Symptoms of menopause are triggered by the hypothalamus, the receptors of which require hormones..

However, not only the hypothalamus has such receptors..

Many tissues of the body have their own receptors that recognize estrogens, since these hormones stimulate them in some way..

Feeling a deficiency of estrogen, they, unlike the hypothalamus, do not “outrage” and do not make sharp tangible disturbances in a woman’s well-being: they begin to change themselves.

These changes are atrophic in nature - in other words, the body ceases to maintain in working condition those organs that, in its opinion, it will no longer need.. It is easy to guess that we are talking about the reproductive systems of the body. As a rule, they cause inconvenience and ailments.. If no action is taken, these violations can drag on for a long time and will make themselves felt in the distant future..

This physiological restructuring for each woman occurs in her own way and at her own time.. It all depends on how fast the estrogen level goes down.. If this process is slow and the ovaries and adipose tissues continue to produce some of it even after menopause, atrophic changes will occur at a slower pace..

If the influx of hormones is reduced in a short time, the process will go faster. And, of course, the option when the ovaries are surgically removed and estrogen production stops abruptly deserves special attention..

If the level of estrogen in the body decreases, the following changes occur:.

- the vagina contracts, its walls become thinner, dryer and more fragile, less firm and elastic;

- the flow of mucus to the cervix and into the vagina is significantly reduced;

- ovaries and uterus shrink to about a third of their original size;

- the lining of the uterus (endometrium) becomes thinner and eventually ceases to function;

- the tissues of the urethra become thinner and much more easily damaged;

- the bladder loses muscle tone and elasticity;

- the muscles that form the pelvic diaphragm and support the internal organs become weaker and sluggish;

- the breast loses its former thick fatty layer, and the mammary glands shrink;

bones begin to lose their mass, becoming more porous and brittle;

- the cardiovascular system no longer experiences the beneficial effects of estrogen, which protects against heart disease, the arteries narrow and become less elastic;

- the skin loses most of the subcutaneous fat layer and becomes drier, thinner and more lethargic.

Internal changes in the vagina.

Let's take a closer look at internal changes in the vagina. The vagina is a tube 10-12 cm long, going from bottom to top from the vestibule of the vagina to the uterus. The upper part of the vagina is connected to the cervix, forming four arches: anterior, posterior and two lateral.

The vaginal wall is 0.3-0.4 cm thick and has great elasticity.. The mucous membrane of the vagina does not contain glands, forms folds, the number of which decreases after childbirth. The surface of the vaginal mucosa is represented by numerous layers of squamous cells, which are called stratified squamous epithelium.. The layers of the epithelium change during the menstrual cycle under the influence of female sex hormones - estrogens and progesterone..

With the onset of menopause, due to a lack of estrogen, the walls of the vagina gradually lose their thick protective layer of keratinized cells.. Drastically reduced amount of mucus. We have already said that one of the symptoms of postmenopause is the drying of the mucous membranes.. The same thing happens with the vagina..

The walls become drier and therefore thinner, they lose elasticity and strength. The folds that allowed the vagina to stretch and contract are also smoothed out.. Now it is easily irritated and injured.. Pain and inflammation become quite frequent. Pain and bleeding can be caused by sexual intercourse. In addition, the vagina is no longer able to defend itself as well as before against various infections and microorganisms..

Such a development of events can be postponed if hormone replacement therapy is used, which will protect the vagina from atrophic changes.. However, taking hormones is a separate serious topic.. Any hormonal preparations should be taken only on the recommendation of a specialist doctor and under his close supervision.; they are selected taking into account the individual characteristics of women. Hormones are able to almost completely restore the previous state of the vagina in a short time..

Another cause for concern in the premenopausal and menopausal periods is the uterus.. The uterus is a hollow, pear-shaped organ made up of smooth muscle.. The weight of the uterus is 50 g, its length is 1-8 cm, the wall thickness is 1-2 cm.

