How do the symptoms of menopause?

Decline in ovarian function (egg) resulted in hormones, especially estrogen and progesterone greatly reduced in our bodies. Lack of estrogen causes these complaints:

Complaints vasomotor

* The volatility of heat (hot flashes)
* Vertigo
* Sweat a lot

Constitutional Complaints

* Palpitations
* Migraine
* Muscle pain, low back pain
* Easily offended

Complaints Psikiastenik and neurotic

* Feeling depressed
* Tired of psychological, somatic tired
* Hard to sleep
* Feeling scared
* Conflict of families, disruption in the workplace

Other complaints - other

* Pain when having sex
* Menstrual Disorders
* whitish, itching in vagina
* Difficult urination
Libido decreased *
* Bone loss (osteoporosis)
* Impaired circulation (miocard infarction)
* An increase in cholesterol, adepositas (obesity-metabolic disorders KH)

The complaints above are not the same in all women. This is due to the biologic effects in tissue hormone estrogen through estrogen receptors in the body derived estrogen receptor alpha and beta. The number of estrogen receptors alpha and beta are not the same in every woman and any individual reaction due to low estrogen causes menopausal symptoms differently. Generally, hot flushes, insomnia, 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 allowed to interfere with daily activities and reduce quality of life for women.

Influential Factors Against Menopause Symptoms

Psychic factor
The changes are psychologically and physically associated with estrogen levels, a prominent symptom is the reduction of energy and passion, reduced concentration and academic ability, the emergence of emotional changes such as irritability, insomnia, feeling of lack, a sense of solitude, fear of malignancy, can not wait anymore, etc. . These mental changes vary from woman's ability to adapt.

Social economy
Social and economic conditions affect the physical factors, health and education. If the factors above is good enough, will reduce the burden of physiological, psychological. Health climacterium will factor as a physiological factor.

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

Other Factors
Women who are not married, both career women who have or have not married, menarch a late effect on complaints of mild climacterium.
Organic Changes In The climacterium
Changes in reproductive organs

The uterus (womb)
Shrink the uterus, in addition caused atrophy of the endometrium is also due to fluid loss and changes in connective tissue form 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 wrinkle, endosalpingo thin horizontal and cilia disappeared.

Cervical (cervix)

Cervical will shrink until completely covered with the vaginal wall, cervical kripta become atrophic, the cervical canal shortens, so as to resemble the size of the cervix during the adolesen fundus.

Vagina (vagina pubic)

Occurrence causing the loss of rugae vaginal thinning reduced vascularity, reduced elastistik, vaginal discharge becomes watery, piknotik kario index decreased. Ph vagina increased because poor growth Donderlein bacilli that cause increased cellular glycogen, thereby facilitating the occurrence of infection.
Joined with the shortened urethral contraction of the vagina, so meatus eksternus urethritis and weaker arise karankula formation.

Basic hip

Strength and elastistik disappeared, because of atrophy and weakness of power caused chock utero vaginal prolapse.

Perineum and anus
Subcutan fat disappears, the surrounding muscle atrophy disappeared causing spincter tonus weakened and disappeared. Alvi incontinence often occurs vagina.

Gallbladder urinary (bladder)
Looks spincter control and detrusor activity is lost, so often urinate involuntarily.

Breast gland

Subcutan absorbed fat, atrophy of parenchyma tissue, the lobules shrink, thicken fibrous connective tissue stroma. Erectile nipples shrink less, pigmentation is reduced, so that the breast becomes flat and loosened.
Changes outside the reproductive organs

Adiposity (fat storage)

The spread of fat found in the upper leg, hips, lower abdomen and upper arms.
Found 29% of women climacterium showed a slightly increase body weight and 20% increase is striking. Allegedly there is a correlation with the decrease of estrogen and the basic substance exchange disturbances of fat metabolism.

Hypertension (high blood pressure)

The existence of hot flushes occur an increase in blood pressure both systole and diastole. It is known that two thirds of hypertensive patients is a primary esential women between 45-70 years who know the beginning of increased tension is most prevalent during climacterium forever. Increased blood pressure at age climacterium occur gradually, then settled and the tension is higher than the previous.

Hiperkolesterolnemia (high cholesterol)

Decrease or loss of estrogen lead to elevated cholesterol levels. 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 etiology of atherosclerosis.

Atherosclerosis

The presence of hypertension and increased cholesterol levels lead to increased risk factor for atherosclerosis. Particularly on primary coronary sclerosis and myocardial miocard will occur 1-2 times more frequent after estrogen levels decline.

Virilization (growth of fine hairs)

The decrease of estrogen in the blood of the effect of androgens causes signs of defeminisasi differentiation and masculinization. This is related to the ovaries themselves form the character of androgen oestrone.

Osteoporosis (porous bone)

With the decline in estrogen levels, then the process is functioning osteoblasts form new bone is inhibited and bone damage increased osteoclast function. Due to old bone is absorbed and destroyed osteoclast but no new bone formed by osteoblasts, so that the bones become osteoporotic.

