Symptoms Of Menopause

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Before I was a little cuplik what is meant by the menopause. A woman called into or
through the menopause when menstruation is not relevant anymore in a span of 12 months.
Age when a woman enters menopause is still a heated debate, but as holding several experts
in the field to give the age of menopause is between 45 to 55 years.
So what happens when women enter menopause? For information, symptoms and signs of
menopause experienced by a woman is very individual. For a robust woman, they will not
be too much to feel symptoms when entering menopause, otherwise a rather 'sensitive'
complaints will feel great both physically and mentally. Some of the signs and symptoms
include:

Bleeding
Bleeding here is bleeding from the vagina. Unlike the arrival of regular menstrual, bleeding
that occurs in menopausal women is irregular. These symptoms appeared mainly at the start
of menopause. Bleeding will appear several times in the span of several months and then
stopped altogether. Since the emergence of early menopause, these symptoms often
referred to as transitional phenomena.

The heat and sweat the night

Burning sensation often experienced women who entered menopause. This feeling is often
perceived from the face of spreading throughout the body. Heat is often accompanied by
redness of the skin and sweating. This feeling is often the case for 30 seconds up to several
minutes. Although the explanation of this phenomenon is not known with certainty but is
thought to occur because of the hormones estrogen fluctuations. As is known, at the time of
menopause, estrogen hormone levels in the blood will drop sharply and therefore
contributes to some body functions controlled by these hormones.
Until now has not found a method to estimate at what age this phenomenon will appear and
when it will end. This burning sensation has occurred even before a woman enters
menopause. These symptoms will disappear within 5 years at around 80% of women, the
rest will continue to experience up to 10 years.
Unfortunately, in addition to feeling hot and flushed, suffering menopausal women who
were also supplemented with sweating at night. These symptoms will certainly disturb the
sleep that causes women who experience it will always lack of sleep.

Vaginal symptoms
Symptoms of the vagina arising from changes in the vaginal lining. The vagina becomes
dry and less elastic due to the decrease in estrogen levels. In addition came the itching of
the vagina and the more severe is the pain during intercourse. Changes in the vaginal area
also resulted in menopausal women prone to vaginal infections.

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Symptoms urination
Changes that occur in the lining of the vagina also occur in the urethra tract. Urethra is the
channel that channel urine from the bladder to the outside of the body. The channel will
also dry up the urethra, thinning and reduced keelastisannya result of decreased estrogen
levels. This change will cause menopausal women prone to urinary tract infections, always
wanted to pee and wetting.

Emotional and cognitive symptoms

Women who will be entering menopause often experience emotional and cognitive
symptoms are varied. These symptoms include, mental fatigue, memory problems,
irritability, and mood changes that take place quickly. Very difficult to know which
symptoms are influenced by hormonal changes. These emotional changes are sometimes
not recognized by the woman who was the menopause, so need a special approach to this
problem. This approach is to convince the woman to what was suffered. Cold sweat that
appears also to suggest the physical exhaustion resulting from lack of sleep.

Other physical changes

Other physical changes include changes in body fat distribution in menopausal women
where the fat deposits on the hips and abdomen. Changes in skin texture, skin wrinkles, and
sometimes accompanied by acne.
After all this time discussing the human body fresh, fresh, not what it once Khan discusses
elderly. We can not close my eyes, we soon will.

Complaints vasomotorik
• fluctuation of heat (hot flashes)
• Vertigo
• Sweat a lot

Constitutional Complaints
• palpitations
• Migraine
• muscle pain, back pain
• Easily offended

Complaints Psikiastenik and neurotic

• Feeling depressed
• Tired of psychic, somatic fatigue
• It's hard to sleep
• Feel the fear
• family conflict, disruption in the workplace

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Other complaints - other
• Pain when having sex
• menstrual disorders
• Keputihan, itching in the vaginal
• hard pee
• decreased libido
• Bone loss (osteoporosis)
• circulatory disorders (myocardial miocard)
• rise of cholesterol, adepositas (obesity, metabolic disorders KH)

The complaints above are not the same in all women. This is due to biological effects of
estrogen hormones in the network through the estrogen receptors in the body derived alpha
and estrogen receptor beta. The number of estrogen receptors alpha and beta are not the
same in every woman and any individual reactions due to low estrogen causes menopausal
symptoms differently. Generally heat fluctuations, difficulty sleeping, anxiety, irritability,
forgetfulness, spinal pain is felt in nearly the majority of menopausal women.

Long-term consequences that must be observed in menopausal women is osteoporosis

(brittle bones), coronary heart disease, stroke, and dementia.
If this condition is left can disrupt daily activities and reduced quality of life of women.