The uterus is divided into three parts: neck, isthmus, body. The cervix makes up approximately one third of the entire length of the organ.. A spindle-shaped cervical canal passes through the entire neck, which contributes to the retention of a mucous plug in its lumen, which has high protective properties..

The mucous membrane of the cervical canal (endocervix) is covered with a layer of cells resembling high cylinders and therefore called columnar epithelium.. The main function of cylindrical cells is the production of mucus, which forms a protective mucus plug..

The wall of the uterus consists of three layers: the inner - the mucous membrane (endometrium), the middle - the muscular layer (myometrium) and the outer - serous (perimetry). The mucous membrane of the uterus (endometrium) is divided into two layers: basal, deeper, and functional, superficial.

During the menstrual cycle, under the influence of female sex hormones, cells of the functional layer grow, a large amount of nutrients are deposited in them, and a kind of pillow is formed for the acceptance of a fertilized egg. If fertilization does not occur, the functional layer of the endometrium is rejected, which is accompanied by menstrual bleeding.. At the end of menstruation, the formation of the functional layer begins again due to the cells of the basal layer..

During the menopause, various chronic diseases will be aggravated. And here the anxiety of women can be caused by pain in the lower abdomen or unexpected bleeding, and the reason for this is fibroids that have developed in the uterus.. This disease begins at a younger age. After the onset of menopause, fibroids often regress until they disappear completely.. Fibroma of the uterus can exist for many years, especially without disturbing a woman.

Fibromas Deterioration of well-being and the manifestation of so-called symptomatic uterine fibroids in premenopause is associated with hormonal regulation disorders, the cessation of the cyclic synthesis of progesterone by the corpus luteum, the development of unsystematic bleeding, which is more severe against the background of a fibromatous uterus, since such a uterus contracts poorly. In addition, those violations of the physiological synthesis of hormones and pathological changes in cellular metabolism, which are caused by the aging of the body, increase the growth of uterine fibroids..

Fibroids are faced by the vast majority of women.

Fibroids are benign tumors. They consist of the same muscular and fibrous connective tissues as the walls of the uterus.. In rare cases, one or two tumors are formed, more often several of them appear at once..

Fibroids are classified into three categories based on where they form: interstitial, submucosal, and subserosal.. The most common interstitial fibromas grow in the walls of the uterus. Submucosal fibroids form under the lining of the uterus, inside its cavity.

Subserous fibroids appear on the outer lining of the uterus. Fibroids can be small or huge, even reaching the size of a fetus in the later stages of pregnancy.. However, the appearance and development of fibroma is not accompanied by painful sensations..

By their nature, fibromas are not dangerous, although they can provoke bleeding, resembling strong discharge during menstruation.. Submucosal fibromas deform the uterine cavity and give unsystematic uterine bleeding.. A feature of this type of tumor is that it almost always turns out to be benign..

And if fibroids, despite the number and size, do not cause concern, there is no reason to do anything to get rid of them.. However, regular follow-up with a doctor - at least once a year - is necessary..

Pain and obvious problems can begin in cases where fibroids reach a significant size, begin to crowd nearby organs and interfere with their normal functioning..

The process of formation of myoma nodes or fibromatosis of the uterus is determined primarily by the violation of enzymatic, redox processes occurring in the cells of hormone-dependent organs, which include not only the uterus, but also the mammary glands, thyroid gland.

The main reasons for these violations are:.

— environmental factors,.

- stress,.

- bad habits,.

- malnutrition,.

- natural aging of the body.

Obese women are much more likely to develop these benign tumors than lean women who exercise regularly.. In addition, if a woman has had two or more full-term pregnancies, the risk of fibroids is reduced..

Fibroids sometimes grow to a considerable size, causing many problems.. As a rule, they grow fastest in the pre-menopausal period and decrease after the onset of menopause.. Accordingly, if a woman with the onset of menopause begins to take hormonal preparations containing estrogens, these preparations will stimulate the growth of fibroids.. Women with fibromatosis should consult their doctor before starting hormone replacement therapy (HRT)..

