Surgical menopause in women: course, how long it lasts

Pathological changes in the female reproductive system caused artificially are surgical menopause. Let's consider its causes, treatment methods and prognosis.

Stopping menstruation caused by surgical manipulations, radiation exposure or chemotherapy is artificial menopause. The pathological condition is characterized by a sharp drop in the level of female sex hormones (estrogens) and the development of menopausal symptoms.

Premature cessation of menstruation is most often associated with hysterectomy, i.e. removal of the uterus, regardless of the state of the ovaries (complete or partial removal). After such an operation, 10-15% of women experience menopause within 1-2 months. In 35-40% after 1-3 years and in 50-65% after 4-7 years. The onset of menopause depends on the woman's age and the extent of the surgical intervention. Many gynecological and inflammatory diseases can also lead to early menopause.

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Epidemiology

Natural menopause occurs in women aged 45-55 years. The epidemiology of surgical menopause has no age dependence. Since this condition develops due to pathological processes in the body.

As a rule, premature cessation of hormone production is associated with oophorectomy and hysterectomy. The operation to remove the ovaries and uterus is performed in case of malignant lesions of these organs and many other gynecological diseases.

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Causes surgical menopause

Forced cessation of the organs responsible for hormone production is artificial menopause. The causes of surgical menopause are most often associated with the following factors:

• Oophorectomy (removal of the ovaries without removal of the uterus).
• Hysterectomy (removal of the uterus and preservation of one or both ovaries).
• Oophorectomy with hysterectomy (removal of the ovaries and uterus).
• Uterine bleeding of various etiologies.
• Endometriosis.
• Uterine fibroids.
• Fibroma.
• Polycystic disease.
• Advanced inflammatory processes.
• Oncological tumors.

Surgical menopause, unlike physiological menopause, is sudden. The body does not have time to adapt to changes in hormonal levels. That is, there is no premenopause during which the body rebuilds itself. The main cause of the disorder is surgical intervention, after which the woman will experience disorders of varying severity in many organs and systems.

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Risk factors

According to medical statistics, the number of gynecological surgeries associated with various diseases is steadily increasing. At the same time, the age of those operated on is decreasing, most of whom are of reproductive age. Risk factors for surgical menopause are associated with the following diseases:

• Fibrosis or uterine myoma (for large tumors).
• Hormonal disorders caused by improper use of hormonal drugs.
• Ischemia of myomatous node.
• Inflammation of the appendages and uterus.
• Endometriosis.
• Ovarian cysts.
• Complications after ectopic pregnancy.

Surgical intervention is also indicated for polycystic disease, malignant lesions, tuberculosis, advanced inflammatory processes in the genitals. The operation is aimed at removing the ovaries and/or uterus. After the procedure, menstruation stops and menopause symptoms increase.

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Pathogenesis

Natural menopause is characterized by a gradual decrease in estrogen levels. This allows the body to adapt to functioning without sex hormones. The pathogenesis of artificial menopause is associated with a sharp drop in estrogen to zero values within 1-2 days. Because of this, the body does not have time to rebuild. Within a week after surgery, 70-90% of women begin to experience a deficiency of sex hormones - postovariectomy syndrome.

The mechanism of development of premature menopause after the cessation of estrogen production: the endometrium does not develop and there is no ovulation, eggs are not produced, there are no menstruations. This leads to the fact that pathological tissues do not receive nourishment for growth, therefore they atrophy and die.

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Symptoms surgical menopause

The time of appearance of artificial menopause symptoms is individual for each woman. They can develop in a few days-months, or even years after the operation. But in most cases, metabolic and endocrine disorders develop and progress faster than with age-related menopause. 60% of women experience severe menopause, 25% have moderate menopause, and 15% have mild postovariectomy syndrome. At the same time, 20% of patients experience persistent disability and incapacity.

The main symptoms of surgical menopause:

• Rapid aging of the skin

Since estrogens are responsible for the production of elastin, collagen and other structural components of the skin, a decrease in hormone production triggers the process of skin aging. The elasticity and firmness of the skin decreases, dryness and pigment spots appear. Wrinkles appear quickly, dryness and brittleness of hair and nails are observed.

