Menopause

menopoz

Menopause nedir?
 
What is menopause?
 
Menopause, a woman in the absence of any other cause, when menstruation for 12 consecutive months, is a natural and normal condition is defined as the last menstrual period. In menopause, estrogen and other hormones in level due to aging of the ovaries that resulted in a fall function and fertility decline is characterized by the termination.
 
Reproductive and after the transition period before menopause, a woman lives in a very physical changes. Most of menopause and aging are normal consequences due to these changes. Depending on the physical part of menopause such as hot flashes harass these changes and are often limited to a period. Some physical changes observed during menopause diabetes in middle age may be the signs of certain diseases such as thyroid disorders and sleep apnea syndrome. Sometimes degişir menopausal hormone levels and physical effects of aging due to personal genetic makeup, unhealthy lifestyle and / or certain health problems may arise when combined with other life stress.
Every woman experiencing menopause shows that individual differences. expectations of menopause a woman may also be important. In different parts of the world and the changes during menopause in different ethnic groups, it supports cultural and ethnic influences.
 
Usually menopause it may just be the end of the menstrual period. A woman can be seen as the end of the concern with birth control to end fertility, or may be upset due to inability to have children at all. For some may be a sign of aging and menopause can cause stress in a society in which this young age and fertility ONE.
 
Experienced menopause due to illness will affect your views on a woman’s menopause.
 
Some symptoms of too much living while others can spend very little or no symptom of this transitional period.
Although those experienced by menopausal women, though specific to each, is to provide opportunities and develop a personal health assessment is correct, the only thing menopause for each woman. Things to do to improve the health, not only throughout the whole rest of life during menopause will strengthen the sense of feeling better.
 
Timing and Terminology
Some of the terms associated with menopause is defined below.
 
Spontaneous (natural) menopause:
Natural menopause is never completely terminated spontaneously without medical intervention of the menstrual cycle. The average age of menopause for many women, including 51 in Western countries is between 40-58. For some women, menopause thirties to sixties are also very few. Despite the increase in life expectancy age at menopause it did not change,. Today, the majority of North American women live a third of their lives after menopause. 2 factors including age of the natural menopause, smoking and genetic structure have been identified. According to those who use early age of menopause for smokers it is 2 years. To be near the age of menopause, women’s mother and sister supports genetic relationship. It applied to a variety of chemotherapy agents for the treatment of cancer and / or pelvic radiotherapy in women who are at risk for early menopause.
If it took a woman epilepsy treatment, has undergone pelvic surgery has been exposed to toxic chemical agents, has received treatment for depression, if you have a history of heart disease, and limited evidence to support it would be sooner, no birth or menopause are available. Menopause age and race, a clear correlation has been found between age of first menstruation or birth control pill use.
 
Perimenopoz
physical symptoms of menopause begins years before the last menstrual period. This period of transition to menopause is called perimenopause. It may take 6 years or more, the last menstrual period ends after the following one year. Perimenopausal changes will occur with changes in the levels of ovarian hormones; as estrogen. This transition doneminde estrogen levels fall, but not regularly. Sometimes the levels may be higher than previous levels. Irregular menstrual periods, hot flashes, vaginal dryness, sleep disturbances, mood swings are common symptoms of normal and perimenopause period.
The fertility rate in the perimenopausal period may be too low even when a woman is pregnant. If pregnancy is not desired is required contraception until menopause.
 
Induced (iatrogenic) menopause
Induced menopause at any age can be regarded the first or last period; especially surgical or medical intervention is sometimes stop of period pieces, depending on the treatment of cancer.
 
Surgical:
Surgical removal of the bilateral ovaries (bilateral oophorectomy), menopause occurs. This is called surgical menopause. If the ovaries are left in place the uterus if taken fertility and cause the termination of menstrual bleeding does not cause menopause. However, it left out in the ovaries in place, the ovarian hysterectomy, possibly disrupting the blood supply to the ovaries from producing estrogen terminate the expected average of 2-3 years ago. Surgery hot flushes in menopausal women, perimenopause and perimenopausal period are impervious changes reported mostly live as vaginal dryness. But women undergoing hysterectomy with the ovaries, the ovaries of perimenopause is less estrogen salgıladık live. However, for the womb of a woman who never see Total, changes in menstrual periods can not use as a marker for the onset of perimenopause.
 
Cancer treatments:
Cancer chemotherapy or pelvic radiation therapy can cause serious damage over. Fertilization and the menstrual period may be terminated immediately or after a few months. Some chemotherapy treatment for young women or low-dose radiation damage can be temporary or reversible ovaries old.
Sexually active women who do not want to become pregnant after cancer treatment should use a reliable method of contraception for a few months will not be menopause.
 
