Menopause is considered to be a natural physiological process in a woman's life. Accordingly, and menstrual irregularities during menopause are the norm options. However, in some cases, there uterine bleeding in premenopausal Premenopausal women - one step in a woman's life That belong to the category of pathologies. Any failure of the menstrual cycle, menopausal woman should as soon as possible to see a doctor as often cycle disorders indicate the presence of a gynecologic pathology occurring in premenopausal age.

Menopause

Menopause begins around 45-55 years and can last from two to eight years. The clinical manifestations of menopause, in addition to menstrual disorders are: emotional and mental disorders (irritability, drowsiness, weakness, forgetfulness, etc.), vasomotor disturbances (hot flushes, headaches, excessive sweating, chills, palpitations) and late metabolic disorders (osteoporosis, cardiovascular diseases).

The mechanism of development of menstrual disorders in menopause

Climax is none other than the physiological extinction of women's reproductive functions .  Menstrual disorders in menopause is associated with the failure of the cyclic release of gonadotropins (follicle-stimulating hormone and luteinizing hormone), follicle development process disorder and hormonal function .  Against this background formed luteal insufficiency with deficiency of the corpus luteum, which is a consequence of anovulatory ovarian dysfunction .  In addition, steroidogenesis in the ovary is characterized by relative giperestrogeniey (excess estrogen) against the absolute gipoprogesteronemii (lack of progesterone) .  All these processes lead to the disruption of cell proliferation and secretory transformation of the endometrium .  This gives rise to cyclic and acyclic often uterine bleeding .  Bleeding occurs from giperplazirovanogo layer lining of the uterus .

Therefore menopausal meet different types of endometrial hyperplasia Hyperplasia endometrial cancer - requires timely detection and treatment Such as: glandular-cystic hyperplasia, glandular polyps, adenomatous and atypical hyperplasia. It is known that endometrial hyperplasia in premenopausal develops much more frequently than in the reproductive. This is due not only to the age-related changes of the ovaries (the extinction of their functions), but with a higher frequency of obesity and age-related immunosuppression.

Treatment

First of all, the treatment of bleeding in women during menopause is determined by the cause of bleeding, concomitant chronic and neuro-endocrine diseases. We should not forget that the bleeding during menopause may be indicative of adenocarcinoma of the endometrium (endometrial cancer), as well as adenomatous and atypical hyperplasia. Do not use hormonal hemostasis, since the subsequent curettage histological changes of the mucous membrane of the uterus, resulting in a reduction of informativeness histological analysis.

Conservative treatment of menstrual disorders is conducted in women with:

• endometrial hyperplasia in the absence of other gynecological and extragenital pathology;
• hyperplastic processes in the background of small fibroids;
• hyperplastic processes in the form of diffuse adenomyosis first degree.

For the treatment of uterine bleeding in menopause after curettage of the uterus Curettage - how dangerous it is?   commonly used progestins. Women up to 48 years with glandular-cystic hyperplasia appointed 17 DIC at 125-250 mg on the 14th, 17th and 21st day of the menstrual cycle The days of the menstrual cycle: Four phases . This treatment should last at least four to six months. Djufaston appoint 10-20 mg from the fourteenth to the sixteenth day of the menstrual cycle and for four to six months. Women over 48 years of suppressing menstrual function. They are administered 17 DIC 250 mg continuously twice a week for six months.

Anna Sozinova

A woman's body is designed so that at the birth of her child is given a certain time. And then the body begins to produce less hormones that disrupt the normal menstrual cycle and during the so-called menopause occurs when the birth of a child is impossible.

The term "menopause"

Menopause - the second phase of menopause, comes after the last menstrual bleeding. During menopauzay terminate cyclic changes in the lining of the uterus, menstrual and reproductive function, hormonal balance changes occur in the hypothalamus - pituitary - ovary and changes in sexual organs associated with their withering.

The term "menopause" is sometimes used to refer to the last uterine bleeding Uterine bleeding outside of menstruation - a sign of a serious breach Due to the action of ovarian hormones. The term "postmenopausal" refers to a period of decline and then cessation of secretion of hormones in the ovaries.

Transition Phase menopause menopause is usually determined within a year after the last menstrual period, because it is difficult to determine what will be the last menstrual period, because they can occur in this period is irregular, with long intervals. This is usually between the ages of 48 to 52 years.

Hormonal changes during menopause

During menopause, the ovaries decreases the synthesis of hormones. Mature follicles (vesicles, which mature egg) are no longer available, progressing degenerative (metabolic, with malnutrition tissue) changes, creating sclerosis and zapustevayut blood vessels in the genital area. At the same time, the ovaries are still capable of producing a number of sex hormones estrogen. Thus the main estrogen secretion Estrogen - the key to bone health   - Estradiol decreases dramatically reduced and the content of other estrogen - estrone. With decreasing secretion of estrogens, particularly estradiol, enhanced secretion of pituitary gonadotropins (follicle-stimulating hormone and luteinizing hormone - FSH and LH), as between these hormones inverse relationship exists: the more estrogens, the smaller the pituitary gonadotropins, and vice versa. But ovaries gradually lose the ability to respond to increased stimulation of gonadotropic hormones that lead to certain changes in the genital organs.

Changes genitals during menopause

Against the backdrop of age-related hormonal changes intensify hypotrophic (with a decrease in the volume of tissue) processes in the genitals. Reduces the size of the uterus (mainly due to the muscle layer) and ovarian cyclical processes in the mucous membrane of the uterus (the endometrium) to an end, cancer in the lining of the uterus atrophy, ovarian cortex becomes thinner and the outer albuginea, on the contrary, thickens.

Changes in the epithelium of the cervix synchronous changes in the mucosa of the uterine body. The glands of the cervical canal is also gradually cease to function, the mucosa becomes atrophic (shrunken). The longer retains its properties vaginal mucosa, it is because it is more sensitive to a small amount of estrogen. But gradually and vaginal mucosa becomes thinner, it disappears folding, stops the reproduction of the epithelial cells.

Changes in other organs and systems

Changes in other organs and systems during menopause are also significant. Especially significant changes occur in the nervous, endocrine and cardiovascular systems. All these organs and systems gradually lose their function. Menopause, as well as menopause, may be accompanied by more or less pronounced changes in the central nervous system: headaches, seizures (sometimes in the form of migraines), sweating, hot flushes, genital itching. Can appear irritability Irritability - you try to control my temper , Resentment, impaired memory and performance, fatigue, insomnia and so on. For some women, menopause occurs on the background of constant depression.

Change the fat, water and carbohydrate metabolism. This is manifested in a decrease or increase of body fat, edema, alteration of daily blood volume and so on. There may be mild expressed functional changes of the adrenal and thyroid glands, which explains some of the types of metabolism, pigment spots on the skin, sweating and so on.

During menopause harder occur cardiovascular disease, diabetes Diabetes - threatening and incurable disease , Liver, kidney, pancreas and thyroid, allergic conditions.

Thus, menopause contributes to the fact that a woman's body gradually decrease the function of all organs and systems.