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The climacteric is the period that precedes menopause , in which the ovaries undergo changes in their function, as a result of which women begin to present menstrual alterations.

The cessation of menstruation is called menopause.

Due to the increase in life expectancy of women in recent decades, a third of the female population is going through this period of menopause and the consequences that it generates.

The importance of this process lies in the significant number of diseases that manifest when the ovaries stop working ( osteoporosis , cardiovascular diseases, hypertension …), which is why a treatment is highly advisable to face this stage in the life of the woman.

Why is it produced?

At birth, women have the potential for oocytes that will develop throughout life. Little by little, the number of these oocytes decreases, until reaching a point when they are exhausted, thus ending the ovarian function itself.

This implies a decrease in the estrogens (female hormone) circulating in the blood and responsible for the set of symptoms that women suffer in this period of their life.

Symptoms of menopause

The symptoms that attract the most attention are, without a doubt, hot flashes, which are characterized by an increase in body temperature, accompanied by facial flushing and sweating, and which occur regardless of the external temperature or another justified cause (exercise, meals hot, etc.).

Almost 80% of women suffer it and appear spontaneously, in most cases. Their duration and frequency are highly variable and unpredictable.

At the local level, in the genital tract, there is usually a dryness of the mucosa that implies vulvar itching (pruritus) and dyspareunia (pain during intercourse).

Psychic alterations such as anxiety, depression, insomnia and decreased libido, and physical such as fatigue can occur .

More in the long term, urinary disorders such as incontinence, osteoporosis and cardiovascular diseases can occur.

Osteoporosis, like all the symptoms of menopause, is caused by a decrease in circulating estrogens in the blood. There are a series of risk factors that may be predisposed to suffer from it:

  • white ethnicity
  • thinness
  • sedentary life
  • diet low in calcium
  • early menopause

Osteoporosis is one of the great problems of menopause because, in the long term, it presents a high risk of fractures, with consequent mobility problems in elderly patients.

Cardiovascular diseases, as well as the risk of suffering from them, increase with menopause, especially arteriosclerosis and heart attack. This increase is based on an alteration of the lipid balance (which implies an increase in cholesterol and triglycerides).

At the same time, coagulation disorders occur which, combined with an increase in cholesterol, increase the risk of myocardial infarction .

How is it diagnosed?

The anamnesis provides a fundamental diagnostic data,

Menstrual disturbances with cycles that become irregular (tendency to space out until they disappear).

An analytical quantifying gonadotropins (increase in FSH) confirms the diagnosis.

Treatment of menopause

Menopause treatment is highly recommended as it improves the quality and life expectancy of women.

Despite the existence of women who do not suffer symptoms throughout menopause, hormone replacement treatment is recommended, as long as there is no contraindication.

Hormone replacement therapy (HRT) can be based on estrogen alone (in women without a womb) or combined with progesterone (in women with a womb).

This last detail is very important because the exclusive administration of estrogens to women with a womb considerably increases the risk of endometrial cancer.

Estrogens can be given:

  • in tablets (one a day)
  • in transdermals (usually two per week)
  • gel (daily)
  • in implants (every 6 months)

The form of administration will be adapted to the woman’s habits and taking into account some clinical parameters, since the metabolic route of these estrogens changes depending on the route of administration.

PROGESTERONE must be associated with all estrogenic hormonal treatment in women with a womb to avoid endometrial cancer.

It can be administered in:

  • pills
  • transdermal
  • vaginal gel

The administration guideline may be:

  • Cyclical, for 12 days a month, after which the patient will have her menstruation.
  • Continuous, throughout the whole month, in such a way that the patient will be in amenorrhea (without rules).

There are currently on the market combinations of both drugs in the same tablet.

Another more recent alternative to non-estrogenic replacement therapy but with the same effect, is TIBOLONE, a menopausal treatment, which retains all the beneficial effects of estrogenic treatment in the long term, but does not cause rules.

Finally and within the category of more natural treatments are phytoestrogens or Soy. It is a natural, soy-based treatment that has the same beneficial effects on a systemic level as a classic estrogen-based HRT.

In cases of severe osteoporosis, a classic HRT is insufficient and a treatment with bisphosphonates must be associated, which inhibit bone resorption and increase the calcium content of the bone.

Absolute contraindications to HRT

They are few and include:

  • Recent thromboses (even though natural estrogens do not increase the risk of thromboembolic disease).
  • Hormone-dependent gynecological cancers (breast and endometrium).
  • Otosclerosis.
  • Malignant melanoma .

How can I avoid it?

We cannot avoid it since it is caused by a “depletion” of the ovary that stops producing oocytes and the ovarian function itself ends.

It is part of a natural process in the life of every woman that she must go through, just as she did previously for menarche.

What we can do is act on the side effects and minimize them, so that the consequences that menopause produces not only on a physical but psychological level and, in general, those that affect the quality of life of women, are diminished to the max.

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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