• Cardiovascular system

Estrogens have a cardioprotective effect. They affect the level of glucose and cholesterol in the blood, prevent the formation of blood clots and atherosclerotic plaques. When their production decreases, this protective mechanism stops functioning. Because of this, the incidence of cardiovascular diseases increases. For example, heart attacks and strokes occur 4 times more often in women without sex glands.

• Urological disorders

Estrogen deficiency has a pathological effect on the urinary tract. The mucous membrane of the urethra and bladder gradually becomes thinner, the ligaments and muscles of the perineum weaken. In 45% of women, this causes urinary incontinence and frequent urinary tract infections. Frequent urge to urinate, urine leakage and pain are also observed.

• Osteoporosis

Premature menopause provokes rapid changes in the structure of bone tissue (within 1 year). Bone density decreases, their fragility increases and, as a result, the risk of fractures increases. In order to prevent this symptom-complication, hormone replacement therapy, calcium and vitamin D intake, as well as regular physical activity are necessary.

• Vaginal dryness and itching

One of the main symptoms of female sex hormone deficiency. The moisture content of the vaginal mucosa depends on the amount of estrogens. Their decrease leads to thinning of the mucous membranes, itching, burning, and painful sensations during sexual intercourse.

• Psychovegetative disorders

Hot flashes and night sweats, increased heart rate – these symptoms develop in 70% of women and only in every fifth woman they decrease a year after the operation. In addition, frequent headaches and dizziness, paresthesia, general weakness and increased fatigue, decreased work capacity appear.

• Psycho-emotional disorders

Irritability, emotional lability, sleep disturbances and loss of appetite, tearfulness appear. Partial or complete loss of libido is also possible. Such symptoms lead to a depressive state, a feeling of fear and anxiety, and lack of self-confidence.

• Decrease in cognitive abilities

Female sex hormones are responsible for many metabolic processes in the body, including the brain. They are necessary for normal functioning of memory and cognitive functions. During menopause, memory deterioration and decreased learning ability are observed.

First signs

In the postoperative period, the first signs of surgical menopause usually develop gradually. In some women, symptoms appear after a couple of days, while in others, only after a couple of months.

The first signs of artificial menopause:

• Increased sweating, especially in the evening and at night.
• Paresthesia and tingling of the skin caused by surges in estrogen and progesterone.
• Feeling of heat and hot flashes up to 10-15 times a day (about 90% of women experience this symptom).
• Frequent headaches, migraines and dizziness.
• Deterioration of general condition, frequent mood swings, anxiety.

The above symptoms occur in all patients. Over time, they become permanent. The second stage of surgical menstrual cessation is characterized by the following signs:

• The frequency and number of hot flashes increases to 20 or more per day.
• Increased body temperature.
• Sleep disorders.
• Constant weakness and malaise.
• Frequent fluctuations in blood pressure.
• Rapid weight gain or loss.
• Burning, dryness and itching of the vagina.
• Rapid aging and withering of the skin.

According to statistics, about 50% of operated women under 35 have severe symptoms of menopause. 20% of patients under 30 suffer from persistent severe complications that lead to disability.

Stages

The natural climacteric period has three main stages: premenopause, menopause and the postmenopausal period. The stages of surgical menopause do not have a preparatory stage, during which the body adapts to a gradual decrease in sex hormones. Instead, there is a sharp stop in the production of estrogens. This entails a number of pathological symptoms that disrupt the normal functioning of many organs and systems.

Postovariectomy stages:

1. The first is that estrogens are not produced, there is no menstruation. Many different symptoms appear from many organs and systems. The duration of this period depends on the chosen hormone replacement therapy, the patient's age and the individual characteristics of her body.
2. The second (postmenopause) - its duration depends on the body's ability to adapt to changes in the endocrine system. The main danger of this stage is that it can significantly worsen health. There may be exacerbations of chronic diseases, various pathologies of the cardiovascular system, thyroid gland, etc.

Depending on the stage of the pathological process, the woman is prescribed therapeutic and preventive measures aimed at improving her overall well-being.

