Menopausal cystitis

According to medical statistics, menopause in women begins, on average, at the age of 45-47 years. Hormonal levels during this period undergo significant changes, which cannot affect health and well-being. A woman experiences hot flashes, her heartbeat periodically quickens, sleep is often disturbed, irritability increases, and chronic cystitis develops. Cystitis during menopause is a common occurrence, because the hormonal "revolution" makes the body very vulnerable to inflammation.

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Causes menopausal cystitis

A significant factor in the pathogenesis of the disease is insufficient production of the hormone estrogen. Due to the lack of estrogen, the mucous membrane of the bladder becomes thinner, and the protective functions are reduced and bacteria are retained, causing inflammation.

The culprits of cystitis are often E. coli, staphylococcus, proteus - opportunistic microorganisms, which means that additional factors played a role in the development of the disease, the presence of which gave impetus to inflammation.

Chlamydia, ureaplasma, mycoplasma are faithful companions of cystitis. According to statistics, chlamydia is found in 33-42% of cases. The urinary bladder is also affected due to chronic inflammation of the kidneys or other adjacent organs. Cystitis often goes away on its own after the source of infection is eliminated.

Not in every case is cystitis during menopause associated with the development of a viral or bacterial viral infection and is diagnosed based on the onset of physiological menopause or in connection with an operation to remove the ovaries. On the other hand, frequent episodes of cystitis are a good reason to conduct a detailed examination.

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Symptoms menopausal cystitis

The development of inflammation is usually triggered by an episode of hypothermia. Then the first signs of cystitis appear - urination sharply increases in frequency and becomes painful. Sometimes the sick visit the toilet dozens of times during the day, and the volume of urine does not exceed 20 ml. With cystitis, the body temperature almost never rises, and palpation reveals a slight pain in the lower abdomen.

Cystitis is characterized by changes in urine: it becomes opaque, blood is mixed into the last portion if the inflammation has affected the neck of the bladder. Compression provokes a small amount of blood to be released from the submucosal layer.

Urine analysis shows an increased content of leukocytes, erythrocytes and epithelium, but in some cases pathological changes are not detected.

Acute cystitis during menopause is accompanied by obvious symptoms for about a week or a little longer, after which they subside. If the signs of cystitis are present for a longer period of time, this indicates that the disease has become chronic. Then an examination will help to establish what exactly is supporting the inflammatory process.

Chronic cystitis during menopause can manifest itself as unpleasant sensations in the lower abdomen, as well as frequent urination and even cases of urinary incontinence. Of course, with the chronic form, there are periodic outbreaks of exacerbations, more often in the autumn and spring seasons.

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Diagnostics menopausal cystitis

For accurate recognition of cystitis, differential diagnostics, laboratory and instrumental studies are necessary.

Differential diagnostics. The characteristic clinical picture of cystitis and the normalization of the woman's well-being after taking antibacterial drugs allow for a quick diagnosis of the acute form. If the body has not responded to such therapy, and the disease has become chronic, it is imperative to identify the cause or differentiate cystitis from other possible diseases. If there are urination disorders without pyuria, the adjacent organs should be checked: such signs are characteristic of gynecological pathology.

Laboratory diagnostics includes several tests:

1. General blood test. Almost always remains normal, sometimes signals the presence of a minor inflammatory process. General urine analysis is a key study that allows identifying pathologies of the genitourinary system. Cloudy urine in cystitis is due to the content of leukocytes, purulent components, bacteria, epithelium, erythrocytes. The appearance of urine is affected by the presence of uric acid salt, protein. A sharp unpleasant odor indicates a very advanced case.
2. Urine analysis according to Nechiporenko. The result of this study will indicate the state of the genitourinary system in more detail. The study reveals the concentration of elements in one milliliter of urine from the middle portion. The middle portion of urine is examined without fail if there is a discrepancy with the normal indicators in the general analysis. Normally, urine contains up to 1000 red blood cells, 2000 leukocytes and 20 cylinders. If these numbers are exceeded many times, acute cystitis is diagnosed.

Instrumental diagnostics. First of all, cystoscopy is performed to detect cystitis. Its essence is visualization of organs using a cystoscope. In the acute form, instrumental manipulations are unacceptable: they can not only cause pain, but also injure organs, which intensifies the infectious process. This procedure is performed exclusively for chronic cystitis; this form is more common during menopause.

