Менопауза: основные признаки, симптомы и методы лечения

Менопауза: что такое, когда наступает, сколько длится?

Многие считают климакс и менопаузу одинаковыми, но действительно ли они одинаковы? В обыденной речи понятие менопаузы зачастую охватывает весь диапазон изменений, происходящих в организме женщины — от появления первых симптомов до полного прекращения репродуктивной функции. Однако с научной точки зрения такое понимание не совсем корректно. В медицине менопаузой называется период, когда после последней естественной менструации, вызванной нормальным функционированием яичников, проходит 12 месяцев. Поэтому правильнее было бы использовать термин «климакс», чтобы охарактеризовать все внутренние изменения, вызванные угасанием репродуктивных функций, так как это определение более обширно.

Климактерический этап делится на три фазы: пременопауза, менопауза и постменопауза. Каждая из этих стадий обладает своими особенностями и временными рамками. Несмотря на индивидуальность протекания климакса, большинство женщин наблюдают свои изменения в указанные временные промежутки.

Пременопауза

Как правило, пременопауза начинается примерно в 45 лет. В этот период у женщин появляются первые признаки изменений, связанных с климаксом, хоть и не выраженные ярко. Симптомы обусловлены гормональной перестройкой, при которой наблюдается снижение уровня эстрогена и прогестерона – двух основных женских половых гормонов. Постепенно в яичниках истощается запас фолликулов, из-за чего овуляция становится все менее регулярной. Главный сигнал о начале изменений в репродуктивной системе – это нерегулярность менструации. Обычно увеличиваются временные промежутки между менструальными циклами, и задержка месячных может вызвать заблуждение, поэтому вопросы о контрацепции остаются актуальными. Продолжительность этого этапа может варьироваться от 2 до 6 лет, однако в редких случаях срок может увеличиться до 10 лет.

Менопауза

После завершения первого этапа климактерия начинается менопауза. Это период наиболее выраженных симптомов и значительных изменений в репродуктивной системе и организме в целом. Уровень эстрогенов, вырабатываемых яичниками, продолжает стремительно снижаться, что приводит к проявлению симптомов со стороны нервной, сердечно-сосудистой, мочеполовой и эндокринной систем. Вероятность зачатия в менопаузе снижается, но полностью исключать ее нельзя, так как редкие овуляции могут сохраняться. Как только после последней естественной менструации пройдет 12 месяцев, диагностируется наступление менопаузы, что происходит примерно в 50-53 года.

Постменопауза

Постменопауза – самый продолжительный этап климактерия, который следует за менопаузой и сопутствует женщине до конца ее жизни. На этом этапе симптомы климакса, как правило, постепенно утихают, хотя некоторые из них могут сохраняться на протяжении 3-4 лет. Период постменопаузы характеризуется полной отменой менструации, атрофией половой системы, окончанием синтеза эстрогенов в яичниках и невозможностью естественного зачатия. Следует отметить, что климактерические изменения могут начать проявляться уже в 40 лет, что называется преждевременным климаксом. Если симптомы отсутствуют до 55 лет, это является признаком позднего климакса. Оба этих случая требуют дополнительного медобследования для выяснения причин возникновения.

Есть ли климакс у мужчин? Узнайте ответ на этот вопрос, перейдя по ссылке.

Что влияет на время наступления этого этапа и характер его течения?

Существуют различные факторы, влияющие на сроки наступления, характер и продолжительность менопаузного периода. К ним можно отнести:

• наследственность: часто у женщин наблюдается аналогичная климактерическая картина среди близких родственниц;
• перенесенные гинекологические операции. Хирургические вмешательства, аборты и осложненные роды могут нарушить течение менопаузы, как ускорив, так и отсрочив ее;
• успешные беременности и роды, а также длительное грудное вскармливание, наоборот, способствуют плавному прохождению менопаузального периода, так как деторождение является ключевой функцией женского организма и залогом его здоровья;
• хронический стресс и эмоциональная нестабильность могут усугубить изменения, происходящие в менопаузе;
• воздействие химиотерапии и радиации при лечении онкологии влечет за собой угнетение работы яичников и ранний климакс;
• социально-экономические условия, в которых живет женщина, также имеют значительное влияние;
• вредные привычки способствуют неблагоприятному течению климакса.

Основные и дополнительные симптомы менопаузы

Существует несколько ключевых признаков начала менопаузных изменений.

1. Нерегулярность менструального цикла – главный сигнал о начале климактерических изменений. Обычно увеличивается временной интервал между менструациями, а сами выделения становятся менее обильными. Однако в некоторых случаях можно наблюдать и обратную динамику.
2. Приливы – другой характерный симптом. Это резкие приступы жара, охватывающие верхнюю часть тела и сопровождающиеся общим недомоганием, одышкой, повышением давления и покраснением кожи. Этот симптом знаком 85% женщин, вступивших в климактерий. Подробнее о том, как избавиться от приливов в период климакса, читайте в нашей статье.
3. Психоэмоциональная нестабильность – зачастую встречающийся признак. Часто в климактерический период женщины становятся более эмоциональными и неуравновешенными, могут испытывать необъяснимое волнение и апатию, теряя способность сосредоточиваться на работе, забывая о важных делах. Нередки и нарушения сна, что приводит к хронической усталости. Все это происходит из-за гормонального дисбаланса. В некоторых случаях у женщин может развиваться серьезная депрессия, требующая профессиональной помощи психолога.

