period- the first phase of the puberty period (10-13 years) - is characterized by the formation of daily cyclicity and an increase in the secretion of GnRH, FSH and LH, under the influence of which the synthesis of ovarian hormones increases. The mammary glands begin to enlarge, pubic hair begins to grow, the vaginal flora changes - lactobacilli appear. This period ends with the appearance of the first menstruation - menarche, which coincides in time with the end of the rapid growth of the body in length.

Third period- the second phase of the pubertal period (14-16 years) - is characterized by the establishment of a stable rhythm of GnRH secretion, a high (ovulatory) release of FSH and LH against the background of their basal monotonic secretion. The development of the mammary glands and sexual hair is completed, the body grows in length, and the female pelvis is finally formed; The menstrual cycle becomes ovulatory.

First ovulation represents the culmination of puberty, but does not mean puberty, which occurs by 16-17 years. Puberty is understood as the completion of the formation of not only the reproductive system, but also the entire woman’s body, prepared for conception, pregnancy, childbirth and feeding a newborn.

Period of puberty. Age from 17 to 40 years. The features of this period are manifested in specific morphofunctional transformations of the reproductive system (Section H.1.1.).

Premenopausal period. The premenopausal period lasts from 41 years to the onset of menopause - last menstrual period in a woman's life, which occurs on average at the age of 50. Declining activity of the gonads. A distinctive feature of this period is a change in the rhythm and duration of menstruation, as well as the volume of menstrual blood loss: menstruation becomes less abundant (hypomenorrhea), their duration is shortened (oligomenorrhea), and the intervals between them increase (opsomenorrhea).

The following phases of the premenopausal period are conventionally distinguished:

Hypolutein - there are no clinical symptoms, there is a slight decrease in the secretion of lutropin by the adenohypophysis and progesterone by the ovaries;
- hyperestrogenic - characterized by the absence of ovulation (anovulatory menstrual cycle), cyclical secretion of FSH and LH, an increase in estrogen content, which leads to a delay of menstruation for 2-3 months, often with subsequent bleeding; the concentration of gestagens is minimal;
- hypoestrogenic - amenorrhea is observed, a significant decrease in estrogen levels - the follicle does not mature and atrophies early;
- ahormonal - the functional activity of the ovaries ceases, estrogens are synthesized in small quantities only by the adrenal cortex (compensatory hypertrophy of the cortex), the production of gonadotropins increases; clinically characterized by persistent amenorrhea.

Postmenopause. The ahormonal phase coincides with the beginning of the postmenopausal period. Postmenopause is characterized by atrophy of the internal genital organs (the mass of the uterus decreases, its muscular elements are replaced by connective tissue, the vaginal epithelium becomes thinner due to a decrease in its layering), urethra, Bladder, pelvic floor muscles. In postmenopause, metabolism is disrupted, and pathological conditions cardiovascular, skeletal and other systems.

Having become familiar with the anatomical and physiological characteristics of a woman’s genital organs at different age periods, it is much easier to understand biological processes that occur in the female body.

Periods of a woman's life

Functional age-related characteristics of the female reproductive system depend on a number of factors. Important periods of a woman's life:

period of intrauterine development;
childhood (from birth to 9-10 years);
puberty (from 9-10 to 13-14 years);
adolescence (14-18 years);
reproductive period, or puberty (18-40 years);
premenopause, transition period (41-50 years);
postmenopause, period of aging (from the moment of cessation of menstruation).

Prenatal period

During this period, all organs and systems of the fetus are formed, develop and mature. The ovaries are also laid and developed - one of the most important links in the functioning of the female reproductive system.

Childhood

During this period reproductive system resides in relative peace. Only during the first few days of a girl’s life can symptoms of a sexual crisis occur (engorgement of the mammary glands, bloody discharge from the vagina). It's all because of the termination hormonal action placenta. In childhood, the organs of the reproductive system gradually grow, but the typical features are preserved: the size of the cervix prevails over the size of the uterus, the fallopian tubes convoluted, mature follicles are absent in the ovaries, etc. And there are no secondary sexual characteristics.

Puberty

During this period, the organs of the reproductive system (mainly the body of the uterus) grow rapidly. The girl begins to appear and develop secondary sexual characteristics: a female-type skeleton is formed, female-type fat is deposited, hair grows first on the pubis, then in armpits, the first menstruation begins.

Puberty

This period is the longest in a woman’s life. As a result of the maturation of the follicle in the ovaries and further ovulation, all conditions for further pregnancy are created in the woman’s body. Menstruation becomes regular - and this is the main indicator women's health childbearing age.

This period is characterized by the transition from puberty to old age. Various disorders of menstrual function often develop; they can be caused by age-related disorders in the central mechanisms that regulate the function of the genital organs.

Aging period

The period of aging is characterized by a complete cessation of menstruation and general aging of the female body. Ovarian function completely fades away (no ovulation, cyclical changes in the body, no menstruation), estrogen levels decrease, which can provoke osteoporosis, atherosclerosis, and cardiomyopathy.