La menopause It is defined as the permanent cessation of menstruation derived from the lack of egg production and the decrease in female hormones; such as estrogen and progesterone that regulate the menstrual cycle and are produced by the ovaries, this occurs when the woman reaches a mature age between 40 and 59 years, a period that will depend on each person, experiencing some menopause symptoms such as changes in the cycle, hot flashes, headaches, even emotional symptoms may appear including sadness, anxiety and changes in mood.
As the Dr. Monserrat Manubens, specialists in menopause, this estrogenic deficit affects various apparatus and systems of the female organism, being the genitourinary apparatus, the locomotive and the cardiovascular system the most affected.
At the gynecological clinic Women's CD of Barcelona we recommend that when a woman begins to feel the menopause symptoms or others gynecological symptoms You should go to your gynecology specialist to plan how to face this stage and determine the most appropriate treatment.
Short-term symptoms of menopause. The climacteric syndrome
The variety of main symptoms are neurovegetative or climacteric syndrome they manifest during the first 3-5 years of the postmenopausal period. They affect 75-80% of women, although not with the same intensity in all of them. In a third of those affected, the severity of the symptoms significantly alters their quality of life.
How to detect the first symptoms of menopause? These symptoms vary depending on each woman, some experience symptoms to a greater extent and intensity than others, according to specialists this implies a change in the reproductive life of every woman, which occurs with some physical and psychological symptoms, all people express symptoms differently; there are those who develop severe symptoms and others very mild, the decrease in the levels of female hormones causes a series of symptoms associated with menopause:
This is one of the first symptoms that occurs when a woman is close to menopause, altering her regular cycle, producing periods with less frequency with a lower or more abundant flow than usual.
It is the most common symptom that occurs with a sensation of heat that rises from the chest, neck and face causing sweating and redness of the skin, accompanied by a series of characteristics such as stomach upset, headaches. Night hot flashes wake you up during the night suddenly.
They are also called suffocations o vasomotor crisis and some women refer to them as waves of heat that run through the body from the chest, rising towards the head, causing flushing of the décolleté, neck and face; It is usually accompanied by sweating that can be more or less profuse and sometimes with palpitations and a feeling of anguish.
The production mechanism is not fully clarified. It is supposed to be related to estrogenic impregnation previous and its subsequent descent. Women who have never menstruated are known not to have hot flashes.
Our paresthesia are a sensation of tingling and numbness of the extremities, usually associated with “Restless legs syndrome”More frequent in the late climacteric (women older than 60 years). This syndrome forces the woman to get up at night and walk so that the discomfort disappears.
Our headaches and dizziness are frequent, an organic cause must be ruled out: visual disturbances, cervical osteoarthritis, arterial hypertension. However the premenstrual migraines that some women suffer especially intense in the perimenopause, usually disappear with the menopause.
Incontinence increases with the years and the loss of premiere plays an important role since the tissues of the urinary tract change, causing involuntary loss of urine in any activity that puts pressure on the bladder causing small amounts of urine to come out.
La decreased estrogen affects vaginal lubrication causing vaginal dryness which causes pain during intercourse. Treatment of this symptom of the menopause with the vaginal laser.
Other symptoms that can accompany the usual menopause are: sweating, palpitations, insomnia, vertigo, headache.
Psychic symptoms of menopause
Sudden mood swings may occur, such as anxiety or sadness. When they do occur, they are usually established in perimenopause. The woman reports very marked changes of character in the days that precede menstruation and that despite being aware that she has no reason for it and wants to stop it, it is not possible for her to achieve it. The emotionality is very labile, going from easy crying to irritability for the slightest reason.
The ability to concentrate decreases, but memory is not lost as some women believe. In this period, the insomnia,
Once the menopause is established, the woman may report a state of mind with a tendency to "depression". If you begin to perceive these types of changes, go to your trusted doctor.
Other psychological symptoms are irritability, nervousness, emotional lability, decreased libido, tiredness, and difficulty concentrating.
Insomnia
During menopause, you can experience insomnia, manifesting itself in a number of ways, including difficulty falling asleep or waking up suddenly during the night, which can cause daytime fatigue due to lack of nighttime sleep.
Medium-term symptoms
In the medium term, drop in estrogen levels, produce a decreased trophism of organs that depend on these hormones, especially affecting the vagina and also some structures of the urinary system, producing atrophy of skin and mucous membranes and decrease in collagen, which is the most important compound in connective tissues, which in turn will cause alterations in the statics of these organs since it determines the degree of resistance and turgor of the tissues. We differentiate 3 types of collagen, 1 is the most abundant, it is in the skin, bone, ligaments, tendons and arteries.
The collagen content varies throughout life, increasing until approximately 25-30 years of age and then decreasing little by little until menopause begins when its decrease is somewhat faster.
Typical alterations are as follows
Vaginal symptoms are a sensation of dryness, itching, dyspareunia and occasional coitorrhagia.
The most frequent sexual dysfunctions are decreased desire accompanied by avoidance of sex.
The vagina is covered by a polylatratified squamous epithelium dependent on the estrogenic stimulus so that when destrogen levels decrease, decreases the proliferation process and as a consequence of it decreases the number of layers of the vaginal epithelium, which will be very thin, and with the nerve endings closer to the surface, giving rise to a increased sensitivity.
Estrogens also regulate the blood circulation of the vagina, and this blood supply decreases in parallel with the decrease in estrogens.
They are symptoms of atrophic vaginitis, dryness, the burning sensation and the disappearance or decrease of the flow that can also modify the color being dark reddish, sometimes, in the presence of very marked atrophies, frankly bloody.
The diagnosis of vaginal atrophy is clinical, but the vaginal cytology indicates the maturation index and confirms the diagnosis, based on the existence of superficial, intermediate or basal (deep) cells in the smear.
Some structures of the urinary system are also dependent on estrogens. Hormone receptors, both estrogen and progesterone, have been found in muscles of the pelvic floor, urogenital ligaments, bladder, trigone, and urethra, but these receptors are not equally distributed in all structures.
Urinary symptoms are nocturia, urinary urgency, dysuria, and recurrent infections.
Studies in young women have shown a clear influence of estrogen concentration on urethral pressure profiles at different times of the cycle; therefore, it is logical to think that the deficit of these hormones will be the cause of a certain urinary pathology in women. postmenopausal. For this reason, we talk about genitourinary syndrome of menopause, but NOT all urinary problems that occur at this stage of life will be secondary to hypostronism.
Long-term symptoms
The long-term symptoms are rather two pathologies related to the postmenopause in which prevention is very important: the disease cardiovascular and osteoporosis.
La Cardiovascular disease (CVD), is the main cause of mortality in postmenopausal women in industrialized countries. When this disease appears the woman goes to the specialist generally in worse conditions than the man, the evolution is more serious with higher mortality. Studies have shown that estrogens can be one of the main protective factors for CVD, which is why their reduction causes this disease.
La osteoporosis it is the most common metabolic disorder of the bones. Clinically, osteoporosis is characterized by an increased risk of fractures with habitual movements and / or minimal trauma.
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