Climax

Climax is a manifestation of the general mechanism of aging. Aging is genetically programmed, on the whole it is a destructive process that disrupts the activity of cells and body systems, which ultimately leads to inferiority of all its functions.

The organism begins to grow old from the moment of its inception: constant dynamic changes take place in it.Some changes occur quickly, others - slowly, they can be found only after a few days, months, years.

Throughout his life the organism is in close contact with the constantly changing external environment. To match these changes, somehow adapt to them, the body changes itself. But these changes should not go beyond a certain "framework".

The constancy of the internal environment of the organism, fluctuating in certain "boundaries", for each person and for each age period - its own, and it is called homeostasis. Thanks to homeostasis, the body retains its vital functions, but nevertheless changes from one age to another, from one stage of development to another. Homeostasis helps to eliminate excessive shifts in the body (which, in fact, are all diseases) and even prevents these "abnormal shifts"

To ensure that the body's vital functions are not disturbed, it is necessary, for example, to maintain body temperature at one level, a certain osmotic pressure of blood and tissue fluid, a certain level of arterial and venous blood pressure, a constant concentration of hydrogen ions (creating a certain level of acidity) and a certain level of metabolism .

Any impact of the external environment can be a stimulus to the fact that the body will come out of the "framework" of homeostasis.

The state of internal stability of the organism has arisen and consolidated in the process of evolution, it allows the body, while preserving itself, to adapt to environmental conditions.

In the process of aging, the mechanisms of regulation are weakened. The aging organism, in contrast to the basic property of the young organism, to restore disturbed homeostasis, is characterized by a gradual loss of the constancy of its internal environment, an imbalance of all its systems, an inadequate (stronger) reaction to changes in the external environment.

Aging is the gradually increasing sensitivity of the organism to the influence of various factors, internal and external, leading to disruption of homeostasis and, as a result, to a decrease in the viability of the individual. Stability of the organism is carried out mainly by the mechanism of feedback through the hypothalamus. It is in it that interaction takes place, on the one hand, with the higher sections of the central nervous system, with the cortex of the brain, and on the other side (through the pituitary gland) - with the underlying sections of the endocrine glands, internal organs.

Throughout life (from inception), a gradual increase in the activity of the hypothalamus occurs, which first stimulates the development of organs and systems (including the sexual development of the girl), and then contributes to the disturbance of their activity and extinction. That is, the same mechanism and turns on and off the sexual activity of the body (as well as other functions).

In the menopause, the activity of the hypothalamus increases, which means that it stimulates the pituitary (gonadotropic hormones), and the pituitary gland stimulates the production of estrogens in the ovaries. But all links of this system (both the hypothalamus, the pituitary gland, and the ovaries) already react poorly in menopausal age.

Regressive (ie, atrophic) processes in the ovaries of a woman have already appeared since the age of thirty. These are sclerotic changes in the ovaries themselves and the vessels feeding them; The ovaries themselves were reduced in size (in 30-40 years the ovary weight was 9.3 g, in 41-50 years it was 6.6 g, in 51-60 years it was 4.96 g, in 61-70 years - 4 G); The changes begin in the structure of the ovaries: with age, the number of follicles decreases (18-25 years - 150,000 follicles, in 40-44 years - 8000-9000 follicles); The cortical layer of the ovary containing the follicles is depleted and wrinkled, and the amount of connective tissue increases. The number of receptors to hormones decreases. The organism at this age begins to develop antibodies to sex hormones and to the ovaries (organ antibodies), which also damage the ovaries and bind (inactivate) sex hormones.

Therefore, despite the increased stimulation of the hypothalamus through the pituitary gland (in the menopausal period, FSH of the pituitary gland in women increases by 1.5-3 times compared with the young age), the ovaries do not give an active reaction with increased estrogen increase, but ovulation does not occur, and no Yellow body.

The activity of the ovaries increases endlessly, without being able to slow down. In the end, the ovary develops a more or less pronounced sclero-polycystic process (a large number of small cysts on the ovary are many follicles that can not ripen and burst), and the mucosa grows in the uterus (in the pathological climax it grows to endometrial hyperplasia ).

