Lali Pkhaladze, M.D., Ph.D., Reproductologist, Gynecologist, Clinical Director of Archil Khomasuridze Institute of Reproductology.
Climacteric period in woman’s life is a transition stage from reproductive to advanced age. The average life expectancy of a modern woman is about 80 years. It means that climacteric period occupies the one-third of her life. Current physiological hormonal changes in the female body during transition stage have a negative impact on physical and mental health, emotions, quality of life. For women it’s very important to maintain the good health at this particular time of their life.
Gradual degradation of ovarian function during the transition period causes decrease in sex hormones. At first the amount of progesterone is lowered, then the level of estrogens drops. This leads to the development of undesirable changes in all system of female body. The early signs of transition period can manifested with mood changes, irritation, nervousness, tendency to get angry, anxiety, loss interest in life, fatigue, depression, insomnia, inattention, memory loss. Generally women do not connect these symptoms with an age-related hormonal imbalance, since they’ve already appeared before the irregular menstrual period starts.
The last menstruation (menopause) – is a key event in climacteric period with average age of 51 ± 2 years. The typical vasomotor symptoms, that are manifested initially, comprise: hot flashes, sweating, heart beating, high blood pressure. According to the studies women, who experience intensive hot flashes, have a high risk to develop Alzheimer’s disease.
At the next stage of climacteric period pathological changes in genitourinary system appear: urinary incontinence, urinary frequency, nocturia, vaginal dryness, itching, painful intercourse, etc.
Estrogen deficiency in menopause leads to joint pain, dry eye syndrome, skin wrinkles. Cardiovascular diseases, metabolic disorders and osteoporosis develop later.
Treatment of menopausal syndrome is necessary, although women’s attitude towards this issue is different. Some believes that menopause is a normal physiological event and complaints will disappear by themselves. Others watch advertisements and take medication without supervision of doctor. Unfortunately, only a small part of women are concerned about their health and visit clinic.
The gold standard in treatment of climacteric syndrome is natural estrogen replacement therapy. Attitudes towards menopausal hormone therapy are also controversial. Women have fear for oncological diseases and weight gain, however it does not correspond to reality. Menopausal hormone therapy should be prescribed by a qualified reproductologist or gynecologist, who will correctly evaluate the risks and benefits of the treatment.
For the treatment of climacteric symptoms over-the-counter drugs can be used. Phytoestrogens are substances, which occur naturally in plants: soy, rice, hops, red clover black cohosh. They have similar structure to the natural female hormone-estrogen, are able to bind estrogen receptors, thereby cause a decrease in hot flashes, sweating, headaches and other symptoms of menopause. It is known that Chinese and Japanese women, whose diet is rich in soy and rice, have mild menopausal symptoms.
The essential recommendation for women is to keep healthy lifestyle during the transition period. Smoking, alcohol, unhealthy diet, excess weight, obesity or underweight worsen menopausal symptoms. Regular physical activity- sport, dancing, swimming, walking, getting enough sleep, healthy environment and positive emotions significantly improve the course of the climacteric period and the quality of life.
The menopause is mainly associated with the beginning of old age. However women over 50 years have important place in society. Women will easily overcome pathological climacteric symptoms, if they are informed in advance.
The management of menopausal syndrome, the education of medical doctors and provide information to women about climacteric issue always was and still remains one of the priorities for our clinic and for the Georgian Association of Reproductive Health, whose founder and President is Professor Archil Khomasuridze.
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