Cystitis with menopause
Last reviewed: 23.04.2024
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According to medical statistics, a woman's menopause begins, on average, between the ages of 45-47. The hormonal background undergoes significant changes during this period, which can not affect the state of health and well-being. A woman feels hot flashes, heart palpitations periodically, sleep is often disturbed, irritability rises, a chronic form of cystitis develops. Cystitis in menopause is a frequent phenomenon, because the hormonal "revolution" makes the body very vulnerable to inflammation.
Causes of the cystitis in menopause
A significant factor in the pathogenesis of the disease is the inadequate production of the hormone estrogen. Due to the lack of estrogen, the mucosa of the bladder becomes thinner, and the protective functions decrease and the bacteria linger, provoking inflammation.
Cystitis's culprits often are E. Coli, Staphylococcus, Proteus - conditionally pathogenic microorganisms, which means that additional factors played a role in the development of the disease, whose presence gave rise to inflammation.
Chlamydia, ureaplasma, mycoplasma are the true companions of cystitis. According to statistics, chlamydia are found in 33-42% of cases. The bladder is also affected by chronic inflammation of the kidneys or other neighboring organs. Cystitis often goes away after the source of infection is eliminated.
Far from in every case, cystitis in menopause is associated with the development of a viral or bacterial viral infection and is diagnosed after the onset of physiological menopause or in connection with an operation to remove the ovaries. On the other hand, frequent episodes of manifestation of cystitis - a good reason to conduct a detailed examination.
Symptoms of the cystitis in menopause
The trigger for the development of inflammation usually gives an episode of hypothermia. Then the first signs of cystitis appear - urination drastically increases 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, body temperature almost never rises, and palpation reveals a small pain in the lower abdomen.
Cystitis is characterized by changes in the urine: it becomes opaque, the last portion is mixed with blood, if the inflammation has affected the neck of the bladder. Compression provokes a small amount of blood from the submucosal layer.
Urinalysis shows an increased content of leukocytes, red blood cells and epithelium, but in some cases, pathological changes are not detected.
Acute cystitis in menopause is accompanied by obvious symptoms about a week or slightly longer, after which they go to a decline. If signs of cystitis are present for a longer time, it indicates the transition of the disease to a chronic form. Then the survey will help to establish what exactly supports the inflammatory process.
Chronic cystitis in menopause can be manifested by unpleasant sensations in the lower abdomen, and by frequent urination even by incontinence. Of course, with a chronic form, there are periodic outbreaks of exacerbations, more often in the autumn and spring seasons.
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Diagnostics of the cystitis in menopause
For accurate recognition of cystitis, differential diagnosis, laboratory and instrumental studies are needed.
Differential diagnostics. The characteristic clinical picture of cystitis and the normalization of the woman's well-being after taking antibacterial drugs allow you to quickly diagnose acute form. If the body does not respond to such therapy, and the disease has spilled into a chronic form, it is necessary to identify the cause or differentiate cystitis from other possible diseases. If there is a violation of urination without pyuria, one should check the neighboring organs: such signs are characteristic for gynecological pathology.
Laboratory diagnostics includes several tests:
- General blood analysis. Almost always remains normal, sometimes signals the presence of a minor inflammatory process. The general analysis of urine is a key study that allows to reveal pathologies of the organs of the genitourinary system. Turbid urine in cystitis is due to the content of leukocytes, purulent components, bacteria, epithelium, erythrocytes. In the form of urine affects the presence of salt of uric acid, protein. A sharp unpleasant smell indicates a very neglected case.
- Urinalysis by Nechiporenko. The result of this study will detail the state of the genitourinary system. The study reveals the concentration of elements in one milliliter of urine from the middle portion. The average portion of urine is examined without fail, if there is a discrepancy with the normal parameters in the general analysis. Normally, the urine contains up to 1000 red blood cells, 2,000 leukocytes and 20 cylinders. If these numbers are repeatedly exceeded, acute cystitis is diagnosed.
Instrumental diagnostics. First of all, cystoscopy is performed to detect cystitis. Its essence is the visualization of organs with the help of a cystoscope. In acute form, instrumental manipulations are unacceptable: they can not only cause pain, but also injure organs, which intensifies the infectious process. This procedure is carried out exclusively with chronic cystitis, with the climax it is this form is more common.