Induced effects of menopause:
Treatment depends on the symptoms of menopause that are created by pressing fire, sleep disorders, may be similar to those linked to natural menopause, including vaginal dryness. But premenopausal women due to treatment without experiencing perimenopausal period are faced with menopause. sudden loss of estrogen can result in fever symptoms such as hot flushes and more powerful. Loss caused by ovary androgens can cause various symptoms such as loss of sexual desire.
psychological effects of menopause treatment can also be connected to more than natural menopause. In addition to the side effects of treatment need medical intervention that causes the disease or condition will need to deal with. Pelvic radiation can only lead to a more severe vaginal dryness is due to loss of estrogen.Some types of chemotherapy hair loss in addition to the active ovaries, nausea, weight gain, fatigue can lead to loss of energy.
Treatment depends on the treatment of postmenopausal women with natural menopause, menopausal symptoms who may need to hear more. Because these women are probably younger than age and constantly monitored in order to reduce the risk of diseases such as menopause-induced osteoporosis in later periods and is sometimes in need of treatment. However, medical treatment can be solved with a chronic health condition; Some women may have a better health and well-being with this treatment.
 
Premature menopause
induced by the treatment of menopause or is in the case of natural or before age 40 is called premature. Premature menopause one or more poorly understood autoimmune condition results to depend on genetic, or not induced by olabilir.medikal response induced by medical intervention show premature menopause in women who perimenopause going and hot flashes, sleep disturbances and natural menopausal symptoms live as vaginal dryness. Compared with women entering menopause at the expected age Besides natural or induced premature menopause in women who spend more years devoid of effect the benefits of estrogen and osteoporosis or are at greater risk for certain health problems like heart disease. Premature menopause due to loss of fertility and femininity and fertility sad, especially for people who may have psychological stressors associated with sexual favor. Besides addressing the psychological effects of premature menopause explore ways to have a child, so it may be important to draw attention to the physical condition.
 
Premature ovarian failure (temporary menopause)
Premature ovarian failure is a term used to reflect a condition that occurs before the age of 40 which led to cessation of the menstrual period the ovaries remain insufficient. If the menstrual period does not improve again premature ovarian failure, ending premature menopause. However, lifestyle factors such as period pieces too much stress, too much exercise and / or diet, fibroids, endometriosis, or because of treatment given for a period of PMS may stop temporarily. In this case, treatment or ovaries are left in geçildig more healthy lifestyle should not be regarded as premature menopause for temporary ll come to normal hormone production.
 
Postmenopoz
Postmenopausal women after natural or induced menopause it includes all year. some menopause symptoms associated with decreased estrogen levels (vaginal dryness rarely fire flashes) is they wish. Years after menopause increases the risk decreased with time for diseases including osteoporosis with estrogen levels.
 
To determine menopausal status
Perimenopause is most of the time a diagnosis can be made by reviewing the medical history of a woman. changes in the forties they notice symptoms in most women menstruation is the beginning of the press and fever. If menstruation for 12 consecutive months, menopause is accepted. hormone levels in a woman menstruating hormone tests are not useful in most cases because it is constantly changing. Sometimes the values of specific hormones to control fertility is particularly concerned can be tested. This can be useful for women to start treatment and to decide in terms of changes. For some women perimenopause symptoms mimicking investigate different causes, such as thyroid disease, menopause gerekebilir.baz to verify that elevated FSH levels kullanılır.fsh pituitary hormones by the ovaries and is a stimulus for the secretion of estrogen. estrogen secretion of ovarian estrogen secretion into the bloodstream to stimulate the pituitary gland to secrete more FSH azaldıkc. A woman’s blood FSH levels are consistently 30 mIU / mL or above and no longer see ads usually one FSH level next edilir.Bu accepted menopause, on a regular basis estrogen levels in perimenopause can be misleading because it falls. Instead, estrogen and FSH levels indicate high to low volatility in the perimenopausal period. Therefore, a single value indicating increase FSH is often not sufficient to confirm the menopause. More importantly, fire flashes and low FSH levels in a woman with irregular menstrual periods can not eliminate the possibility of perimenopause. 
 
Menopause Terminology
 
  • Menopause adetsiz passed after the last menstrual period of 12 consecutive months or both ovaries to be adopted in case of damage or completely.
  • Perimenopause is 6 years or more immediately prior to the commencement of natural menopause and menopausal symptoms including 1 year of transition. 
  • Induced menopause both ovaries to be medical or surgical intervention or serious damage has occurred as a result of menopause.
  • Premature menopause is menopause that occurs 40 years or earlier.
  • Postmenopausal women after menopause covers the entire year.
 