The most common of the main symptoms of fibroids are bleeding, as well as pressure and pain, strongly felt in any area of \u200b\u200bthe abdominal cavity.. Some fibroids cause very heavy menstrual or spontaneous bleeding between periods.. The source of these bleedings are not the fibromas themselves, but the walls of the uterus. Sometimes these benign tumors cause the endometrium to bleed so much that it can cause severe anemia..

Sometimes fibroids grow so large that they begin to crowd the bladder and intestines.. As a result, problems such as urinary incontinence or an increased need to urinate appear.. In addition, a fibroma can compress the urethra or one of the ureters that runs from the kidneys to the bladder, thereby contributing to the development of infectious diseases of the kidneys..

The most reliable way to treat fibromas is to remove them..

There are two ways to remove fibroids: myomectomy - removal of the fibroids themselves and hysterectomy - removal of the uterus along with fibroids. However, if a woman is already well over 40, it makes sense, if possible, not to take any measures before the onset of menopause, when, after a sharp reduction in estrogen production in the body, fibroids stop growing and even decrease in size..

There are specific indications for the appointment of the operation: the size of the fibroids is more than 12 weeks, rapid growth: 3-4 weeks per year, pain syndrome, dysfunction of nearby organs, suspicion of malignant degeneration of the tumor, bleeding leading to anemization of the woman.

The removal of the uterus is usually recommended - the surest way to get rid of these tumors once and for all.. However, there are other ways to treat fibroids.. This includes the use of hormonal drugs that cause a decrease in fibromas, and surgical operations, in which only tumors are removed, and the uterus remains intact..

Surgical treatment is used, such as conservative myomectomy. This is a surgical operation in which only the fibroids are removed, and the uterus remains in place.. Although most women opt for myomectomy to preserve the uterus, extensive abdominal surgery is required to remove fibromatous nodes.. Each node of the tumor is cut (excised) from the walls of the uterus.

And, despite such a complex operation, a woman is not at all immune from further education and development of fibroids.. And this is the main disadvantage of this procedure.. According to medical statistics, only a small percentage of women after myomectomy permanently get rid of fibroids, and many of them, in the end, still undergo a hysterectomy.. Usually, myomectomy is used in the treatment of nulliparous women in order to preserve the childbearing function, and in the menopause, this operation is not justified..

There are other ways to get rid of fibromas without removing the uterus, which do not require extensive abdominal surgery.. The first is the removal of tumors using a device called a laparoscope..

Laparoscope - a long thin tube equipped with a light source and a lens system is inserted through a small incision in the umbilical region, while instruments are inserted into another small incision. Secondly, it is a hysteroscopic (uterine) myoctomy. It is used only in relation to small submucosal fibroids on the inner wall of the uterus that have grown into the uterine cavity.. The hysteroscope is inserted through the vagina and the fibroids are also cut or cauterized with a laser.

And back to hysterectomy, which, as already mentioned, once and for all allows you to do away with fibroids. A hysterectomy is the surgical removal of the uterus (usually including the cervix) either through the abdomen or through the vagina..

If a woman has a fibroma, this does not mean at all that she will certainly have a surgical operation.. Most women do not show any symptoms, and they are not even aware of the existence of a fibroma until a doctor discovers it during an examination.. The risk of degeneration of benign fibromas into malignant ones is low, even for those that grow rapidly.. They should be treated only when they cause noticeable discomfort and problems: bleeding, pain, pressure..

Any post-menopausal bleeding that is not on schedule should definitely be investigated.. As soon as menopause finally comes into its own, menstruation stops.. They can only recur if the woman starts restorative hormonal therapy.. In this case, she will have very light regular periods - short-term, not abundant and devoid of clots..

If suddenly at any time, except for these few days, bleeding occurs, it should be taken very seriously.. It is necessary to find out what caused it. The physician should be aware of the timing and nature of this bleeding.. A gynecologist should also be consulted if the planned bleeding continues longer than it should be.; if it is not on schedule; if it is very strong or if it contains clots.

If a woman who does not take hormonal drugs detects bloody discharge, she should immediately go to see a gynecologist.

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