In addition to these studies and analyzes, the causes and severity of cystitis in menopause help determine the analysis for infection, ultrasound, uroflowmetry, biopsy.
What do need to examine?
How to examine?
What tests are needed?
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Treatment of the cystitis in menopause
For the treatment of cystitis in menopause prescribed, in addition to antibacterial medicines, replacement life-long hormone therapy. Accepted drugs and their release forms can be adjusted over time.
The most widely used for menopause are medicines in tablets, you can also use special patches, ointments, vaginal suppositories, injections.
All these medicines are united by the fact that they contain exclusively natural female sex hormones and therefore they are used with a minimal risk of development of side effects, consequences and complications. Many of the medicines consist of gestagens - hormones that prevent the development of excessive overgrowth of the endometrium.
Preparations of Cyclo-proginova, Divina, Klimonorm, Klimen have a similar composition and mechanism of action - these are two-cholic estrogen-progestogen preparations. They contain a progesterone hormone derivative that prevents hyperplasia and endometrial cancer. Estradiol replenishes the lack of estrogens, which eliminates climacteric symptoms of the psycho-emotional and vegetative genus, slows the aging of the epidermis and thinning of the mucous membranes, including the urea-genital system.
Climonorm is especially recommended for women with excessive hair, a skin with enlarged pores and excessive work of sebaceous glands, a reduced voice timbre and other signs of excessive production of male hormones.
As part of the Gynodian Depot, on the contrary, male sex hormones are present. The drug is suitable for women who are too dry and prone to wrinkle skin. Gynodian Depot is applied as a monthly injection.
Trisequens is a new development of the pharmaceutical industry. The package is not 21, but 28 tablets: Triesequence is accepted not by traditional intermittent courses 21/7, but daily without interruptions.
Women who have had an opportunity to undergo an operation to remove the uterus are recommended drugs containing exclusively estrogens. These include Proginova, Premarin, Hormoplex, Estrofem.
To normalize the work of the genitourinary system with menopause a good result will be given by an estrogen preparation - Ovestin or Estriol. The use of female hormones, which are injected directly into the vagina, contribute to the growth of the vaginal epithelium, activation of blood circulation, restoration of the elasticity of the vaginal walls, increased glycogen production, normalization of microflora. Due to intensive blood supply of the bladder and urethra, the tone is normalized, urothelium grows, and the production of necessary mucus is established. In addition, estriol in the composition of Ovestina or Estriola helps the epithelium of the genitourinary system to withstand the development of infectious and inflammatory processes, contributes to the normalization of urination. Estriol, in contrast to other drugs with estrogens, acts for a short period of time. Therefore, there is no need for a full cyclic administration of progestogen and there are no consequences of sudden withdrawal, fraught with bleeding.
Suppositories Ovestin are applied to 1 suppository (0.5 mg) every day for 14-21 days during intensive care, and as maintenance treatment for menopause-1 suppository 2 times a week.
When can we do without an operation?
When therapeutic methods have not yielded results, surgical treatment is indicated. According to statistics, about 6% of patients with a diagnosis of chronic cystitis need surgical treatment.
- 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, thereby injuring the orifice of the canal and causing pain. Just such a structure provokes the development of infections that easily penetrate into the bladder, and inflammation in it. During surgery, the surgeon moves the channel hole, and then the problem is solved. This is a relatively simple surgical intervention, so recovery is rapid. After the operation, they prescribe a course of antibiotics and abstinence from sexual activity during the recovery period.
- Recurrent cystitis. What causes relapse of cystitis in menopause? This is due to many reasons, including, due to the lowering or loss of the uterus or because the muscle fibers around the neck of the bladder are replaced with a connective tissue. The neck section is removed by means of a special loop, heated by electric current. The operation goes bloodless: the loop not only cuts the tissue, but also coagulates the vessels at the same time.
- With necrotic forms of cystitis, when the necrosis of the bladder wall occurs, an epicystostomy is applied - a special tube for urinary diversion. Then treat the inflammation and remove the tube only when the body capacity is obtained by training to increase to 150 ml.