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Forms

There are several types of surgical menopause, which depend on what kind of surgery was performed. Let's look at the main types of surgical menopause:

• Oophorectomy without hysterectomy

Removal of the ovaries without the uterus. A rare but radical method in which the ovaries are completely excised. Most often performed on women of reproductive age with tubo-ovarian formations, oncological tumors in the ovaries, mammary glands or uterus. The consequences of the operation are irreversible, restoration of ovarian functionality is impossible.

• Hysterectomy with oophorectomy

Removal of the uterus with ovaries. Quite a common type of surgical menstruation cessation. It is performed in case of oncological alertness, cystic changes in the ovaries.

• Hysterectomy

This operation completely removes the uterus while preserving one/both or part of the ovaries after their resection.

In addition to the above types, there is radiological menopause. It occurs due to the effect of X-rays on the ovaries (carried out for malignant tumors). The pathological condition can occur during radiation therapy prescribed for pathologies of the blood or pelvic organs. With the right approach to treatment, the functionality of the ovaries can be partially restored.

Another type of artificial menopause is drug-induced menopause. It is one of the most gentle and occurs due to the use of certain drugs. After the therapy, the production of estrogens and the functioning of the ovaries are completely restored.

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Complications and consequences

Removal of internal genital organs entails certain consequences and complications. In the first days after the operation, there is increased sweating, frequent hot flashes, tachycardia. Over time, these symptoms worsen. There is nervousness, dryness and itching of the vagina, various skin problems, weight changes, urinary incontinence and much more.

Consequences and complications of stopping hormone synthesis:

• Metabolic disorders, decreased hemoglobin levels, exacerbation and development of autoimmune diseases.
• Anemia due to a decrease in the level of red blood cells in the blood
• Development of diabetes.
• Various diseases of the urogenital system (cystitis, colpitis, etc.).
• Cardiac ischemia, increased cholesterol levels, thrombosis, arterial hypertension.
• From the musculoskeletal system, osteoporosis is often observed and bone fragility increases. Bone tissue destruction after ovary removal reaches 4% per year.
• Various psycho-emotional disorders: depression, increased tearfulness, frequent mood swings, irritability.

In addition to the above-described pathologies, women complain of increased sensitivity of the abdomen, bloody scarlet discharge, changes in the biochemical composition of the blood. Low levels or absence of hormones increases the risk of developing many diseases, which very often become chronic.

The possibility of complications depends on the body's ability to adapt to hormone replacement therapy. At the same time, the consequences of induced menopause in women aged 20-30 are much more difficult to bear than in older patients.

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Diagnostics surgical menopause

Menopause is not a disease, but requires medical supervision. Diagnosis of surgical menopause consists of:

• Collection of anamnesis and analysis of the patient's complaints (reasons for artificial cessation of menstruation, presence of pregnancies, abortions, chronic diseases).
• Gynecological examination, taking smears, bacterial culture from the vagina. Examination of the mammary glands.
• Laboratory tests (blood test for hormones, biochemistry, test for syphilis and HIV).
• Instrumental diagnostics (ultrasound of the pelvic organs and mammary glands, measurement of bone density, electrocardiography).

Diagnostics are necessary to determine the stage and condition of the body after a complete cessation of hormone synthesis. Examinations are carried out when differentiating various pathologies, to identify diseases and complications associated with hormonal imbalance, and before prescribing hormone replacement therapy.

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Tests

To determine the stage of menopause and its course, laboratory diagnostics are indicated. The tests consist of a biochemical blood test (glucose, cholesterol, calcium, phosphorus), determination of hormone levels, detection of syphilis, HIV.

To determine hormone levels, blood is tested for FSH. Menopause is characterized by reduced estrogen levels and increased FSH concentrations. In surgical menopause, many patients have blood estradiol levels of less than 80 pmol/l, estrone concentrations are higher than estradiol, and testosterone levels are reduced.

An additional cholesterol test may also be performed. If the cholesterol level is high, the risk factors for cardiovascular diseases are corrected. Additionally, a Pap smear is performed (detects precancerous or cancerous cells in the vagina and cervix), and thyroid function and a coagulogram (blood clotting) are assessed.

