Climacteric syndrome (menopause)

Climacteric syndrome (climax) is a symptom complex that develops in some women during the period of extinction of the functions of the reproductive system against the background of the general age involution of the organism.

ICD-10 code

• N95.1 Menopause and menopause in women.

Epidemiology

Climacteric syndrome occurs on average at the age of 45-55 years and can bother a woman under 60 years, and sometimes longer. The incidence and prevalence of the disease reach 89.7%, individual symptoms of it - from 20 to 92%. In the climacteric, premenopause, perimenopause and postmenopause are distinguished. Menopause is the last independent menstruation in a woman's life. Perimenopause refers to the period from the onset of the first climacteric symptoms to one year after the last independent menstruation, i.e. It includes premenopause, menopause and one year after menopause.

Risk factors for cardiovascular disease:

• smoking;
• arterial hypertension;
• hypercholesterolemia;
• obesity;
• sedentary lifestyle.

Risk factors for genital and breast cancers:

• presence of genital and breast cancer in immediate relatives;
• presence in the anamnesis of precancerous diseases of genitals and mammary gland;
• frequent sexually transmitted infections and the presence of human papillomavirus;
• early menarche (up to 12 years);
• late menopause (over 50 years);
• absence of birth;
• the presence of a history of frequent abortions, especially before the first birth.

[1], [2], [3], [4], [5], [6],

Classification of menopause

Climacteric disorders are divided as follows.

• Vasomotor: hot flushes, chills, sweating, headache, hypo- or hypertension, palpitations.
• Emotional-vegetative: irritability, drowsiness, weakness, anxiety, depression, memory and attention impairment, decreased libido.
• Urogenital: dryness, itching and burning in the vagina, dyspareunia, pollakiuria, cystalgia, urinary incontinence.
• Skin and its appendages: dryness, brittle nails, wrinkles, dryness and hair loss.
• Exchange disorders: cardiovascular disease, postmenopausal osteoporosis, Alzheimer's disease.

Distinguish forms of menopausal syndrome in terms of severity:

• light - the number of tides to 10 within 24 hours, with a satisfactory overall condition and working capacity of the woman;
• average - the number of tides 10-20 during the day, observe severe symptoms of the disease (dizziness, headache, worsening of sleep, memory, etc., deterioration of general condition and decreased efficiency);
• heavy - the number of tides more than 20 per day, indicate a significant decline in efficiency.

[7], [8], [9],

Diagnosis of menopause

To assess the severity of the climacteric syndrome, the Kupperman index is used in the modification of E.V. Uvarova. Selected symptom complexes are analyzed separately. The significance of the symptom complex (a), estimated from 0 to 10 points, is considered as the absence of clinical manifestations, 10-20 points - as an easy form, 21-30 points - as an average, over 30 points - as a severe form of the syndrome. The significance of symptom-complex (b) and (c), estimated 1-7 points, is considered as an easy form, 8-14 points - as an average, over 14 points - as a severe form of climacteric syndrome.

Climacteric syndrome (menopause) - Diagnosis

[10], [11], [12], [13], [14], [15], [16]

Treatment of menopause

Hormone replacement therapy (HRT) is an estrogen (ET) or estrogen-progestational therapy for women in the menopausal period. The clinical symptoms of menopausal syndrome are caused by estrogen deficiency, so the use of estrogen replacement therapy is justified. Progestins - drugs that act like natural progesterone, they are used as hormone replacement therapy to prevent hyperestrogenic conditions (endometrial hyperplasia, genital and breast cancer) against estrogen monotherapy in women with a uterus. Hormone replacement therapy is an effective way to prevent and treat osteoporosis, urogenital atrophy and primary prevention of cardiovascular diseases.

Climacteric syndrome (menopause) - Treatment

Prevention of climacteric syndrome

A healthy lifestyle (avoiding smoking and excessive consumption of alcohol) contributes to a later onset of menopause and a decrease in the intensity of symptoms of menopausal syndrome. In addition, the use of hormone replacement therapy (HRT) in the perimenopausal period, with the development of the first symptoms of the disease, reduces the frequency of menopause moderate and severe.

Forecast

Favorable.

[17], [18], [19], [20], [21], [22], [23],