- Interstitial cystitis. Occurs because of scarring or on the walls of the bladder. They may not disturb, but sometimes they are the culprits of painful urination. Removal is performed under general anesthesia with a cystoscope.
- In the most extreme cases, when the prognosis of the development of the disease is unfavorable, and it is impossible to cope with other methods, the bladder is resected. The reservoir for urine is replaced by part of the thick or small intestine.
Homeopathy with menopause
In addition to hormonal therapy, menopause takes homeopathic remedies based on phytoestrogens.
Phytoestrogens have the most gentle effect on the female body, are absolutely safe for long-term use. Thus, the body of a woman for a long time receives small doses of plant estrogens and its adjustment occurs gradually and naturally. The most popular homeopathic medicines:
- Remens reduces manifestations of menopause (mood swings, dizziness, excessive sweating, nervousness, hot flashes). Remens slows the processes of withering and aging, prevents the recruitment of extra pounds, is perfectly tolerated by the female body, has no contraindications and its reception is not fraught with side reactions. Remens prescribed for 10 drops three times a day. Therapy for menopause should last at least 6 months.
- Ladys formula "Menopause" contains extracts of plants, minerals and vitamins of groups E and B. This means is suitable to prevent brittle bones and replenishes the lack of vitamins, stabilizes the emotional state.
- Qi-Klim. It is based on the extract of tsimicifuga. Effective with increased irritability, apathy, mood swings, insomnia, excessive sweating, hot flashes and disorders accompanying menopause. The drug is contraindicated in women who have found estrogen-dependent neoplasms.
- Estroel activates the protective functions of the body, prevents brittle bones, reduces tidal intensity.
- The creation is based on the extract of red clover, the drug replenishes the lack of sex hormones in menopause.
Alternatives and herbs for menopause
To support the body and help cope with cystitis in chronic form will help a profuse drink - it helps remove the "provokers" of inflammation from the bladder. It is also suitable for cranberry or cranberry juice, and unconcentrated compote, and mineral water, and herbal tea. Acidophilic sour-milk products contribute to the restoration of normal flora.
The menu should not contain too sharp or salty foods. It is better to dwell on dairy products and plant foods.
If the urine does not contain blood, you can warm up: you can take a bath, a hot water bottle on your stomach or you can get your feet stuck.
After the onset of menopause, it is useful to take a rowan tincture. It improves well-being, increases work capacity and energy. 200 gr. Fresh or 100 gr. Dry crushed rowan and insist 14 days on a liter of cognac or vodka. Then tincture filter and drink 1 teaspoon three times a day.
Hops cones contain herbal phytohormones, which relieve the symptoms of menopause caused by estrogen deficiency. 100 grams of cones are insisted on 500 ml of vodka for 7 days, then filter. Dosage intake - twice a day for 10 drops. Under this scheme, you can take a tincture for several weeks, and then take a break.
Do not underestimate the healing effect of herbs, from which you can prepare infusions and decoctions.
- Take equal parts of juniper fruit, yarrow and St. John's wort, cowberry leaves. 2 tablespoons of the mixture to brew 0.5 liters of boiling water in a thermos for the night. Drink 50-100 ml 4-5 times a day before meals. The course of treatment is two months. If the cystitis is chronic, after a course of treatment make a two-week break, and then continue treatment with the help of another collection.
- Take equal parts of cranberry leaves, calendula flowers, flax seeds, violet grass tricolor. 2 tablespoons of the collection to brew 0.5 liters of boiling water in a thermos for the night. Take the same course as the first collection.
- Another decoction is prepared from the shoots of a rosemary - 5 parts, St. John's wort - 5 parts, flax seeds - 1 part, leaves of mint - 3 parts, pine buds - 3 parts, horsetail - 4 parts. It is prepared and adopted according to the same scheme.
- A decoction of parsley seeds is an excellent diuretic for cystitis. A teaspoon of seeds is poured with a liter of liters of water at room temperature overnight, then drink 3 tablespoons of infusion every 3 hours.
Cystitis in menopause is an insidious disease that can cause a lot of trouble. Strictly enough measures of therapy are dictated here, because during the menopause the disease easily passes into a chronic form. It can be defeated faster by combining the treatment according to the established medicinal methods with treatment by alternative means.
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