At a young age, the hypothalamus, through a negative feedback system through the pituitary gland, inhibits the formation of estrogens in the second phase of the cycle, and the increasing amount of the hormone of the yellow body (progesterone) counteracts the effect of estrogens. This prevents excessive proliferation and hyperplasia of the endometrium and there are secretory transformations, maturation and subsequent rejection in the next menstruation.

Disorders (delays and irregularity) of the menstrual cycle and excessive overgrowth of the immature mucous membrane of the uterus in the menopause occur not so much and not only because of a more or less elevated amount of estrogens, but because of the duration of their exposure.

Delays in menstruation in both normal and pathological menopause occur precisely because of the unassailable level of estrogen and the absence of ovulation. But the uterine mucosa, sooner or later, is still rejected because of the development of dystrophic processes in it, after a delay, "menstruation" occurs in the form of more or less profuse bleeding. The amount of blood lost depends on the level of estrogens and the thickness of the overgrown layer of the mucosa, as well as on the individual ability to contract in the uterus and the blood coagulation system.

In the normal (physiological) course of the climacteric period, the atrophic processes in the ovaries and their extinction correspond to the age, and therefore, in response to strong pituitary stimulation (from the hypothalamus), these ovaries are unable to respond in a "fitting" way. Eventually, there is a gradual fading of the function: "monthly" are becoming less and less, until they stop at all. In some women (rarely), the cycle can immediately break off abruptly, but more often still 3-5-7 menstruation (or more) periodically come, but less abundant and more rare. It does not disturb the woman and does not break the general state of her health.

In the pathological course of menopause, two variants of development are possible.

In the first case, the sensitivity of the ovaries to the effects of FSH is maintained or even increased. Therefore, in response to strong stimulation from the hypothalamus and FSH of the pituitary gland, the ovaries begin to intensively isolate their hormones - estrogens. But ovulation still does not come, the hypothalamus also can not give a negative feedback, that is, it can not begin to produce pituitary-inhibiting factors in response to a sharp increase in the level of estrogens (as at a young age). Therefore, in response to the high amount of estrogen and prolonged, continuous exposure to the uterus, the mucosa proliferates - endometrial hyperplasia.

Various forms of endometrial hyperplasia are possible, depending on the composition of the cells: glandular (63.9%), glandular-cystic (9.8%), mixed forms.

The glandular and glandular-cystic endometrial hyperplasia in cancer rarely change, but they are the background for the development of atypical hyperplasia of the endometrium, and this form is already a precancerous disease.

Doctors believe that long-term, especially in premenopausal and climacteric periods, bleeding (even uninvolved) causes a real threat of precancerous changes in the endometrium and the development of uterine cancer. In addition, bleeding during hyperplasia of the endometrium is very abundant and, therefore, in itself also threatens the health and life of women.

The second version of the pathological menopause happens at a fast advancing ovarian failure (rapidly declining level of estrogen) and dysregulation of the work of the hypothalamus, while developing menopausal syndrome, manifested by a set of symptoms, the most important of them are the "tides" - recurrent vascular reactions with a sense of feeling the heat in Upper half of the trunk and head. They appear in 70% of menopausal women.

The reason for these changes is a sharp decrease in the level of estrogen and an imbalance in the autonomic nervous system due to abnormalities in the hypothalamus. In this case, the metabolism of the autonomic nervous system is disrupted. In particular, the transition of noradrenaline to adrenaline is difficult, norepinephrine accumulates in the blood (the "stress hormone"). Also, the activity of the enzyme cholinesterase, which destroys acetylcholine, also decreases, which also accumulates in the blood. The dopamine mediator accumulates in the blood. As a result of expanding the skin vessels, and internal organs spazmiruyutsya vessels, blood pressure begins to "jump" appears hyperemotivity, palpitations, wherein in the cerebral cortex, on the contrary, there has been increasing braking processes.

Thus, the climacteric period in a woman can go in three ways:

• 1) normal physiological path first with a slight increase, and then a gradual decrease in estrogens, with a gradual decrease in the monthly and a decrease in their number; While the general state of health is almost unchanged;
• 2) pathological (painful) version of menopause with a significantly increased level of female sex hormones (a woman looks younger than her years) with the development of hyperplastic processes in the uterus, ovaries and even in the mammary glands, with more or less profuse and (or) prolonged bleeding after delays ;
• 3) pathological menopause on the sharply lowered level of female sex hormones, called climacteric syndrome, the main manifestation of which are "hot flashes" (the woman at the same time "grows old" outwardly).