Также имеются дополнительные симптомы менопаузы. Их наличие может указывать не только на изменения, связанные с окончанием репродуктивной функции, но и на возможные патологические состояния, которые развиваются отдельно. К таким симптомам относятся:

• сердечно-сосудистые проблемы: брадикардия, стенокардия, аритмия в период менопаузы, одышка, гипотензия или гипертензия, боль в груди;
• изменения в мочевыделительной системе. Недостаток эстрогенов снижает тонус мочевого пузыря, что может привести к частым позывам и недержанию;
• изменения в половой системе. Гормональные изменения негативно влияют на состояние слизистых оболочек, в том числе во влагалище, что может вызывать зуд, жжение или дискомфорт во время полового акта;
• изменения во внешнем виде. Из-за нехватки эстрогенов снижается выработка коллагена и эластина, что ведет к потере упругости кожи, образованию морщин, а волосы становятся тонкими и ломкими;
• временное увеличение веса в период менопаузы, что связано с эндокринными изменениями, вызванными гормональным дисбалансом;
• изменения в опорно-двигательном аппарате, проявляющиеся в болях в суставах и мышцах, особенно по ночам;
• нарушения в работе желудочно-кишечного тракта, проявляющиеся замедлением перистальтики и обострением имеющихся болезней.

Диагностика периода

Важнейшее, что может сделать женщина для поддержания своего здоровья в период менопаузы, – это обратиться за медицинской помощью к квалифицированному специалисту. В идеале, даже в молодом возрасте рекомендуется проходить медицинское обследование не реже одного раза в год, но в период климакса это становится особенно критично. Посещения врача должны происходить не реже одного раза в полгода.

Типичный вопрос, возникающий у женщин с первыми признаками менопаузы: к какому специалисту обратиться? Существует два варианта: можно посетить терапевта, который определит необходимость дальнейших консультаций со специалистами на основе собранной информации. Или же напрямую обратиться к гинекологу, визит к которому станет необходимым при решении вопросов, связанных с климаксом.

Для определения гормонального фона и оценки состояния женщины обычно назначают ряд исследовательских процедур:

• анализы крови: общий и биохимический анализы, анализ на инфекции, передающиеся половым путем, анализ на гормоны;
• общий анализ мочи;
• УЗИ органов малого таза;
• УЗИ и маммография молочных желез;
• цитологическое исследование цервикального слизи;
• ЭКГ.

Если выявляются отклонения в работе тех или иных органов, пациентку направляют к узким специалистам для дальнейшей диагностики.

Когда может понадобиться лечение?

Смена гормонального фона в период менопаузы не следует считать заболеванием. У многих женщин симптомы не выражены настолько ярко, хотя бывают и исключения. Иногда организм не успевает адаптироваться к резким переменам, что приводит к серьезным нарушениям. Эти сбои могут затрагивать любые органы, поскольку большинство внутренних процессов регулируется гормонами.

Решение о необходимости медикаментозного лечения принимает врач на основе жалоб пациентки и результатов ее обследования. Когда может возникнуть необходимость начать лечение? Например, это может произойти из-за развития гипертонии, проблем с сердцем, нарушений в эндокринной системе, маточных кровотечений, а также сильных приливов. То есть, любые процессы, выраженность которых значительно увеличена.

Методы терапии патологического климакса

Терапия патологических проявлений менопаузы включает несколько направлений.

1. Наименее агрессивным вариантом будет использование отваров, фиточаев и настоев из лечебных трав, которые содержат растительные аналоги эстрогенов. Это такие растения, как пастушья сумка, боровая матка, шалфей, красная щетка, клевер красный и другие. Эти средства помогают мягко регулировать гормональный баланс без негативного воздействия на организм.
2. Применение биологически активных добавок (БАДов) также является актуальной практикой в период менопаузы. Эти растительные препараты призваны смягчить климактерические симптомы и повысить адаптивные возможности организма, компенсируя нехватку эстрогенов. К таким препаратам относятся: Климаксан, Эстровэл, Климакт-Хель, Ременс, Климактоплан, Менсе, Менопейс, Ци-Клим.
3. Если менопауза значительно изменяет образ жизни женщины и у нее возникает угроза для здоровья, то может потребоваться более серьезное решение – заместительная гормональная терапия (ЗГТ). Это лечение отличается высокой эффективностью, но требует внимательного и осознанного подхода. Компетентность врача в данном вопросе является критически важной. В гормональной терапии особенно актуален принцип: «Прежде всего, не навреди». ЗГТ имеет большое количество противопоказаний и может вызывать серьезные побочные эффекты, включая риск онкологии, поэтому необходимо постоянное наблюдение.
4. В некоторых случаях для корректировки гормонального дисбаланса могут быть назначены оральные контрацептивы. Выбор препарата лучше доверить гинекологу, так как существует множество разновидностей с различными комбинациями искусственных аналогов прогестерона и эстрогена, что требует индивидуального подхода к нуждам конкретной пациентки.

