Practice diagnosis and treatment of menopause

2021-04-16 03:54 PM

Most women experience vaginal dryness during menopause. The depletion of oestrogen causes the lining of the vagina to atrophy thin, the vagina susceptible to infection and pain during sex.

Menopause is a menstrual termination phenomenon that occurs spontaneously in women between the ages of 45 and 55, because the ovaries no longer ovulate (ovarian failure), leading to a sharp decrease in the hormone oestrogen and an increase in androgen. , gonadotropin in the blood. A sharp drop in oestrogen is responsible for menopausal disorders.

Diagnose

Diagnosis of a case of menopause is mainly based on symptoms: hot flashes (red, hot face) and sweating, dry vagina, painful intercourse ... accompanied by a number of symptoms psychological conditions such as anxiety, depression ...

About 70% of menopausal women experience hot flashes and night sweats, which can last for 2 to 5 years or longer.

Most women experience vaginal dryness during menopause. The depletion of oestrogen causes the lining of the vagina to atrophy thin, the vagina susceptible to infection and pain during sex.

In other cases, the neck of the bladder and urethra also atrophy, which can cause urethral syndrome, making the patient feel full of the bladder and want to urinate continuously.

Other common disorders are sleep disturbances, forgetfulness, loss of concentration, easy crying, anxiety, loss of sexual activity ...

Need to diagnose and exclude special cases such as:

Pregnant.

Thyroid dysfunction.

In addition, follicle stimulating hormone (FSH) should be examined when diagnosis is suspected in subjects:

Women have had a hysterectomy.

Women who take combined oral contraceptive pills (COCP) or hormone replacement therapy (HRT) and have frequent withdrawal bleeding, similar to menstrual blood.

Women who have experienced amenorrhea from taking progesterone-only birth control pills (POP).

People with amenorrhea or amenorrhea and early menopausal symptoms, before age 45.

If the FSH serum is> 20U / liter then the diagnosis is confirmed as menopause, but even a slight increase may suggest this possibility.

Postmenopausal metabolic disorder symptoms usually appear very late, perhaps 10 - 15 years later, such as osteoporosis that causes bones to break easily, increased fat accumulation increases the risk of atherosclerosis. arteries and the risk of coronary artery diseases, cardiovascular strokes ...

Treatment

Provide patients with the necessary insights into menopause, explain to them that this is an inevitable natural transformation, and that there is nothing to worry about changes in the body.

Instruct patients on adapting to changes and creating an appropriate emotional and psychological environment, reducing the stresses in life into menopause.

Prevention of cardiovascular diseases and osteoporosis with appropriate measures.

In cases of extreme menopausal symptoms, treatment can be done using hormone replacement, which supplies an amount of oestrogen to the body to alleviate symptoms of depletion of oestrogen. Some patients who are unable to take this hormone replacement therapy, for example, have breast cancer, may use beta-blockers.

Uneven vaginal bleeding, heavy bleeding or pain are not normal signs of menopause, need to refer immediately to a specialist to find out the cause, may need endothelial biopsy. uterus.

Vaginal bleeding less and less as you approach menopause. Any vaginal bleeding that occurs about 6 months or more after the last menstrual period should immediately be referred to a specialist for a diagnosis to rule out malignancies.