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Instrumental diagnostics

To monitor a woman's condition during surgical menopause, instrumental diagnostics are indicated. This method consists of:

• Ultrasound examination of the genitals using an intravaginal probe.
• Mammography to detect breast diseases.
• Cytology – a smear from the cervical canal and the surface of the cervix.
• Transvaginal ultrasound and endometrial biopsy.
• Osteodensitometry (measurement of bone density).

Special attention is paid to osteoporosis screening. For this purpose, an ultrasound of the heel bone is performed. If the tissue density is low, the patient is sent for dual-energy X-ray absorptiometry (DXA). If significant deviations are detected, a complex of drugs and minerals that restore tissue density is prescribed. Instrumental studies are indicated every 2 years to assess the condition of the body.

Differential diagnosis

Complete cessation of hormone synthesis caused by surgical intervention requires careful monitoring of the body's condition. Differential diagnostics of surgical menopause is carried out with the following pathologies:

• Myocardial dystrophy (occurs due to lack of estrogen and coronary heart disease).
• Thyroid diseases, which are accompanied by various endocrine and immune disorders (changes in body weight, constipation, increased anxiety, increased libido, chronic fatigue).
• Autoimmune disorders and infectious diseases.
• Hyperprolactinemia (increased concentration of prolactin in the blood).
• Adrenal cortex hyperplasia.
• Pheochromocytomas (hormonally active neoplasms).
• Psychopathy with panic attacks.

A consultation with an endocrinologist, neurologist and psychoneurologist is mandatory.

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Treatment surgical menopause

After surgery to remove the uterus and/or ovaries, a woman experiences painful symptoms of body restructuring. Postovariectomy syndrome significantly impairs quality of life. Treatment of surgical menopause depends entirely on the nature of the surgical intervention and the reason for which it was performed. All medications and drug complexes are selected by the attending physician.

Hormonal and non-hormonal drugs may be prescribed for treatment. Hormonal replacement therapy is used to prevent and reduce dysfunction of organs and systems associated with a deficiency of sex hormones. This method has a number of absolute contraindications:

• Estrogen-dependent malignant tumors.
• Pathological bleeding from the genital tract of unknown etiology.
• Kidney and liver diseases, dysfunction of these organs.
• Acute thromboembolic diseases of the veins.
• Autoimmune diseases.

In addition to the above-described prohibitions, hormone therapy can cause a number of negative reactions. The risk of heart attack, stroke, Alzheimer's disease, thromboembolism increases. There is a possibility of gallstones and breast cancer.

Combination therapy is most often used for surgical menopause. This treatment involves the use of hormonal and non-hormonal drugs, vitamin complexes and even homeopathy.

Medicines

There are drugs that vary in effectiveness, composition and form of release used to treat hormone synthesis deficiency. The drugs are selected by a doctor, individually for each patient. The woman's age, causes of menopause, and presence of chronic diseases are taken into account. Most often, oral tablets, vaginal creams and suppositories are prescribed; subcutaneous implants can also be used.

If menopause is associated with the removal of the uterus, then estrogen-containing drugs are prescribed that restore and maintain normal well-being.

1. Divigel

An estrogenic agent used for replacement therapy. It contains endogenous estradiol, which is similar in structure and action to human estradiol. Compensates for estrogen deficiency in women after ovariectomy/hysterectomy. Prevents osteoporosis and other pathological consequences of menopause.

• Indications for use: elimination of symptoms associated with estrogen deficiency. Artificial and natural menopause. Prevention of osteoporosis and deficiency of female sex hormones of any etiology.
• Method of application: the preparation is used transdermally during long-term continuous or cyclic therapy. The gel is applied to the lower part of the anterior abdominal wall or buttocks. It is prohibited to apply to the chest, face, genitals or damaged skin. The frequency of application of the product and the duration of therapy are determined by the attending physician, individually for each patient.
• Side effects: swelling, change in body weight, headaches and migraines, increased blood pressure, emotional lability, decreased libido, pain in the mammary gland and its malignant lesions, various allergic reactions, nausea, vomiting, decreased liver function.
• Contraindications: hypersensitivity to the components of the drug, hormone-dependent neoplasms in the anamnesis, vaginal bleeding of unknown etiology, acute thromboembolism of arteries, liver diseases. With special caution it is prescribed for women with endometriosis, cerebral circulation disorders, cardiovascular pathologies and endometrial hyperplasia.
• Overdose: painful sensations in the mammary glands, flatulence, increased irritability may occur. To eliminate painful symptoms, it is necessary to reduce the dosage or stop using the drug.