In addition to these studies and tests, the causes and severity of cystitis during menopause can be determined by testing for infections, ultrasound, uroflowmetry, and biopsy.

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Treatment menopausal cystitis

To treat cystitis during menopause, in addition to antibacterial medications, lifelong hormone replacement therapy is prescribed. The medications taken and their forms of release can be adjusted over time.

The most widely used medications for menopause are tablets, but you can also use special patches, ointments, vaginal suppositories, and injections.

All these medications have in common that they contain only natural female sex hormones and therefore they are used with a minimal risk of side effects, consequences and complications. Many of the medications consist of gestagens - hormones that prevent the development of excessive growth of the endometrium.

The preparations Cyclo-proginova, Divina, Klimonorm, Klimen have a similar composition and mechanism of action - these are two-phase estrogen-progestogen preparations. They contain a derivative of the hormone progesterone, which prevents hyperplasia and endometrial cancer. Estradiol replenishes the lack of estrogens, due to which climacteric symptoms of psycho-emotional and vegetative nature are eliminated, aging of the epidermis and thinning of the mucous membranes, including the genitourinary system, are slowed down.

Klimonorm is especially recommended for women with excessive hair growth, skin with enlarged pores and excessive sebaceous gland activity, a lowered voice and other signs of excessive production of male hormones.

Gynodiane-Depot, on the contrary, contains male sex hormones. The drug is suitable for women whose skin is too dry and prone to wrinkles. Gynodiane-Depot is used as a monthly injection.

Trisequence is a new development of the pharmaceutical industry. The package contains not 21, but 28 tablets: Trisequence is taken not in traditional intermittent courses 21/7, but daily without breaks.

Women who have had to undergo hysterectomy are recommended to take drugs containing only estrogens. These include Proginova, Premarin, Hormoplex, Estrofem.

To normalize the genitourinary system during menopause, estrogen preparations - Ovestin or Estriol - will give a good result. The use of female hormones, which are introduced directly into the vagina, promote the growth of vaginal epithelium, activation of blood circulation, restoration of elasticity of the vaginal walls, growth of glycogen production, normalization of microflora. Due to the intensive blood supply to the bladder and urethra, the tone is normalized, the urothelium grows, and the production of the necessary mucus is established. In addition, estriol in Ovestin or Estriol helps the epithelium of the genitourinary system resist the development of infectious and inflammatory processes, promotes the normalization of urination. Estriol, unlike other drugs with estrogens, acts for a short period of time. Therefore, there is no need for a full-cycle administration of progestogen and there are no consequences of sudden cancellation, fraught with bleeding.

Ovestin suppositories are used 1 suppository (0.5 mg) every day for 14-21 days during the period of intensive therapy, and as a maintenance treatment during menopause - 1 suppository 2 times a week.

When is surgery unavoidable?

When therapeutic methods have failed to produce results, surgical treatment is indicated. According to statistics, approximately 6% of patients diagnosed with chronic cystitis require surgical treatment.

1. Features of the anatomical structure, when the urethra is too close to the entrance to the vagina. Then during sexual intercourse, the canal can be drawn into the vagina, as a result of which the opening of the canal is injured and pain occurs. Also, such a structure provokes the development of infections that easily penetrate the bladder, and inflammation in it. During the operation, the surgeon shifts the canal opening, and then the problem is solved. This is a relatively simple surgical intervention, so recovery is quick. After the operation, a course of antibiotics and abstinence from sexual activity are prescribed during the recovery period.
2. Recurrent cystitis. What causes recurrent cystitis during menopause? This occurs due to many reasons, including prolapse or prolapse of the uterus or because the muscle fibers in the bladder neck area are replaced by connective tissue. The neck area is removed using a special loop heated with an electric current. The operation is bloodless: the loop not only cuts the tissue, but also coagulates the vessels at the same time.
3. In necrotic forms of cystitis, when the bladder wall dies, an epicystostomy is applied - a special tube for urine drainage. Then the inflammation is treated and the tube is removed only when the organ capacity is increased to 150 ml through training.
4. Interstitial cystitis. Occurs due to scars or on the walls of the bladder. They may not bother you in any way, but sometimes they are the culprits of painful sensations when urinating. Removal is performed under general anesthesia using a cystoscope.
5. In the most extreme cases, when the prognosis for the development of the disease is unfavorable, and it is impossible to cope with other methods, a resection of the bladder is performed. The urine reservoir is replaced with a part of the large or small intestine.

