Climax without hot flashes

With age, sooner or later, but menopause comes to every woman. There is no need to panic about it, but it would be very useful to prepare for this period. After all, not everyone experiences menopause smoothly and painlessly: mood swings, apathy, irritability, insomnia, headaches and hot flashes - this is just a small and incomplete list of the main symptoms of this stage of life. True, some women experience menopause without hot flashes - this course of menopause is considered atypical, and it is sometimes difficult to recognize.

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Causes of menopause without hot flashes

It is generally accepted among medical professionals that hot flashes always occur during menopause. It is just that in some cases they are hidden, poorly expressed, unnoticeable, or are disguised as other sensations. For example, some patients noted the absence of typical hot flashes, and at the same time the appearance of night sweats, intolerance of stuffy rooms, short-term trembling in the hands, weakness. Such sensations, like hot flashes, can last from 30 to 60 seconds, several times a day.

The pathogenesis of hot flashes is simple: hot flashes during menopause are caused by the pituitary gland's response to a sharp decrease in the amount of estrogens in the body - the so-called estrogen imbalance. In response, the pituitary gland increases the production of LH - luteinizing hormone, which, in turn, leads to a sharp short-term increase in body temperature, which is the moment of the hot flash.

It can be assumed that any changes in this chain of reactions can lead to the absence or veiling of climacteric hot flashes, since many sensations can also depend on the state of the woman’s autonomic nervous system.

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Symptoms of menopause without hot flashes

When describing the first signs of menopause, hot flashes are invariably meant. However, this age period can also occur without them: in this case, other symptoms come first, by which menopause can be recognized.

Usually, the onset of physiological menopause begins with a failure of the monthly cycle. The periods of delayed menstruation gradually become longer, the degree of blood loss decreases. In some women, bleeding during menstruation may alternate with pathological uterine bleeding - sometimes profuse and prolonged.

Menopause without hot flashes may be accompanied by some symptoms, which can be divided into several groups:

• psychoneurological signs: lethargy, sleep disturbances, apathy, the appearance of phobias, depression, loss of appetite, mood swings;
• cardiovascular symptoms: headaches, dizziness, increased sweating, fluid retention;
• endocrinological signs: weight fluctuations, joint pain.

Hot flashes may go unnoticed and manifest as nausea, temporary increased heart rate, and headache.

In rare cases, menopause with hot flashes but without sweat occurs. The absence of excessive sweating is not a pathology, just like the absence of hot flashes themselves - it is simply a feature of the autonomic nervous system.

Complications and consequences

The increasing deficiency of estrogens during menopause can gradually lead to the development of certain complications, which can be expressed in the form of:

• persistent increase in blood pressure;
• osteoporosis – weakening of bone tissue;
• atherosclerotic changes in blood vessels;
• heart disease, heart attack;
• vascular problems, stroke;
• other diseases of the cardiovascular system.

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Diagnostics of menopause without hot flashes

Diagnosis of this age period usually does not present any problems, since most often the typical clinical picture is observed at the age that is typical for the onset of menopause - after 40-45 years. However, the diagnostic process can be complicated if a woman has any diseases of the reproductive organs - especially chronic ones. It is for this reason that the diagnosis of menopause without hot flashes may require some diagnostic clarifications.

During the examination, the doctor pays attention to the general condition of the patient: the condition of the skin, hair, mood, constitutional features (often, as menopause approaches, women's skin condition worsens and excess weight appears).

Among the additional tests, the doctor may prescribe:

• blood tests for hormone levels – estradiol and FSH (a follicle-stimulating hormone level of more than 30 IU/L may indicate the onset of menopause);
• instrumental diagnostics – mammography (reveals changes in the mammary glands), ultrasound (allows to assess ovarian function and cyclic changes in the uterus).

To diagnose atrophic processes inside the genitals, an examination and pH testing are performed, supplemented by a microbiological examination of vaginal discharge.

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Differential diagnosis

Menopause without hot flashes is differentiated from the following painful conditions:

• early ovarian failure (before age 40);
• thyroid pathologies;
• autoimmune diseases;
• elevated levels of prolactin in the bloodstream;
• congenital adrenal hyperplasia;
• polycystic ovary syndrome;
• chronic alcoholism;
• hormone-dependent tumor processes;
• infections;
• neuroses, panic attacks.

To conduct differential diagnostics, consultations with an endocrinologist, neurologist, psychiatrist and other specialized specialists may be required.

Treatment of menopause without hot flashes

In menopause without hot flashes, treatment with such drugs as bromides is prescribed - for example, 0.05 mg of sodium bromide twice a day, with a possible increase in dosage to 0.2-0.4 mg/day. The intake is continued until the symptoms of irritability and nervousness are relieved.

Often, medications such as trioxazine, devincan, meprotan, and andaxin have a positive effect.

Hormone replacement therapy for menopause without hot flashes is prescribed taking into account the stage of this period, the patient's age and the presence of menstruation.

• At the initial stage of menopause - when the estrogen level is not yet critically low, but other symptoms are already present - small doses of estrogens can be used. Such drugs affect the processes in the central nervous system, normalizing the course of inhibitory reactions. In the first phase of the monthly cycle, folliculin is prescribed by intramuscular injection of 1000 IU once a day, or octestrol 1 tablet up to 2 times a day.

If the patient is found to have functional uterine bleeding, progesterone (5-10 IU intramuscularly for a week) and testosterone propionate (25 mg intramuscularly once every 3 days) or methyltestosterone up to 2 times a day sublingually for 10 days may be prescribed.