2. Estrofem

A medicinal product based on 17-beta-estradiol, i.e. natural estrogen produced by the ovaries. Stimulates normal functioning of female reproductive organs. Increases bone density, prevents osteoporosis and bone fractures.

• Indications and method of administration: estrogen deficiency during menopause, after various gynecological surgeries. The tablets are taken orally. The recommended dosage is 1 tablet once a day, after three months the dosage is revised.
• Side effects: headaches, increased sensitivity of the mammary glands, swelling. Gastrointestinal disorders, attacks of nausea and vomiting, weight gain.
• Contraindications and overdose: malignant lesions of the mammary glands, vaginal bleeding of unknown etiology, deep vein thrombophlebitis, liver dysfunction and porphyria. Use with extreme caution in endometriosis, diabetes, epilepsy, otosclerosis. In case of overdose, symptoms of digestive disorders occur.

3. Proginova

Hormonal estrogen-containing agent. Contains a synthetic analogue of endogenous human estradiol – estradiol valeriate. It is an excellent preventative measure against postmenopausal osteoporosis and restores hormone levels after removal of the ovaries.

• Indications for use: hormone replacement therapy after removal of the ovaries and during menopause. Before taking the drug, it is necessary to undergo a gynecological examination and other diagnostic procedures. The package is designed for 21 days of treatment, 1 capsule per day.
• Side effects: metabolic disorders and gastrointestinal pathologies, tachycardia, blood pressure disorders, headaches, decreased visual acuity, uterine and vaginal bleeding, various allergic reactions, changes in libido.
• Contraindications: individual intolerance to the components of the drug, lactase deficiency, glucose-galactose malabsorption syndrome, hormone-dependent malignant neoplasms.
• Overdose: development of uterine bleeding, vomiting, attacks of nausea. There is no specific antidote, therefore symptomatic therapy is indicated.

4. Ovestin

A pharmaceutical product that contains the natural female hormone estriol. It helps restore the epithelium of the vaginal mucosa and the pH of the natural microflora, and increases local immunity.

• Indications for use: premature menopause, age-related atrophic changes in the vaginal mucosa, urogenital pathologies, prevention of complications after operations with transvaginal access, infertility caused by cervical factor.
• Directions for use: the drug is available in the form of tablets, cream and vaginal suppositories. Regardless of the form of release, it should be taken once a day. The course of treatment depends on the doctor's indications and the characteristics of the woman's body.
• Side effects and contraindications: local irritation, itching and burning in the vagina, headaches and increased blood pressure. The drug is prohibited for use in case of hypersensitivity to its components, oncological diseases, liver damage, vaginal bleeding of unspecified etiology.
• Overdose: nausea, vomiting, vaginal bleeding. There is no specific antidote, symptomatic therapy is indicated.

5. Klimen

A combined estrogen-containing drug based on the antiandrogen, estradiol valerate and cyproterone acetate.

• Indications for use: replacement therapy of disorders in the climacteric period, psychovegetative disorders, prevention of osteoporosis, estrogen deficiency, atrophic processes on the skin and increased dryness of the mucous membranes of the genitals. The tablets are taken regardless of the cycle phase, 1 capsule per day for 21 days, followed by a seven-day break.
• Side effects: painful sensations in the mammary glands and epigastric region, changes in body weight, headaches, frequent mood swings, changes in libido.
• Contraindications: hypersensitivity to the components of the product, liver dysfunction, liver tumors, any malignant neoplasms, inflammatory diseases, otosclerosis, diabetes mellitus, thromboembolic processes, lipid metabolism disorders.

6. Divina

A medicine for the treatment and prevention of menopause of various origins, as well as menstrual cycle disorders. It is used to prevent osteoporosis, during the postmenopausal period and for various climacteric disorders. The drug is taken before bedtime, one capsule per day. The duration of therapy is determined by the attending physician.