Changing Body Menopause 
 
Every woman’s menopause experience is different. The biggest change is seen among menopausal women undergoing natural menopause early or induced.women undergoing natural menopause, reported that they experienced significant physical changes outside of menstrual irregularity before menopause. Hot flashes in some women, in addition to menstrual disorders, and sleep disorders have symptoms such as vaginal dryness. This varies from person to person the seriousness of the complaint. In fact, some experts and women who are perceived as a disease of this period review the situation “perimenopausal symptoms” definition they do not prefer.
 
Perimenopausal changes usually around the age of 40, sometimes begins in the 30s. It can be added to the stress of living with concurrent symptoms of aging. As a result, most of the changes will end after menopause and does not require treatment. a group changes under the remaining thyroid disorders, depression or drug side effects can be found. 
 
The discomfort associated with menopause often experienced exercise, diet regulation, to be reduced with lifestyle changes such as smoking cessation. A healthy lifestyle contributes into the general well-being. 
 
Changes in Number Period 
 
two hormones released from the ovaries of reproductive years (estrogen and progesterone) play an important role in the menstrual cycle. These hormones endometrium thickens, provides a suitable environment for the settlement of the fertilized egg. If the fertilized egg does not reach the uterus, the ovaries stop producing hormones, the endometrium thin and pouring menstrual cycle is completed. 
 
Perimenopause reaching women in both the amount of menstrual bleeding is a very common condition and a change in frequency. A few women were periodically suddenly stops menstrual periods again and ignore. But 90% of women before they reach menopause, menstrual cycle changes lives between 4 and 8 years. In this case the unstable ovarian hormone secretion, and will depend less ovulation happen. Initially, this may shock değişikliklergöz. Generally, shorter menstrual periods and 28 days, takes place often. Bleeding may be reduced, it can only be as heavy or spotting. Late in the period in perimenopause usually jump. 
 
Many perimenopausal women seen in the normal changes in menstrual bleeding, and treatment gerektirmez.y, evaluate the bleeding of a physician, do you need to determine whether the physiological or pathological. 
 
To recommend the use of menstrual calendar menstrual changes in women can move to distinguish normal and abnormal bleeding. It is recommended that medical attention if experiencing the changes listed below.
  • heavy bleeding periods were not previously 
  • Said bleeding 7 days 
  • 21 days to be seen in the frequent menstruation 
  • Spotting or bleeding between periods 
  • Bleeding after sexual intercourse 
cause abnormal bleeding should be investigated before starting treatment when detected. Doctors study the abnormal bleeding patterns in ultrasound, hysteroscopy, biopsy, dilatation / curettage may resort to such methods.
 
Treatment of abnormal uterine kanamycin is aimed at the underlying cause. Often bleeding is hormonal and low-dose birth control pills that contain estrogen-progesterone or progesterone may be resolved only by the intermittent treatment. Sometimes it may require surgical treatment of abnormal bleeding, such as frequent fibroids require surgical treatment. The procedure fibroid size, based on the number and location vary depending on the severity of symptoms. Sometimes you may also need a hysterectomy.
 
After the menopause, when a woman living without losing the underlying bleeding should reach a cancer physician to jump. If the symptoms of menopause because estrogen and progesterone replacement therapy when bleeding occurs, it does not cause bleeding donor concerns. Such therapy should report whether the difference in bleeding normally experienced bleeding properties. 
 
Reduced Fertility
 
In many cases women are shifted to the advanced age of the birth experience. But jeopardize fertilization with aging. While menopausal women who were born closer to 1-2 million eggs remain only 100 eggs. The increasing number of aging and low egg quality, is reduced fertility with age-related changes seen in addition to the uterus. maze. Also experienced in advanced age pregnancies are more risky than in the main living young. This increased proportion of low risk, genetic abnormalities that may occur in infants, pregnancy related diabetes mellitus, hypertension, stillbirth and caesarean section need be considered. 
 