• In the second stage of menopause, with a sharp decrease in the amount of hormones and the onset of a stable menopausal period, with significant vegetative disorders, the following medications are used:
  • folliculin intramuscularly in the amount of 1000 IU daily, or 3000 IU once every 2 days, 10 injections per course;
  • estradiol dipropionate in the amount of 10,000 IU intramuscularly once every 4-7 days, 5 injections per course;
  • Sinestrol 1 tablet orally up to 2 times a day for 14-20 days.

The duration of estrogen use is short, but each course can be repeated after about 5 months.

• At the third stage of menopause, estrogen preparations are used to slow down the function of the pituitary gland and reduce the synthesis of gonadotropic hormones. Treatment is prescribed according to the following schemes:
  • testosterone propionate in the form of intramuscular injections of 25 mg every other day (a course of about 7 injections), or methyltestosterone sublingually at 0.005 up to 3 times a day (a course of up to one month);
  • methylandrostenediol 25 mg/day (10-day course);
  • folliculin 3000 IU intramuscularly once every three days (course of 7 injections) or sinestrol 1 tablet up to 2 times a day (course of treatment – up to 1 month).
  • This type of treatment must be carried out under mandatory and constant control of the amount of estrogens in the body. Hormonal therapy is not prescribed:
  • for various tumors in the reproductive system and mammary glands;
  • in case of repeated uterine bleeding.

Side effects of hormonal treatment for menopause may include:

• nausea, dyspepsia;
• swelling;
• headaches;
• soreness and increased sensitivity of the mammary glands;
• changes in libido.

Hormone replacement therapy should be combined with taking sedatives, relaxing physiotherapy procedures, proper nutrition, and maintaining sleep and rest regimens.

Folk remedies

• At the first signs of menopause, it is recommended to carry out juice therapy: drink 2-3 glasses of fresh beet, carrot or cucumber juice daily. Such juices prevent the formation of blood clots, strengthen blood vessels, eliminate swelling, and restore hormonal balance.
• It is useful to take peony tincture: 20 drops of the preparation 3 times a day before meals. Peony soothes, eliminates painful sensations, improves mood and normalizes sleep.
• Experts recommend eating 100 g of fresh red grapes with honey daily during menopause. This combination of products leads to cleansing of the body and weakening of negative menopausal symptoms.
• It will be very beneficial to consume 1 tablespoon of flaxseed or soybean oil every morning. Such oils contain natural phytoestrogens, which naturally slow down the onset of menopause. The oil can also be added to salads and ready-made non-hot dishes.

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Herbal treatment

• Aromatic tea with oregano:
  • pour 250 ml of boiling water over 2 tbsp of dry grass and leave for an hour and a half;
  • take 1 glass in the morning and evening, without sugar or other additives.
• Valerian drink:
  • brew 1 teaspoon of valerian root in 250 ml of boiling water, leave for half an hour;
  • take 1 glass in the morning and at night.
• Sage tea:
  • steam 50 g of dried herbs in 0.5 l of boiling water;
  • We drink it during the day instead of tea.
• Birch infusion:
  • steam 100 g of birch leaves and buds in 0.5 l of boiling water in a thermos overnight;
  • In the morning, filter the infusion and drink 100 ml every 2 hours.

In addition, herbs such as orthilia secunda and red brush are very helpful during menopause, with or without hot flashes. You can buy ready-made tinctures of the listed plants at the pharmacy. They are usually taken 25-30 drops before meals, three times a day.

Homeopathy

To ease the feeling of well-being during menopause, both without hot flashes and with hot flashes, you can successfully use homeopathic remedies. Such drugs have long been recognized as one of the most effective and safe.

• Remens - take 1 tablet or 10 drops three times a day. Treatment usually lasts for several months. The drug is well tolerated and has virtually no side effects: only occasionally may there be a temporary increase in salivation.
• Klimaktoplan – take 1 to 2 tablets three times a day, half an hour before or half an hour after meals. Allergic reactions to the drug may occur extremely rarely.
• Klimaxan - taken between meals, 1 tablet twice a day, under the tongue. In severe cases of menopause, it is recommended to increase the dosage to 3-4 doses per day. Rarely, allergic reactions to the drug may occur.
• Klimakt-Heel - take 1 tablet three times a day between meals, sublingually. The drug is well tolerated, only occasionally causing allergies in people with increased sensitivity to the components of the homeopathic remedy.
• Inoklim - take 1 capsule daily for 3 months, and in severe cases of menopause - 2 capsules daily. No side effects have been observed when taking the drug.

Surgical treatment

Usually, doctors do not perform surgical interventions to alleviate the condition during menopause without hot flashes. Surgery may be appropriate only in cases where hormonal imbalances have provoked the development of malignant neoplasms of the reproductive organs or mammary glands.

Complete removal of the ovaries and uterus does not exclude the appearance of menopausal symptoms.

Prevention

Unfortunately, it is impossible to slow down the onset of menopause. However, any woman can reduce the degree of unpleasant sensations if she thinks about some preventive measures in a timely manner.

For example, to soften and ease the symptoms of menopause (even if this period is not accompanied by hot flashes), you can follow these recommendations:

• regularly do simple gymnastics and yoga;
• prevent the development of obesity;
• avoid abortions, promote a comfortable and natural course of pregnancy;
• observe the work and rest schedule;
• do not neglect diseases, treat any pathology in a timely manner;
• give up bad habits;
• eat properly and nutritiously.

It is safe to say that maintaining a healthy lifestyle reduces the risk of developing negative symptoms during menopause.

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Forecast

Menopause without hot flashes is no different in its prognosis from the typical course of this physiological period. If you use replacement therapy in a timely manner, as well as follow the recommended preventive measures, you can significantly alleviate the condition, reduce the degree of discomfort, improve well-being, and reduce the likelihood of developing negative consequences of menopause.

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