Как помочь организму в период менопаузальных перемен?

Ключом к успешному преодолению периода менопаузы является выбор здорового образа жизни. Что включается в это понятие? Обратите внимание на следующие аспекты:

1. Питание должно быть частым и небольшими порциями. Лучше отдавать предпочтение нежирным сортам мяса, кисломолочным изделиям, овощам, фруктам, зерновым и орехам. Очень полезно включить в рацион растительные продукты, которые богаты фитоэстрогенами: соя, бобы, чечевица, горох, овес, брокколи, цветная капуста, красный виноград. Узнайте, какую диету следует соблюдать во время климакса.
2. Отказ от напитков с кофеином в пользу чистой воды, травяных чаев, морсов и натуральных соков;
3. Регулярная физическая активность и прогулки на свежем воздухе помогут предотвратить застойные процессы в организме и насытят кровь кислородом.
4. Избавление от вредных привычек. Комментировать это не стоит — никотин является ядом, а алкоголь, хотя и может употребляться в редких случаях, часто провоцирует приливы, повышение давления и нарушения сердечного ритма.
5. Прием поливитаминных комплексов — отличный способ восполнить запасы энергии и предотвратить нехватку важных для организма элементов.
6. Регулярные визиты к врачу и прохождение медицинского обследования являются основой для предупреждения серьезных патологий. В период менопаузы зачастую могут проявиться скрытые заболевания, вызванные гормональными нарушениями. Оперативная диагностика помогает выявить симптомы на ранней стадии и начать соответствующее лечение.
7. Устранение источников стресса — это важная, но сложная задача. Современный быстрый ритм жизни может быть достаточно тяжёлым, и порой мы не успеваем за всеми изменениями. Избежать проблем невозможно, но поддерживать нервную систему в трудные времена можно разными способами. Важно, во-первых, научиться дистанцироваться от проблем и формировать к ним осознанное отношение. Во-вторых, в сложных ситуациях можно принимать седативные препараты для улучшения состояния нервной системы.

Опыт других людей

Анна, 52 года, домохозяйка:

«Когда у меня началась менопауза, я сначала не обратила на это особого внимания. У меня просто начали пропадать месячные. Но вскоре я заметила, что начинаю неожиданно потеть в течение дня и у меня появились приливы. Это было довольно странно и неприятно. Я решила почитать об этом больше и узнала, что это нормальный процесс старения. Сложнее всего было справиться с перепадами настроения, которые иногда вызывали недопонимание в семье.»

Иван, 55 лет, инженер:

«Я всегда думал, что менопауза — это что-то, что касается только женщин. Однако, когда моя жена начала проходить через этот этап, я заметил, как это на неё влияет. Она стала более чувствительной и иногда раздражительной. Я пытался поддерживать её, слушал, когда она делилась своими переживаниями. Понять, что происходит с её телом, помогло мне быть более терпеливым и внимательным.»

Мария, 48 лет, врач:

«Как специалист, я всегда знала о менопаузе, но когда сама столкнулась с её симптомами, это было совершенно другой опыт. Я ощутила, как быстро меняется моё тело, появились проблемы со сном и различными эмоциональными перепадами. Я начала принимать фитопрепараты и больше внимания уделять спортом. Теперь, когда всё это позади, я осознаю, что поддержка друзей и понимание своего организма очень помогли мне адаптироваться к новому этапу жизни.»

Вопросы по теме

Как менопауза влияет на эмоциональное состояние женщин?

Менопауза может оказывать значительное влияние на эмоциональное состояние женщин. Многие женщины в этот период испытывают изменения в настроении, такие как раздражительность, тревожность и депрессию. Это может быть связано с гормональными колебаниями, а также с физическими симптомами менопаузы, такими как приливы и ночная потливость. Также изменения в жизни, например, дети вырастают или меняется профессиональная деятельность, могут вызывать стресс и неопределенность. Поддержка со стороны близких и консультирование у специалистов могут помочь справиться с этими эмоциональными вызовами.

Существуют ли альтернативные методы управления симптомами менопаузы?

Да, существует множество альтернативных методов, которые могут помочь в управлении симптомами менопаузы. Это может включать изменение диеты, включая больше продуктов, богатых фитоэстрогенами, таких как соя, увеличение физической активности, практику йоги и медитации для снижения стресса, а также использование растительных добавок, таких как черный кохош. Тем не менее, прежде чем начинать любой новый метод лечения, важно проконсультироваться с врачом, чтобы убедиться в его безопасности и эффективности.

Как меняется сексуальная жизнь женщины во время менопаузы?

Менопауза может повлиять на сексуальную жизнь женщины несколькими способами. Изменения в уровнях гормонов могут привести к снижению либидо, а также к физическим симптомам, таким как влагалищная сухость, что может вызывать дискомфорт во время полового акта. 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