Conversation with the doctor about women’s health

The absence of menstruation for 12 months in adulthood, confirmed by a certain level of sex hormones, gives rise to the diagnosis of menopause. All changes occur gradually: menstrual flow becomes scarce, the interval between them is shortened about a year before cessation.

The average age at menopause is 50-51 years. In 1% of women, the so-called early menopause occurs at the age of 40. Possible development of late menopause (after 53 years).

There is a surgical menopause after removal of the uterus, ovaries. Signs of approaching menopause: sudden fever, repeated hot flashes during the day, interfering with communication with other people, night sweats, alternating with a feeling of cold and causing sleep disturbance, fatigue, memory impairment – all of this may be absent or persistent and prolonged, which greatly reduces the quality of life …

The frequency and severity of these symptoms largely depends on the lifestyle, health status of the woman and is largely predetermined genetically, so I always advise my patients to check with their mother how she went through menopause.

Do I need to prepare for menopause, and if yes, then why?

In the modern world, a woman after the onset of menopause lives for about 30 more years. During this period, significant changes occur in the woman’s body. At an early stage of the gradual extinction of ovarian function and a decrease in the amount of estrogen, vasomotor symptoms occur. After about five years of menopause, urogenital symptoms, urinary incontinence, signs of prolapse of the vaginal walls may appear. After 60 years, urogenital syndrome, hypothyroidism, non-insulin dependent diabetes mellitus, osteoporosis and some oncological diseases progress. After 70 years, cardiovascular diseases appear, such as hypertension, strokes, coronary heart disease, as well as dementia, breast cancer and various cancers.

Often, women see a doctor late, usually only when symptoms appear. I recommend taking care of your health long before the onset of menopause, because if a woman approaches the age of 50 with a certain baggage of chronic diseases, then her menopause will be more difficult. If by the period of menopause she is not overweight, has regular physical activity, proper balanced nutrition, a favorite thing that gives a feeling of satisfaction, then this guarantees an easier passage of menopause and preservation of health for many years. It turns out that it depends only on ourselves how we will live 20-30 years of our mature life: actively or painfully fading away.

But even a completely healthy postmenopausal woman should remember about the need for regular preventive examinations, including a general and biochemical blood test, checking the level of thyroid hormones, taking smears, screening for cervical cancer, pelvic ultrasound, examination of the mammary glands and mammography …

What worries women most often when they think about the aging process?

Women are most afraid of changes in appearance: skin aging, decreased joint mobility, stretching of the musculo-ligamentous apparatus. This is quite reasonable, since a decrease in the level of sex hormones leads to changes in the homeostasis of all tissues containing collagen and elastin.

Another common cause of concern is a decrease in libido, a violation of sexual function. A persistent decrease in estrogen (female sex hormone) levels leads to severe dryness, vulnerability, unprotected vaginal and vulvar mucosa, soreness during sexual intercourse, which leads to frustration, dissatisfaction and ultimately avoidance.

There are frequent fears about the risk of developing pulmonary embolism and deep vein thrombosis of the lower extremities. These fears are valid for women who smoke, women with overweight, physical inactivity and an unfavorable family history. Hormone replacement therapy is not recommended in these cases due to the high risk of thrombosis. Many people worry about the consequences of osteoporosis.

For a healthy woman with a normal height-to-weight ratio, densitometry (a check for bone density) is indicated after age 60.

However, thin, smoking women with a family and their own history of pathological fractures should be examined as early as 50 years old, because they often develop early osteopenia and osteoporosis, which means a high risk of injury and disability.

Is there anything you can do to help such patients?

Of course you can. The most effective method for correcting early menopausal disorders and preventing the long-term consequences of menopause is hormone replacement therapy, which is prescribed for severe symptoms. The essence of the treatment is to pharmacologically replenish (replace) the lost function of the ovaries. In therapy, estrogens and in some cases androgens are used. Androgens are prescribed to improve libido and sexual function. But the combined preparations containing estrogens and gestagens have been studied sufficiently, are safe when used correctly in the first five years of menopause and are widely used in our practice.

The use of hormone replacement therapy improves the condition of the skin, mucous membranes, musculoskeletal system, cartilage tissue, and maintains vascular tone. It has been proven that women who have used or are using HRT before the age of 60 are less likely to need joint surgery, and the risk of pathological fractures is reduced. It has also been proven that in women who previously did not have any cardiovascular pathology, mortality from coronary heart disease is reduced. In the long term, this can actually reduce the overall mortality from cardiovascular diseases.

It is very important to understand that the period of menopause and postmenopause for a woman is a third of her life, for which it is worth preparing, coming up healthy, slim, beautiful, prosperous. Consult a gynecologist in advance and get effective treatment if problems arise. Take care of your health!

You don’t have to fight menopause, you have to learn to live with it. It is worth revising the lifestyle strategy: quit smoking, limit alcohol consumption, maintain good physical shape, intellectual and social activity, follow diet recommendations, control your weight. It cannot be assumed that it is enough to start taking the medicine and life will improve. This does not happen. You need to understand this in time and embark on the path of a healthy lifestyle!

local_offerevent_note March 8, 2021

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