Birth control 
 
In addition to reduced fertility perimenopause, menopause confirmation adetsiz with a 12-month period without fully pregnant woman can not be said to be free from risks. Pregnant women who do not want to stay fit, should use an effective and safe method of birth control. Physicians way of life that every woman can determine the appropriate method of sexual activity and medical history. Hormonal birth control methods as a female contraceptive methods in middle age (estrogen-progesterone or only birth control pills, progesterone), non-hormonal birth control methods (vaginal ring, transdermal, injection methods), hormone / hormone-free IUD or sterilization methods ( connecting tube for women and vasectomy for men) can be used. barrier methods of the other options (diaphragm with spermicide, sponge with spermicide, male and female condoms) must be disciplined ideal choice to use up. The natural contraception method calendar method is not recommended for premenopausal patients with irregular periods. Emergency contraception (morning after pill) is not recommended as a regular contraceptive method. Other advantages / disadvantages of the pregnancy prevention methods;
  • Besides regular menstrual periods and birth control pills to prevent pregnancy, less bleeding (reduction in iron deficiency anemia) reduction in ovarian and endometrial cancer risk. 
  • Only barrier methods for HIV (AIDS virus) prevent sexually transmitted diseases like. 
  • Hormonal methods can be used in women over the age of 35 healthy non-smokers. However, estrogen-dependent cancers in the background, heart disease, high blood pressure, diabetes, and should not be used if any coagulation disorder. 
  • Common side effects of hormonal methods, nausea, breast tenderness. withdrawal bleeding like a normal number of pills that contain estrogen-progesterone occurs. 
  • The regular menstrual periods with hormonal contraceptive methods Right wellbeing will perimenopause symptoms of menstrual irregularities have not seen and can not help in predicting when the menopause. In addition, the FSH test because they will also affect the levels of FSH used as a marker of menopause. 
 
Hot flushes 
 
revenues experienced early menopausal discomfort. While the actual cause is thought to be still undiscovered by change of the temperature regulation center in the hypothalamus in the brain. When the body appointed by the hypothalamus initiates arrangements for reducing heat gain. Expansion of capillaries close to the skin becomes, this may result in the face and neck to appear red. Sweating realized tried to reduce body temperature. Pulse acceleration and appears along with palpitations. Hot flashes are mostly chills, followed by chills. Rarely, some women just live with the feeling of tremor.
 
It can prevent severe sleep at night but not enough to wake the experienced hot flashes. If it happened too heavy sweating, night sweats if DENILLE. According to the beliefs of people who have irritable accepted, the menopause, irregular sleep causes fatigue, fatigue irritation.
 
 Hot pressing is not the only reason to menopause, in some medical conditions (thyroid disease, infections, cancer rarely) may cause these symptoms. In addition, certain treatments for breast cancer, tamoxifen, raloxifene can cause hot flushes for osteoporosis. women with these symptoms should be investigated for cause by the physician. 
 
Ovaries in women who have entered menopause removed by surgical operation would be serious hot flashes. Symptoms begin immediately after surgery and continues for longer than women entered menopause naturally.
 
Menopausal hot flashes are connected to the pharmaceutically tolerated or distress, you can create shyness or person may weaken. Most women will experience hot flashes by up to 3 to 5 years. Rarely, some women do not experience any of these symptoms, some only a few months to live. Sometimes it continues long stretches up to age 70. when the symptoms will start or end there is a method which envisages.
Hot flashes often increases with stress associated with palpitations may be associated with ankiyet sensation. Disturbed transmitter findings may resemble symptoms of panic attacks.
 
Treatment
To treat hot flashes many options listed below will be required. The best treatment of the severity of symptoms, quality of life that affect how health profile, is done according to personal preference.
 
Lifestyle changes:
also does not see much support by research, no loss is a cheaper method. Sometimes it can improve hot flashes.
  • avoiding stimulus that triggers hot flashes (eg hot environments, hair dryer, hot drinks, hot food), alcohol, caffeine, cigarettes to use. 
  • exercising regularly to reduce stress, provide restful sleep. Meditation, yoga, biofeedback, relaxing methods such as acupuncture or massage 
  • Cotton clothing to use, serinleştiril of the environment with air conditioning, a pillow under apply cold packs to keep cold water to wake up in the night table. read the book to go back to sleep, sweating and moisture use attractive bed linen 
  • Using the abdominal muscles at the beginning of hot flushes deep, slow breathing from the nose and mouth to breathe 
Prescription drugs:
If specified by the user provides the benefits are unproven benefits of scientific studies. Many experts believe that the benefits seen in the “placebo effect,” he thinks, and this is shown by the placebo effect benefit studies.
  • Isoflav Philippines (poor, effective plant estrogens) are mostly found in soy foods, it may also be found in dietary supplements as drugs. hot flashes only modestly, reduced transmission of 30% and 15% were determined. In contrast, other studies have found these drugs ineffective. Day 1 or 2 servings of soy foods is received (25 g soy protein) was found to be more beneficial than diet drug support. Soy beans or nuts are wounded option. not recommended for people who have had breast cancer. 
  • “Black cohosh” containing medicines may reduce support to press the hot diet. This Remifemin which the product is produced under good quality control in Germany. 20mg tablets 2 times a day will reduce the discharge of moderate fire use 8 to 12 weeks, but not all studies prove it. Side effects include gastrointestinal side effects are rarely as liver damage. Large-scale thickening of the endometrium in a study of people with 40mg per day using black cohosh were not followed for 1 year. research on the use of more than one year, the impact is not known because there is no data. 
  • Tropical progesterone creams, tablets containing plant primrose oil, ginseng, kava, the effectiveness of products such as sage has not been proven by scientific studies. 
 