Factors affecting Menopause symptoms

Psychic factor
Psychological changes and physical levels are associated with estrogen, the symptoms are
less prominent and passionate energy, reduced concentration and academic ability,
emotional changes such as the emergence of irritability, difficulty sleeping, feeling lack, a
sense of loneliness, fear of malignancy, can not wait anymore, etc. . Psychic changes varies
depending on the woman's ability to adapt.

Socioeconomic
Socio-economic conditions affecting the physical factors, health and education. When these
factors on well enough, will reduce the burden of physiological, psychological. Health will
klimakterium factor as physiological factors.

Culture and environment

The influence of culture and environment have been proved to greatly affect a woman can
or can not adjust to klimakterium early phase.

Other factors
Unmarried women, both career women who have or have not married, the late menarch
affect klimakterium complaints are minor.

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Organic Changes In The Klimakterium
Changes in reproductive organs
The uterus (womb)
Uterus shrink, but also caused atrophy of the endometrium due to loss of fluid and tissue
deformations intertesial. Muscle fibers thickened myometrium, myometrial blood vessels
thickened and prominent.

Fallopian tubes (egg line)

Folds - the folds of the tube becomes shorter, thinner and contract, flat and thin
endosalpingo cilia disappear.

Cervix (cervical)
Cervical be covered by the contract until the vaginal wall, cervical kripta be atropik, the
cervical canal is shortened, so that the size of the cervix during the adolesen fundus.

Vagina
Occurrence of depletion causes loss of rugae vaginal vaskularisasi reduction, which
reduced elastistik, vaginal secretions become diluted, kario piknotik index decreased.
Vaginal ph increased because of growth inhibition of bacillus that causes Donderlein
increased cellular glycogen, making it easier for infection.
Urethra is shortened by the shrinking part of the vagina, so the meatus externus arises
urethritis and weaker karankula formation.

Basic hip
Strength and elastistik disappeared, because of atrophy and weakness due to the prop
prolapsus vaginal utero.

Perineum and anus

Subcutan fat disappears, muscle atrophy surrounding the cause tone disappeared spincter
weakened and disappeared. Alvi incontinence often occurs vagina.

Vesica urinary (bladder)

Looks spincter activity and detrusor control is lost, so often urinated involuntarily.

Breast gland
Fat absorbed subcutan, parenchymal tissue atrophy, shrink lobules, fibrous connective
tissue stroma thickened. Nipples shrink less erectile, pigmentation is reduced, so that the
breast becomes flat and relax.

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Changes outside the reproductive organs
Adipositas (fat accumulation)
The spread of fat found in the legs over, hips, lower abdomen and upper arms.
Found 29% of women showed an increase klimakterium a little weight and a 20% increase
in striking. There alleged relationship with the decline of estrogen and the exchange of
substance disorders of fat metabolism.

Hypertension (high blood pressure)

The existence of heat shocks occurred an increase in blood pressure both systole and
diastole. Given that 2 / 3 of primary hypertension is esential between 45-70 years old lady
who knows the beginning of the increase in blood pressure occurs most times klimakterium
Salama. Increased blood pressure at age klimakterium occurs gradually, and then settled
and the tension is higher than before.

Hiperkolesterolnemia (high cholesterol)

The decrease or loss of estrogen causes increased levels of cholesterol. Increased levels of
cholesterol in women 10-15 years occurred more slowly in men. Increased levels of
cholesterol which is a major factor in the cause of arterosklerosis.

Atherosclerosis (blood vessel walls perkapuran)

The presence of hypertension and increased cholesterol levels lead to increased risk factors
for the occurrence of atherosclerosis. Particularly on primary coronary sclerosis and
myocardial miocard will occur 1-2 times more often after declining estrogen levels.

Virilization (growth of fine hairs)

Drop in estrogen in the blood of the effects of androgens causes signs of defeminisasi
differentiation and masculinization. This is related to the ovaries themselves form which is
androgen oestrone.

Osteoporosis (bone loss)

With the decline in estrogen levels, then the process of osteoblasts that form new bone
function and inhibited osteoclast function increases bone damage. As a result of old bone is
absorbed and destroyed osteoclast but not the new bone formed by osteoblasts, so that the
bones become osteoporosis.

How menopause therapy?

The principle of menopause treatment is given from outside or estrogen known as Hormone
replacement therapy (HRT) or call in Bahasa Indonesian is hormone replacement therapy
(HRT).

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TSH granting basic principles:
1. women who still have a uterus, it must always be of estrogen combined with
progesterone. The purpose is the addition of progesterone to prevent endometrial cancer.
2. women without a uterus, it is enough of estrogen alone and estrogen is given by continue
(without break)
3. in perimenopausal women who are menstruating and still menginkan period, given in
sequential HRT. Postmenopausal women who still want to be a sequential period, except if
no period is given by continue. While that does not want kontinue given period.
4. type of estrogen used is a natural estrogen and progesterone is also a natural.
5. giving always start with a low dose
6. can be combined with androgen or provided with a TSH which have androgenic
properties.

