Climax – a normal physiological state of the body, the transition from reproductive period to menopause. It is caused by the age-related involutional rearrangement in the higher parts of the central nervous system, which leads to a violation of the cyclical nature and intensity of the secretion of gonadotropic hormones by the pituitary gland, as a result of which the function of the sex glands is insufficient. Climacteric neurosis and dysfunctional uterine bleeding include pathological climax.
Climacteric neurosis is a condition of the body caused by pathological age-related changes in the function of the central nervous system, primarily the hypothalamic centers, and characterized by autonomic-nervous and neuropsychic disorders.
Climax occurs in women 45-55 years. Climax, which arose up to 40 years, is called premature, and after 55 years – called late. There are two stages in the menopause: the period of menopausal changes in menstrual function, usually occurring at the age of 43 years, and the menopause period, combined with the hormonal activity of the ovaries.
The latter occurs on average at 46 years and usually lasts for 3-5 years, after which the senile menopause begins (physiological rest of the female reproductive system).
Climacteric neurosis can appear during an irregular, preserved, and even correct menstrual cycle and at various times after menopause (sometimes even after
10-15 years). The frequency of menopausal neurosis in women ranges from 10 to 84%.
Etiology and pathogenesis. The causes of premature menopause can be long-term negative emotions, abundant blood loss during childbirth, a pituitary tumor, prolonged lactation, frequent childbirth and abortions, malnutrition, chronic debilitating infectious diseases, prolonged mental overstrain, and heavy physical labor.
According to V. G. Baranov, menopausal menopause occurs primarily due to age-related changes in the hypothalamus centers, leading to a violation of the cyclical nature and intensity of secretion of the pituitary gonadotropic hormones – FSH and LH. It was also found that one of the causes of menopause (age irreversible cessation of menstruation) is an increase in the secretion of FSH, which begins 6 months before the cessation of menstruation. With the onset of menopause, especially with marked involution of the reproductive system, there is a constantly high secretion of gonadotropins and persistently low secretion of estrogen.
In the development of menopause in women can be traced 3
The first stages. There is a gradual transition from ovulatory to anovulatory menstruation. Disturbance of menstruation is different: anovulatory cycles with preservation of rhythm, sleepiness. In the second stage, menstruation stops, but relative hyperestrogenism persists, gradually turning into hypoestrogenism. The third stage of menopause is characterized by a strong involution of the reproductive system, which is manifested in a decrease in the estrogenic function of the ovaries. Due to the lack of estro genes, atrophic changes occur in the uterus, vagina, ovaries (ovarian sclerosis), external genital organs and mammary glands. Lack of estrogen is also one of the causes of osteoporosis in women.
Due to the imbalance of estrogens and androgens, increased facial hair growth, increased libido, etc. often begin. Lack of estrogens in turn leads to disinhibition of the gipadi function of the gipofi, resulting in an even greater increase in gonadotropin secretion.
Climacteric neurosis is mainly due to primary
pathologically increased reactivity of the centers of the hypothalus of the musa (V. G. Baranov), which leads to the excitation of the sympathetic-adrenal system. In turn, this causes “hot flashes”, sweating, irritability, tearfulness, etc. An additional factor that enhances the neurosis, apparently, is hypoestrogenism, especially quickly arising. It affects the function of the hypothalamus for the second time (VG Baranov).
Relative hyperestrogina, loss of the progesterone phase in the first stage of menopause create conditions for the development of hyperplastic processes in target organs, particularly in the endometrium. Endometrial hyperplasia, the absence of its transition to the secretion phase due to the lack of progesterone predisposes to dysfunctional uterine bleeding. The latter arise as a result of the inferior process of rejection of the endometrium (abundant, prolonged, anemizing acyclic bleeding).