Prescription drugs:
This group of drugs proven most effective drugs to severe hot flashes. All have side effects or contraindications. It may not be suitable for every woman.
  • Systemic estrogen therapy: low doses and are known as the most effective preventive treatment of hot flashes. for hot flashes FDA (US Food and Drug Administration) is the only treatment approved. Approved indication is for moderate to severe hot flashes. Some women began treatment immediately benefit While most provide maximum effect with 6 to 12 weeks of use. Systemic therapy when used at the lowest dose possible, be dissociated from the damage it will bring a high dose and long duration using the lowest. 
  • Other hormonal drugs: These groups are not approved for the indication of hot flashes also be used as official drugs for these complaints. For example, without the need for birth control, but complaints of hot flashes you can use birth control pills contain a healthy nonsmokers available perimenopausal woman’s estrogen-progesterone. 
  • non-hormonal drugs: no option to use hormones in people is concerned. This group of drugs has not received official approval for the treatment of hot flashes, but some research is supported by the consequences. Gabapentin used in migraine or epilepsy treatment in this group (Neurontin), paroxetine used in the treatment of depression (Paxil), fluoxetine (Prozac), venlafaxine (Effexor), hypertension, used to treat methyldopa (Alfamet), and clonidine. 
  • Bilinmelidir that treatment failure with symptoms occur again, one must be in contact with the physician or the side effects of the treatment process is always formed. The recommended treatment for estrogen cutting shape, shaped cut in terms of reducing the symptoms come back. 
 
Sleep Disorders
 
Menopausal transition occurring hormonal changes, sleep patterns at night if induced hot flashes, changes in the quality or quantity may occur. Sleep assessed taking into consideration the adequacy of performance shown in the daily activities of women. Overall, just 6-9 hours of sleep a night for most adults. 
 
The first lifestyle changes and the treatment of sleep disorders should be initiated to correct the sleep routine. For this evening, heavy meals should be avoided and the bedroom light, noise and temperature levels should be set. Only instead of the evening, alcohol throughout the day, avoiding stimulating substances such as caffeine and nicotine has helped to increase the total sleep time and sleep quality. Regular daily exercise is useful to ensure sleep patterns but also should be noted that an adverse effect of the exercises performed close to bedtime. 
 
create a favorable environment for sleep (quiet, cool, dark) is very important. The bedroom should be used only for sleep and sexual activity. Or after removal of the person, if not first fall asleep within 15 minutes, from the bed to the room to deal with relaxing activities in a different environment it is appropriate to return again and sleep on the bed. It is quite necessary to be repeated. There is also a regular sleep schedule is important and should be included in efforts to wake up at the same time to ensure that the weekends. 
 
Where insufficient to improve the sleep disorder of lifestyle changes, to discuss other options, thyroid disorders, allej, anemia, restless leg syndrome, to determine the presence of disease that may cause sleep disorders such as depression or sleep apnea should consult a physician. 
 
Investigations Although not approved to treat sleep disorders of the hormone estrogen, hot flashes in some women, estrogen therapy and has shown to be beneficial by preventing night sweats. The treatment of sleep disorders in menopausal period to be useful in some of the botanical origin of the product are also known. The use of sleeping pills can be useful to break the cycle of insomnia but it may be only a short term solution. In the long run further tests a person with sleep disorders and complaints should be referred to a sleep center for evaluation.
 
Central Nervous System Changes
 
In the perimenopausal period, associated with the menopause process or unrelated headaches, memory and concentration changes, fluctuations in mood, depression and anxiety disorders (anxiety) in various central nervous system changes, such as may occur. 
 
Headache
 
There are many types and causes of headache. Infections, dental problems can occur in cases such as headache, stress or allergies. Some foods in susceptible persons (cheese, red wine), fasting or skipping meals, too much or too little sleep, emotional changes (stress, anxiety, anger, excitement) and environmental factors (noise, bright lights, air pressure or elevation changes) headaches can be triggered by many causes such. These trigger factors may vary from person to person or may occur in the same person at different times. 
 
Studies have shown that the production of the hormone as a result of headaches. During the period total in the previous year, or birth control pills to women with a history of headache using the perimenopausal period it is at higher risk for hormonal headache. Hormonal headaches are found typically end with menopause due to a significant decline in hormone levels that occur.
Headaches of a few weeks on a daily basis is formed by the note “headache diary” with a follow-up to investigate the reasons and may be useful in order to plan treatment.
 