How to giving TSH:

• Oral
• Trasdermal
• Spray the nose
• Implants (implant)
• vaginal (vaginal cream)
• sublingual
• intramuscular

Side effects giving TSH

This is largely due as high doses of estrogen.
1. Breast pain
2. Weight gain
3. Discharge and headaches
4. Bleeding
Giving the hormone estrogen as hormone replacement therapy, to replace the lack of the
hormone estrogen, has been investigated and eliminated estrogen deficiency clinical
complaints well after 2-3 weeks of delivery in high-dose estrogen and 4-5 weeks delivery in
low-dose estrogen. The increase in bone density of estrogen + natural progesterone +
calcium + vit. D, will increase by 4,1-5,8% Rachman IA research, not unlike many of the
research Pepi (Post Menopause Estrogen / Progesterone Investigator) is 4-5%. Addition of
estrogen / progesterone naturally improve fat metabolism, which increases levels of HDL
(good cholesterol) and lowers LDL (bad cholesterol) up to ± 70%, and the pressure of bone
fractures between 40-60%.

In today's world hormone estrogen + progesterone 5-year limited with strict controls,
because research in the United States by the WHI (Women Health Initiative) found 33.8%
of breast malignancies, stroke 49.1%, 125.3% thromboembolism, cardiology problems
34.4%. Despite the good side, eliminate the complaints of estrogen deficiency, prevent the
occurrence of colon malignancy 32.8%, 17.4% prevent osteoporosis and osteoporosis
fractures 29.3%. The greatness of a drug as estrogen + progesterone HRT to improve
complaints estrogen deficiency clinically disturbing elderly mother's life has proven, thus

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improving the quality of life of elderly women prime, but the 5-year limitation provision
(there is a proposed 7 years) is a separate issue have sought a replacement drug. Other
drugs such as joint bisfosfonat, SERMs groups clearly improve and increase bone density,
but did not improve the quality of mothers in full even if followed by exercises that merely
reducing the burden of clinical complaints of this estrogen deficiency. To these researchers,
began to replace natural estrogen is considered to take over the position of estrogen as
HRT, but safe does not cause malignancy, bleeding but increases bone density and quality
of life of the mother are the ones phytoestrogens (estrogens from plants) that resemble the
chemical formula of estradiol ), which is currently considered as a supplement.

Currently phytoestrogens have been studied groups around the world including Indonesia,
because phytoestrogens found in soy beans, fruit leather that bangkwang brown color.
Famous in the world of composite plants containing red clover isoflavones 4 (genestein,
daidzein, formononetin, and biochanin A) and black cohosh can grow well in Mexico with
high isoflavone content. At that time several researchers in Indonesia trying to grow it in
Indonesia.

Phytoestrogens as an alternative treatment of menopausal

Given the many obstacles in the use of TSH as the fear of breast cancer, should be used
long term, the number of side effects and a high price is necessary to find other alternatives
as penganti TSH that can meet the criteria for a natural, cheap, comes from plants, effective
and acceptable to menopausal women. Another alternative is phytoestrogens.

Fito means plant estrogen while the point has the chemical structure and biological
properties like estrogen.

Chemical structure of phytoestrogens most steroids, while estrogen is not usually a steroid.

Phytoestrogens consist of:

1. isoflavones (genistein, daidzein and glycetein)
2. coumestan (coumesterol)
3. lignans (matairesinol, secoisolariciresinol, enteroldiol)
4. Isoflavones commonly found in legumes (especially soybeans legumes with processed
dairy products, tofu, tempeh and miso)
5. lignans in fruits, vegetables, whole grains (cereals)
6. comestan in Redclover and bean sprouts

In addition the patient refuses to use HRT for fear of breast cancer occur due to estrogen.

Recent research shows that women who reach menopause early stage is very difficult to
admit to sleep.

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The researchers interviewed 110 women. Everything is old healthy female average age 49
years. They all experienced their last menstruation at least three years.
In these studies most women experience a sense of heat accompanied by sweating, both day
and night, dry vagina, insomnia, problems with mood and forgetfulness.

Respondents were asked about menopausal symptoms for several weeks and how severe
the symptoms that occur, this is their answer:
1. 94.5% had difficulty sleeping
2. 92% felt to be forgetful
3. 87% became quick-tempered
4. 85.5% night sweats

Most respondents answered, the most severe symptoms and often happens is that sleep
problems, night sweats and become more short-tempered.
Judith A. Berg, PhD, who examined it in the Journal of Clinical Nursing WebMD quoted
saying that the study of women who look young enough and have since forgotten memories
of their last menstrual period was shorter than the previous.
It is known that heat is accompanied by sweating as the progress of menopause and other
symptoms appear much more severe in early menopause.

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