Side effects include headaches, discomfort in the mammary glands, and tension in the lower extremities. The main contraindication is hypersensitivity to the active ingredients, deep vein thrombophlebitis, vascular obstruction, acute and chronic liver disease, and estrogen-dependent tumors. It is not prescribed for patients with heart failure, hypertension, and endometriosis.

7. Trisequence

A combined drug based on estrogens. It is used in hormone replacement therapy. It normalizes estrogen deficiency during menopause, prevents osteoporosis. The drug is taken 1 capsule per day, the treatment regimen and duration of therapy are determined by the attending physician.

The drug may cause side effects: irregular bleeding, soreness of the mammary glands. Headaches, various skin allergic reactions, visual impairment, thrombosis, alopecia, increased blood pressure are also possible. The main contraindication is hormone-dependent tumors, liver dysfunction, uterine bleeding, porphyria, thromboembolism.

If surgical menopause is associated with endometrial cancer, hormonal drugs are not prescribed. Herbal and homeopathic remedies are used for treatment. In case of severe disorders of the genitourinary system, gels, creams and vaginal suppositories are used. All the above-described drugs are used only with a doctor's permission. Self-therapy can aggravate painful symptoms and worsen the patient's condition.

Medicines are taken according to a specially developed scheme. This may be a short-term treatment aimed at preventing climacteric syndrome (urogenital disorders, psychoemotional disorders, hot flashes, headaches). The duration of such therapy is from 3 to 6 months with the possibility of repeated courses. Another treatment option involves long-term use of drugs, for 5-7 years or more. The goal of such therapy is to prevent late menopause disorders (osteoporosis, Alzheimer's disease, cardiovascular pathologies).

Non-hormonal drugs for surgical menopause

Despite the effectiveness of hormone replacement therapy, it has a number of restrictions on use and side effects. Non-hormonal drugs for surgical menopause have a moderate effect, but have a minimum of contraindications. Such drugs are prescribed by a doctor, who selects the dosage and makes up a treatment plan.

Non-hormonal means herbal and homeopathic remedies. Let's look at the most effective of them:

1. Klimaktoplan

A homeopathic remedy with active components that have a receptor-modulating effect on estrogens. Normalizes the vegetative functions of the central nervous system, stabilizes the state of the cardiovascular and endocrine systems.

The drug contains a plant extract of black cohosh, which affects the hypothalamus, reducing nervous excitement, hot flashes during menopausal disorders. Normalizes the hormonal balance in the adrenal cortex, pituitary gland and genitals. Another component of the drug - ignatia, stops excessive sweating, improves overall well-being, eliminates headaches, reddening of the skin and hot flashes.

• Indications for use: menopause with increased sweating, hot flashes, rapid heartbeat, nervous excitement, headaches, insomnia and other climacteric disorders.
• The medicine is available in tablet form. It is necessary to take 1-2 tablets per day 30 minutes before meals or an hour after meals. The duration of therapy is determined by the attending physician, but if the patient's condition does not improve after 2 months, then the drug should be discontinued.
• The main contraindication is intolerance to the active components. Side effects and overdose symptoms are extremely rare and manifest as allergic reactions. Side symptoms do not require discontinuation of treatment and disappear on their own.

2. Climadion

A plant product with a special extract BNO 1055 – black cohosh. It has complex estrogen-like activity. Organoselective and highly specific phytoestrogens have a pronounced estrogen-like and dopaminergic effect.

• Indications for use: surgical and natural menopause, psychoemotional and vegetative-vascular disorders, excessive sweating, hot flashes, sleep disorders, irritability and excessive sweating, depression.
• The drug is available in the form of drops and tablets. Drops are dripped into a glass of water or onto a piece of sugar, tablets are taken orally. The treatment regimen and its duration are determined by the attending physician. The course of treatment depends on the severity of climacteric symptoms.
• Side effects: abdominal pain, discomfort and soreness in the mammary glands, weight gain, bloody discharge.
• Contraindications: individual intolerance to active components, allergic reactions, estrogen-dependent diseases.

3. Remens

A homeopathic medicine, the action of which is aimed at normalizing the hypothalamus-pituitary-ovarian system. Restores hormonal balance, reduces the severity of climacteric syndrome.