Many do not require treatment or headache can be treated with prescription painkillers. Some headaches are serious. In the presence of any one of the following conditions must consult the doctor:
  • not before, very severe (worst until now) the presence of headache
  • Violence progressively increasing headache
  • more severe headache than usual
  • Waking from sleep headache
  • Neck stiffness and headache associated with fever
  • Confusion, dizziness or headache associated with fatigue.
Severe headaches or migraines requires the presence of prescription drugs. Perimenopausal headaches caused by hormonal fluctuations, can be relieved with hormone therapy that prevents fluctuations. Migraines may improve or may worsen if treatment with hormones. If hormone therapy should be discontinued if the migraine worse. The available evidence suggests that some types of headaches worsen progesterone. 
Interruption of pain ricocheting back (rebound) can cause headaches. If the headache is more than two weeks, daily preventive medications can help. 
 
Memory and Concentration Disorders
 
Memory and other mental abilities are subject to lifelong changes. Decreased mental performance with aging is a natural phenomenon but with natural menopause in memory or other cognitive functions are no firm evidence that a reduction. Besides the perimenopausal period, and difficulty concentrating and remembering immediately after menopause are common complaints. Some women can detect the early signs of Alzheimer’s disease or other dementia, these difficulties lead to the disease, and this can be quite scary. However, the real situation is rarely the case. More clinical studies are needed to elucidate the reasons for this is unknown, although the reason for the complaints. Sleep disturbances, hot flashes and has been suggested that stress factors can cause memory and concentration disorders but studies show that a combination of inadequate bond. Physically, it should be noted to prevent the loss of memory remain socially and mentally active. 
 
Effect of ovarian hormones on brain functions Although the role of the hormone therapies is unclear. Also of perimenopausal or menopausal hormone therapy was started early, cognitive (the ability to understand and comprehend, cognitive) evidence that positive or negative impact on the function is insufficient. with women in a more advanced age (65 years) is a cognitive effects observed in many studies. Only one study of postmenopausal hormone therapy in older women after 5 years use has been shown to increase the risk of dementia. 
 
The situation is different than for younger women entering menopause surgery. Small-scale studies have adverse effects on the memory of the experience sudden menopause and hormone treatment of cognitive ability, at least in the short term, it has been shown to affect positive. Menopausal women sometimes use non-prescription drugs to improve memory and other mental functions. Japanese plum (ginkgo) as including the use of drugs after 60 years of being shown to have an impact on memory. Many other product efficacy could be proven. For this purpose, more research is needed before any medication is recommended. Apply to physicians worry that women should be offered for declining cognitive performance. 
 
Mood fluctuations, Depression, Anxiety Disorder
 
Menopause the actual clinical depression, severe anxiety or unstable, there has been little scientific evidence that the effect of the formation of unstable behavior, but some perimenopausal women crying, mood swings, feeling depressed or discouraged are symptoms such as feeling broken. 
 
This mood is unclear whether complaints of ovarian origin is due to a decrease in hormone levels, but the degree of night sweats and sleep disturbances often fatigue, irritability and can cause sensitivity. sudden hormonal fluctuations in the perimenopausal period also have an impact on these complaints. Reproductive age, they get used to a lot of women hormonal rhythms. In the perimenopausal period this abrupt rhythm changes and hormonal fluctuations, although normal, can cause loss of feeling and control in women is disturbing.
 
Perimenopausal mood disorders often pre-menstrual period of depressed mood, are associated with menopausal symptoms such as longer transition periods or severe hot flashes. Other causes include thyroid disorders in perimenopausal period of mood changes, medication side effects and stress factors can be considered. 
 
Women, in addition to midlife career and financial problems, particularly variable relationships that may occur in this age, divorce, widowhood, generation gap, to come home with the children and adults, children lack, are susceptible to problems such as aging parents are. It can also be difficult in a society where aging is precious youth. middle-aged women, mostly self-perception, the experience changes on body image and self-confidence and can become in this case, questioned the purpose and meaning of life.
 
During this period as an opportunity for positive change, some women may be over-excited, out of control, they may feel angry or dull. In this case, you can search for refuge in places such as alcohol or drugs and can make more complex problems in this way. In fact, women melancholic mood, such as death or divorce, loss or pain to deal with children who leave home more than men, they seek refuge in alcohol. 
 
Psychological problems due to menopause to be formed is easy to understand why worsened in this period. Support for women and to encourage the best years of their lives at a time that could help to overcome the difficulties. 
 
