Menopause syndrome (menopause): diagnosis

Climacteric syndrome (menopause) has the following symptoms:

• disorders of the menstrual cycle (delay in menstruation, poor menstruation or lack thereof, as well as menometrorrhagia);
• the presence of tides (especially in the evening and at night);
• mood changes (irritability, tearfulness, anxiety, anxiety, etc.);
• urination disorders (frequent urination, soreness with urination, urinary incontinence);
• change in the sexual sphere (decreased libido, soreness in sexual intercourse).

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.

The examination assesses the general condition of the patient (general appearance, facial expression, color and turgor of the skin), the development and distribution of subcutaneous fat, measures the growth and weight of the body (with a climacteric syndrome often show an abdominal type of obesity).

The decrease in the patient's growth and the curvature of the spine (kyphosis) indicate osteoporosis.

When examining the mammary glands, you need to pay attention to their shape, consistency, local compaction or retraction.

When gynecological examination it is important to exclude pathological changes in the genital organs and pay attention to the presence of atrophic processes of the vulva and vagina, the presence of cystorektotsele.

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

Indications for consultation of other specialists

• Endocrinologist: in the presence of symptoms similar to menopausal syndrome, in women younger than 40 years (another pathology of the endocrine system is possible).
• Neuropathologist or psychoneurologist: while maintaining symptoms of menopause (vegetative-vascular, psychoemotional or neurovegetative disorders) on the background of therapy.

Special methods of studying climacteric syndrome

• The content of follicle-stimulating hormone in the blood serum is increased (more than 30 IU / L), in the perimenopause may be 12-30 IU / l.
• Mammography: for diagnosis of breast diseases.
• Ultrasound of genitals using a vaginal sensor.
• Cytological examination of the smear from the surface of the cervix and cervical canal.
• Endometrial biopsy in patients with acyclic hemorrhage.
• To diagnose atrophic processes of the vulva and vagina, a pH test and a complex microbiological study of the vaginal discharge (microscopic examination of the smear and bacteriological culture) should be used.

Screening

It is necessary to examine women with risk factors for cardiovascular diseases and, especially, oncological diseases of the breast and genital organs.

Differential diagnosis of climacteric syndrome

Differential diagnosis is performed with the following diseases:

• premature shutdown of ovarian function (age younger than 40 years);
• thyroid gland diseases (increase or decrease in body weight, cold intolerance, fatigue, anxiety, constipation);
• autoimmune diseases;
• hyperprolactinemia;
• congenital hyperplasia of the adrenal cortex (elevated levels of 17-hydroxyprogesterone);
• polycystic ovary syndrome (menstrual irregularity from the age of menarche);
• alcoholism;
• pheochromocytoma;
• infectious disease (eg, malaria);
• psychopathies, accompanied by panic attacks.

[7], [8], [9], [10], [11],