Homeopathy for menopause

In addition to hormonal therapy, homeopathic remedies based on phytoestrogens are taken during menopause.

Phytoestrogens have the most gentle effect on the female body, and are absolutely safe for long-term use. Thus, the woman's body receives small doses of plant estrogens over a long period of time and its adjustment occurs gradually and naturally. The most popular homeopathic preparations:

1. Remens reduces the symptoms of menopause (mood swings, dizziness, excessive sweating, nervousness, hot flashes). Remens slows down the processes of fading and aging, prevents the accumulation of extra pounds, is well tolerated by the female body, has no contraindications and its use is not fraught with side effects. Remens is prescribed 10 drops three times a day. Therapy for menopause should last at least 6 months.
2. Ladies formula "Menopause" contains plant extract, minerals and vitamins of groups E and B. This product is suitable for preventing bone fragility and replenishing vitamin deficiency, stabilizing the emotional state.
3. Qi-Klim. It is based on the extract of black cohosh. It is effective against increased irritability, apathy, mood swings, insomnia, excessive sweating, hot flashes and disorders accompanying menopause. The drug is contraindicated for women who have estrogen-dependent tumors.
4. Estrovel activates the body's protective functions, prevents bone fragility, and reduces the intensity of hot flashes.
5. Feminal is based on red clover extract; the drug replenishes the deficiency of sex hormones during menopause.

Folk remedies and herbs for menopause

Drinking plenty of fluids will help support the body and help cope with chronic cystitis – it helps remove inflammation “provocateurs” from the bladder. Lingonberry or cranberry juice, non-concentrated compote, mineral water, and herbal tea are all good here. Acidophilic fermented milk products help restore normal flora.

The menu should not include too spicy or salty dishes. It is better to stick to dairy products and plant foods.

If the urine does not contain blood, you can warm up: taking a bath, putting a heating pad on your stomach, or steaming your feet will do.

After menopause, it is useful to take rowan tincture. It improves well-being, increases work capacity and energy. 200 g of fresh or 100 g of dry crushed rowan and insist for 14 days on a liter of cognac or vodka. Then strain the tincture and drink 1 teaspoon three times a day.

Hop cones contain plant phytohormones that relieve the symptoms of menopause caused by estrogen deficiency. 100 grams of cones are infused in 500 ml of vodka for 7 days, then filtered. The dosage is 10 drops twice a day. According to this scheme, you can take the tincture for several weeks, and then take a break.

The healing properties of herbs, from which infusions and decoctions can be prepared, cannot be underestimated.

1. Take equal parts of juniper berries, yarrow and St. John's wort, lingonberry leaves. Brew 2 tablespoons of the mixture in 0.5 liters of boiling water in a thermos overnight. Drink 50-100 ml 4-5 times a day before meals. The course of treatment is two months. If cystitis is chronic, take a two-week break after the course of treatment, and then continue treatment with another collection.
2. Take equal parts of lingonberry leaves, calendula flowers, flax seeds, and wild pansy. Brew 2 tablespoons of the mixture in 0.5 liters of boiling water in a thermos overnight. Take the same course as the first mixture.
3. Another decoction is prepared from wild rosemary shoots - 5 parts, St. John's wort - 5 parts, flax seeds - 1 part, mint leaves - 3 parts, pine buds - 3 parts, horsetail grass - 4 parts. It is prepared and taken according to the same scheme.
4. A decoction of parsley seeds is an excellent diuretic for cystitis. A teaspoon of seeds is poured with a liter of water at room temperature overnight, then drink 3 tablespoons of the infusion every 3 hours.

Cystitis during menopause is an insidious disease that can cause a lot of trouble. Rather strict therapeutic measures are dictated here, because during menopause the disease easily becomes chronic. It can be defeated faster if you combine treatment using proven drug methods with treatment using folk remedies.

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