Establish equilibrium: the perimenopausal period, mental health, when separate one’s self, to create depends on the balance between the interest of the working life and those around show. When many women recognize their symptoms and causes of stress are well defined and ultimately difficult to separate them in time. To identify a problem, the first step is to understand the causes and to create mechanisms to cope. While there are many challenges to overcome in life stressors changed person, a self-confidence may improve their ability to cope and renovated in this way, you can create balance and harmony. 
 
Overcoming Stress
  • to participate in activities that delight 
  • talk with friends 
  • Eat 3 meals a day. Oil, salt, refined sugar, alcohol and caffeine and stay away from foods that contain fruit – vegetables mainly to feed
  • Taking the time to regular daily exercise 
  • meet the mental and spiritual needs with a creative activity 
  • Take some time to separate (massage, pedicure or personal activities such as bubble bath) 
  • stress reduction and relaxation techniques such as deep breathing or meditation providing
  • enough sleep each night to sleep 
  • laugh as much as possible 
  • To join a support group 
  • When necessary, it is necessary to apply for professional help. 
More help needed

Sometimes the ability to cope with stress specification to treat and life-style changes may not be enough. side effects of a drug of this symptom, a symptom of a disease, clinical depression or anxiety should be noted that the results may be. Physicians determine the stressors that negatively affect mental health and help organize appropriate treatment. For example, mood disorders caused by the resulting sleep disorder due to hot flashes often improved by treating hot flashes. 
 

Perimenopausal period, while unstable hormone levels, such as low-dose birth control pills, hormonal drugs are helpful in balancing mood. Women in particular feel depressed living conditions such as hormonal fluctuations due to the menstrual period or post-natal depression in youth may benefit from this treatment but no hormone drug is not currently licensed for psychological complaints. 
 
Some women use prescription drugs to improve mood and to prevent episodes of mild depression. Hypericum (St. John’s wort) containing products may be useful.Side effects include stomach – intestinal discomfort, fatigue and increased sensitivity to sunlight. This product is used, and should not sunbathe sunglasses to protect from the sun and hats must be worn. Hypericum also be used in combination with drugs that affect blood clotting, such as aspirin and coumadin system and the physician must be consulted prior to use. Many physicians are recommending the use of this drug for more than 2 years. Another nutrient, omega-3 fatty acids also have a positive effect on mood. Dietary sources are fatty fish (salmon and trout); finished tablets are also available.
More severe depression and anxiety require special attention.
 
clinical depression

Often a perimenopausal woman may indicate that depressed feeling. Did she feel melancholic or physician that the patient is required to distinguish with a chemical imbalance in the brain, whether in developing clinical depression. Prolonged fatigue, lack of interest in normal activities, sadness, symptoms such as irritability and decreased sexual desire, where 2 week long ride should be suspected in this case. Menopause does not cause clinical depression depreseyo but for more development in women with perimenopausal period prior depressive episode are particularly at risk.
 

In severe depression suggested that antidepressant medications to correct the chemical imbalance in the brain. Even if many women to take a few weeks for the effectiveness of drug side effects are much less pronounced improvement with this drug. Antidepressants are more effective when used in conjunction with psychotherapy. Although it is known to be useful in mild depression of hypericum is no place in the treatment of clinical depression.
 
Anxiety Disorder

Everyone felt at certain times by hope, it is already being exaggerated feelings of anxiety and fear. Menopause does not cause anxiety disorders in perimenopausal period, but many women live more concern because physical and psychological changes that occur alongside the existing stress factors. Often anxiety disorder requiring treatment along with panic attacks or sometimes also declined to be his marker. Panic attack symptoms include shortness of breath, chest pain, dizziness, palpitations and / or feeling out of control. Sometimes a feeling of restlessness that can trigger hot flashes occur prior to the attack. 
 

Anxiety may be associated with depression. Severe symptoms are often, medication, relaxation techniques, can be treated with one of several methods, such as psychotherapy or stress reduction techniques. 
 
Help search

Some people are troubled by mental problems or embarrassed to explain, but no one should suffer in silence. How accurate and complete personal and family information, if given, doctors will help it immensely. Many family physicians are not adequately trained in the treatment of mental problems but are knowledgeable and helpful. In some cases, it may be useful to consult a mental health professional. In the presence of special circumstances such as marital problems or eating disorders should be taken of the views of experts on this issue. 

 
Symptoms vulvovagina
 
at least one third of women throughout their lives vulvovagina region (external genitals and vagina) about uncomfortable situations live. These conditions can vary from mild discomfort from daily activities and often restrictive disorders vaginal discharge, irritation, burning, dryness, itching, or occur with symptoms such as pain.
 