Tides may also occur in a woman with the first form of a pathological climax, with hyperplastic changes in the endometrium, and with an increased hormonal background, since the main role in their appearance is played not so much by a reduced amount of estrogens as a disturbance in the work of the hypothalamus as a central regulator of the autonomic nervous system and Metabolism. But most often in practice, either one or the other is observed: either excessive bleeding with hyperplastic processes, or a climacteric syndrome with "hot flashes".

How will the menopause develop in a woman, depends on herself. If the nervous system is balanced, there are no severe and chronic diseases, good relations at work and in the family, a warm, friendly atmosphere of love and attention, then in such a woman the climax will flow in a normal (physiological) type, with a slow and gradual fading, without noticeable violations In a state of health, without impairment.

Especially dangerous is the very initial period of menopause, when in response to stimulation by the hypothalamus, the ovaries begin to increase their function somewhat.

During this period, the physiological climax can pass into the pathological under the influence of most often mental and physical traumas, overstrain and fatigue, lack of sleep and malnutrition, as well as under the influence of unfavorable factors of the environment, diseases, intoxications, etc. Under the influence of these influences in the ovaries, And either pathological, excessive strengthening with subsequent heavy bleeding, or a sharp decrease in hormones against the background of further dysfunction of the hypothalamus with the appearance of "tides."

Even in the normal course of the climacteric period, the woman still has symptoms of a general nature, most of which characterize the aging of the endocrine, cardiovascular, nervous systems and worsening metabolism: disturbance in the rhythm of sleep and falling asleep, fatigue, emotional lability (ie, increased emotional Excitability), memory impairment, changes in blood pressure, blurred changes in the heart (cardiopathy), weight gain, changes in bone structure. In the normal course of menopause, these symptoms are moderately expressed, appear gradually, little worries for a woman, and, as a rule, normalization of work and rest, walks, water procedures and herbal medicine always help.

Women need to pay attention to the fact that in the menopausal period, the course of existing diseases can worsen: hypertension, coronary heart disease, thrombophlebitis before the appearance of trophic ulcers, diabetes mellitus, etc. In addition, at the present time generally worn out, atypically occurring forms of diseases , And in the climacteric, erased forms are much more frequent than in other periods of a woman's life. Therefore, it is important to distinguish the symptoms of normal aging from signs of a pathological climax and from diseases that arise in the climacteric period.

And the main criterion for a woman here is the degree of manifestation and well-being. That is, as in any period of her life, a woman and in the climacteric should carefully and carefully treat yourself, listen to your body, try to understand it and help him in time.

External signs of normal aging are wrinkles on the skin of the face and neck, an increase in the deposition of cutaneous fat - appear already in the first stage - in the premenopause. Then, more pronounced general age changes appear in postmenopause: on the skin of hands and hands - pigment spots - "old age spots", graying and thinning hair, nails become brittle, teeth are destroyed, hearing and hearing deteriorate. And also decreases muscle strength, accuracy and speed of movement (i.e., decreases and coordination), decreases the vital capacity of the lungs, increases sensitivity to changes in ambient temperature and climate change. With a physiological climax, these changes occur and develop gradually and slowly. At the same time, about 40-50% of women adapt to age-related changes and feel almost healthy.

The genetic program of development and aging is individual. But the life expectancy can increase, and the quality of life - too, if a woman will take care of herself, listen to changes in her body, turn to the doctor in time to diagnose and treat diseases, especially cardiovascular and tumor ones.

In old age, the number of receptors on the membrane of nerve cells decreases, which is typical for the ovaries, this occurs in other organs and cells of the body. The state of the remaining receptors also changes.

Changes occur in the cerebral cortex, and in sinuses, vegetative ganglia, and in peripheral nerve cells. As a result, the reaction of these cells to all stimuli (including chemicals, drugs) is disrupted, and interaction between cells is disturbed, their coordinated work is disrupted, and the participation of cells in general regulatory responses is reduced. Control of the central nervous system is weakened beyond the activity of cells.С

Aging of nerve cells first leads to their functional inferiority, and then changes in structure and metabolism go so far that the cell eventually dies.

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