Indications for use: pathological menopause, dysmenorrhea, PMS, adnexitis, endometritis, amenorrhea, algomenorrhea. The drug is taken according to a special scheme: 1-2 days 1 tablet/10 drops 5-8 times a day, from the 3rd day of therapy 1 tablet/10 drops 3 times a day. The duration of treatment depends on the severity of the pathological condition. Side effects are manifested in the form of allergic reactions. Remens is contraindicated in case of intolerance to one of its components.

4. Klimakt-hel

A plant preparation, the action of which is aimed at eliminating pathological symptoms of complete cessation of hormone synthesis. Contains several active components: sepia, cedron, metallic tin, ignatia, canadensis and others. Reduces painful sensations, has a sedative and anti-inflammatory effect.

• Indications: complex therapy of vegetative disorders during menopause (hot flashes, headaches, increased nervous excitability). The drug is taken 1 tablet 3 times a day before meals or one hour after meals. Duration of therapy is 1-2 months, if necessary, therapy is extended.
• Side effects: skin allergic reactions, increased liver activity. Contraindications: hypersensitivity to components, glucose-galactose malabsorption, lactose intolerance.

5. Sigetin

A drug similar to sinestrol in structure and to estrogen in activity. It is used for various climacteric disorders in women and as a preventive measure for intrauterine fetal asphyxia. It is available in ampoules and tablets. During menopause, 50-100 mg is used twice a day or 1-2 ml of a 1% solution once a day. The duration of therapy is 30-40 days. In case of hypersensitivity to the components, the drug is contraindicated.

6. Estrovel

Dietary supplement based on plant extracts, vitamins and amino acids of natural origin. Used for non-hormonal support of the female body during menopause. Used during menopause and its complications, post-castration and premenstrual syndrome and as a preventative measure against aging.

The dietary supplement reduces the frequency of hot flashes, reduces attacks of headaches and dizziness, improves mood, reduces nervousness and irritability. Not used in case of phenylketonuria and intolerance to active substances. Tablets are taken 1 pc. 1-2 times a day, if necessary, the dosage can be increased to 3-4 tablets per day. The course of treatment should not exceed 2 months.

The above-described medications prevent neuropsychic and vegetative-vascular manifestations of menopause, pathologies of the bone, cardiovascular and urogenital systems. To eliminate hot flashes, irritability and headaches, antidepressants (Paroxetine, Fluoxetine), drugs to reduce blood pressure and hot flashes (Clonidine), as well as various anticonvulsants (Gabapentin) can be prescribed.

Another option for non-hormonal therapy of surgical menopause is folk treatment. Alternative medicine involves the use of various decoctions and infusions to improve well-being and speed up recovery after surgery. The most commonly used for treatment are: hawthorn, valerian, hop cones, sage, lemon balm.

Do not forget about taking vitamin and mineral complexes, which help to balance hormonal levels and improve overall well-being. During postovariectomy, you can use Vitatress, vitamins and minerals Alphabet, Menopace, Ladies (menopause formula) and other complexes.

Prevention

The main reason for artificial menopause is the operation to remove female genital organs. Prevention is aimed at preventing diseases and symptoms that require surgical intervention.

Basic preventive recommendations:

• Timely and systematic treatment of any diseases, especially chronic ones.
• Physical activity and regular exercise.
• Healthy eating, consumption of foods rich in phytoestrogens (soy, red clover, flax seeds).
• Maintaining water balance – 2 liters of clean water per day.
• Complete rest, minimum stress and worries.
• Regular preventive examinations by a gynecologist (2 times a year).

All prevention methods are based on a healthy lifestyle. Surgical menopause is much easier to prevent than to cure, since this pathology leaves a significant negative imprint on further life.

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Forecast

Surgical menopause leads to irreversible consequences. The prognosis in most cases is negative. It is impossible to restore the functionality of the ovaries, as well as to restore normal hormonal balance. The prognosis is affected by the patient's age. If the pathological condition occurs in women whose age is closer to natural menopause, the consequences will be minimal. Young patients may have severe complications, loss of ability to work and even disability.

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