There are many causes of vulvovaginal complaints;
  • Created by fungus infections.
  • Bacterial vaginosis (vaginal bacterial overgrowth is a result of some fishy smelling discharge occurs).
  • Sexually transmitted diseases (gonorrhea, chlamydia, herpes). These vaginal inflammation, 
  • discharge can lead to pain and intent.
  • condition of the skin; such as eczema or vulvar lichen sclerosis (crusting of the skin, dandruff) can cause itching and irritation.
  • Some bowel diseases (Crohn’s disease or inflammatory bowel disease).
  • Pelvic radiation therapy can cause severe vaginal dryness and irritation. 
  • Damage to the pelvic nerve fibers can burn or pain in the vulva (vulvodynia).
  • Soap, bath foam, spermicides, condoms, hygienic spray or deodorant tampons and pads in allejik reactions to chemicals.
  • Buffer or diaphragm, cervical cap, such as vaginal birth control causes irritation to stay longer than the norm.
Menopause can also cause symptoms of vulvovaginal complaints but can not or may not be as disruptive as in all women after the menopause for many years in some. menopausal women with estrogen levels fall. Thus vulva and vagina causing a thinning and drying out of the tissue lining, loss of elasticity occurs (atrophy).Vaginal secretions decreases and causes a decrease lubricity. The reduction of estrogen, vaginal acid-base balance is disturbed. Acidic vaginal pH leads to a healthy increase in the infection of the vagina is more sensitive to the environment by making it alkaline. 
 
problems can worsen if left untreated and inflammation may occur in the vaginal tissue. This condition is known as atrophic vaginitis. Fragile vaginal tissue damaged by sexual intercourse or pelvic examination, are more likely to rupture and bleeding. The resulting pain can worsen sexual intercourse as it becomes increasingly be impossible. Sexually active women who may be suffering from vaginal dryness and itching, and these symptoms can be worsened in recent years.
 
The transition to menopause in women decreased during the period of vulvovaginal problems need to know that due to estrogen. These women should be evaluated by a physician to investigate the cause of your symptoms. During and after the menopause transition all women vulvavajinal deyatl and a regular health assessment to be made. 
 
Treatment
 
Nonhormonal prescription vaginal lubricants and moisturizers are used for the treatment of vaginal dryness. Water based vaginal lubricants reduces friction and reduces discomfort in the relationship. Unlike moisturizers lubricant directly to relieve dryness and thus affecting the texture. Humidifiers irritation and burning complaints may be preferred by women who have sex outside of these products because they maintain the acidic environment of the vagina and helps to prevent the formation of recurrent vaginal infections.
Lubricity required, specially designed products for vaginal use is preferred. A lot of hand and skin creams that contain alcohol or perfume because they do irritate the vaginal tissue-like substances. Oil-based products may also cause irritation. It also can damage the condom and diaphragm, and sticking to the walls of the vagina can cause infection environment. The only exception in this case can be vitamin E oil. Vitamin E oil of slipperiness caused no side effects have been shown to provide relief of vulvovaginal itching and irritation of the complaint.
If shortness massage at the entrance during sexual intercourse, masturbation or partner other techniques such as compassion may be more appropriate. Regular sexual stimulation by stimulating the blood flow to the genital area is useful in protecting the health of the vagina.
 
Vagina vinegar, yogurt or lactobacillus cultures are not useful in the implementation of the method and is not recommended moisturizer. Drugs used in the treatment of allergy (antihistamine tablets) have a drying effect in all membrane-covered tissue, including vaginal tissue. In addition, soaps, bath oils and bubble bath should be advised to limit their.
 
Vaginal dryness and atrophy of estrogen therapy because estrogen deficiency often is the cause of the problem. Estrogen therapy is effective in correcting the thickness and elasticity of the vaginal tissue, creating a healthy vaginal pH and eliminate vaginal dryness. Improvement usually occurs after 1-2 weeks after starting treatment, but relief from the severe atrophy may take much longer. estrogen dose is enough activity in all products. Systemic (oral administration to form affects the whole body through the bloodstream), or in nonsistemik (direct vaginal application, at low doses, to reduce blood levels and side effects) can be used. If severe vaginal atrophy, vaginal estrogen forms (cream, tablet, or ring) is more effective than oral tablets or skin adhered to the adhesive tape. 
 
Vaginal estrogen therapy is also suitable for long-term absorption into the bloodstream because it is very small. Female reproductive system has been operated due to cancer, hot flushes and other menopausal related conditions, effective, if not non-vaginal, vaginal estrogen therapy may be a short-term option. Pros and cons should be weighed for each patient, and the patient should be discussed. vaginal lubricant or moisturizer when using estrogen therapy may be required. Sometimes when estrogen than healthy tissues state received hormone therapy can be interrupted and necessary lubricant or moisturizer can be used alone.