Related articles: Menopause
Definition
Menopause is the permanent interruption of menstruation, due to a reduction / cessation of ovarian function for physiological or iatrogenic reasons.
The menopause period is characterized by hormonal changes and other physiological changes. As the ovaries age, their response to pituitary gonadotropins (follicle stimulating hormone FSH and luteinizing hormone LH) decreases, initially causing a shorter follicular phase (with shorter and irregular menstrual cycles) and less frequent ovulations; all this translates into reduced production of progesterone and estrogen.
The cessation of cyclic ovarian activity and of the fertile season normally occurs around the age of 45-55 years (if it occurs before the age of 40 it is called early menopause). The iatrogenic (artificial) menopause, on the other hand, can be the result of bilateral ovariectomy surgery (removal of both ovaries), hysterectomy (removal of the uterus), pharmacological ovarian suppression (chemotherapy) or pelvic irradiation.
Most common symptoms and signs *
- Alopecia
- Changes in the menstrual cycle
- Amenorrhea
- Redness of the face
- Asthenia
- Weight gain
- Chills
- Burning to the tongue
- Burning in the mouth
- Decline in sexual desire
- Swollen ankles
- Depression
- Difficulty concentrating
- dysphoria
- Ovulatory dysfunction
- Bladder dysfunction
- dysgeusia
- Dismennorea
- Mood disorders
- Dysuria
- Gum pain
- Ovarian pain
- Pain during sexual intercourse
- Pelvic pain
- Articolar pains
- Swollen legs
- Retired Gums
- Sensitive gums
- Breast swelling
- Goiter
- Insomnia
- Heat intolerance
- Hyperhidrosis
- infertility
- Hirsutism
- Headache
- Menometroraggia
- Menorrhagia
- Teeth mobility
- Nervousness
- nocturia
- oligomenorrhoea
- Urticaria
- Osteopenia
- Osteoporosis
- Dry skin
- Memory loss
- Vaginal discharge
- Swollen and tired feet
- polymenorrhea
- pollakiuria
- Uterine prolapse
- itch
- Vaginal itching
- Water retention
- Vaginal bleeding
- Mouth Metal Flavor
- Mood swings
- Eye dryness
- Vaginal dryness
- Drowsiness
- Sweating
- Cold sweating
- Night sweats
- Tachycardia
- Cracked Heels
- Bladder tenesmus
- Retrospective Uterus
- Hot flashes
Further indications
Menopause is initially characterized by irregular menstrual flows, with rarefaction of menstruation (oligomenorrhea) or increase in their frequency (polymenorrhea); there can also be an abundant loss of blood in conjunction with menstruation which tends to last longer (menometrorrhages). These signals evolve into amenorrhea, ie in the prolonged absence of menstruation; with their final cessation, women lose their reproductive capacity.
The symptoms of menopause can also include hot flushes (sudden sense of heat followed by intense sweating), aggravation of premenstrual syndrome, irritability, mood swings and insomnia. In addition, some women may experience problems with bladder control (incontinence or increased urination frequency), transient tachycardias, mild depression and decreased sexual desire. Other possible symptoms of menopause are: hair loss, breast tenderness, weight gain, vaginal dryness (atrophic vaginitis) and pain during sexual intercourse.
At the genital level, atrophy due to decreased estrogen can cause vulvar thinning, irritation, dyspareunia, dysuria and increase in vaginal pH. Furthermore, the estrogenic decline increases the risk of osteoporosis, periodontal disease and alterations of skin trophism (dry skin and signs of skin aging).
The diagnosis of physiological menopause is confirmed by the absence of menstruation (amenorrhea) for at least 12 consecutive months. Women with amenorrhea must be evaluated by the doctor to rule out any pregnancy and the presence of abnormal pelvic masses or ovarian tumors.
Therapy is considered when menopause causes intense symptoms. The goal of treatment is to ensure a good quality of life and to prevent or treat particular diseases associated above all with estrogen deficiency, such as osteoporosis. The therapeutic approaches envisaged for symptom relief include: hormone replacement therapy, oral contraceptives (to reduce the unpredictability of the onset of menstruation), antidepressant drugs (SSRIs or SNRIs), creams and lubricants to alleviate vaginal dryness.
The therapy for menopausal disorders must be personalized and must take into account the possible associated complications (risk-benefit ratio).