How menopause therapy?

The principle of treatment is to give estrogen from menopause or known outside Hormone replacement therapy (HRT) or call in Indonesian is hormone replacement therapy (HRT).
The basic principle of TSH:

1. women who still have a uterus, the estrogen should always be combined with progesterone. The objective is the addition of progesterone to prevent endometrial cancer.
2. women without a uterus, then simply giving estrogen alone and estrogen is given continuously (without break)
3. in perimenopausal women who are still menstruating and still menginkan menstruation, TSH given sequentially. Postmenopausal women who still want to menstruation given sequentially, unless otherwise occur given a continuous period. While those who do not want your period is given continuously.
4. type of estrogen used was a natural estrogen and progesterone are also natural.
5. administration always starts with a low dose
6. can be combined with androgen or given by TSH which have androgenic properties.

The way of TSH:

* Oral
* Trasdermal
* Spray your nose
* Implants (implant)
* Vaginal (vaginal cream)
* Sublingual
* Intramuscular

Side effects of TSH
This is mostly caused by high estrogen doses.

1. Breast Pain
2. Weight gain
3. Discharge and headaches
4. Bleeding

Giving the hormone estrogen as hormone replacement therapy, to replace the hormones estrogen or less, have been studied and eliminate complaints of estrogen deficiency clinically well after 2-3 weeks of the high estrogen dose and 4-5 weeks delivery on low-dose estrogen. Increased bone density in the delivery of natural estrogen + progesterone + calcium + vit. D, will increase from 4.1 to 5.8% according to research by Rachman IA, did not differ much with the research PEPI (Post Menopause Estrogen / Progesterone Investigator) of 4-5%. In addition, estrogen / progesterone naturally improve fat metabolism, which increases levels of HDL (good cholesterol) and lowers LDL (bad cholesterol) up to ± 70%, and reduce the occurrence of bone fractures between 40-60%.

In today's world of the hormone estrogen + progesterone 5-year limited by strict control, because research in the United States by the WHI (Woman Health Initiative) found 33.8% of breast malignancies, stroke 49.1%, 125.3% thromboembolism, cardiology problems 34.4%. Although on the bright side eliminating complaints of estrogen deficiency, prevent the incidence of colon malignancy 32.8%, 17.4% and prevent osteoporosis osteoporotic fracture 29.3%. The greatness of estrogen + progesterone drug as TSH improve complaints that interfere with estrogen deficiency clinically elderly mother's life has been proven, so the increase in quality of life for the elderly mother of the prime, but the limitation of 5 years (there is a proposed 7 years) is a separate issue that to look for a replacement drug. Other medications such as combined bisphosphonate, SERM group clearly improve and increase bone density, but does not improve the quality of mothers in full even though followed by gymnastics burden that only reduces the estrogen deficiency is a clinical complaint. To these researchers, start looking for a natural estrogen replacement is considered to take over the position of estrogen as HRT, but safe does not lead to malignancy, bleeding but increases bone density and quality of life of the mother is a class of phytoestrogens (estrogens from plants) that resemble the chemical formula of estradiol ), which is currently considered as a supplement.

Currently, class phytoestrogens have been studied around the world including Indonesia, because of phytoestrogens found in soy beans, fruit peel bangkwang a brownish color. In the world famous from the combined plants containing 4 red clover isoflavones (genestein, daidzein, formononetin, and biochanin A) and black cohosh can grow well in Mexico with high levels of isoflavones. At that time, some researchers in Indonesia trying to plant in Indonesia.

Phytoestrogens as alternative menopausal treatment

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 are relatively expensive price it is necessary to look for other alternatives in lieu of TSH that can meet the criteria of a natural, inexpensive, derived from plants, effective and acceptable to the menopausal women. Another alternative is phytoestrogens.
Fito means the plant, while the mean has a chemical structure estrogen and estrogen-like biological properties.
The chemical structure of phytoestrogens, while most of the non steroidal estrogens generally are steroids.
Phytoestrogens consists of:

* Isoflavones (genistein, daidzein and glycetein)
* Coumestan (coumesterol)
* Lignans (matairesinol, secoisolariciresinol, enteroldiol)

Isoflavones are found in

* Legumes (legumes, especially soy milk with other dairy products, tofu, tempeh and miso)
* Lignans in fruits, vegetables, grains (cereals)
* Comestan in Redclover and bean sprouts

In addition, the patient refused to use HRT because of fear of breast cancers arise due to estrogen.

Recognize Early Symptoms of Stress

Everyone has certain times when they feel uncomfortable with him or trying to fight very hard in the face of a condition. It's just endurance per individual is different.

All human beings without exception have the same risk of depression leading to a more severe psychiatric illness. Legislative candidate (candidates) are the most talked about during this election, are experiencing it in the face of failure.

One of the most easily recognizable sign is if a particular state managed to make you forget about the various aspects of life. Maybe the decision to see a doctor psychiatric experts is the most appropriate decision.

American Psychiatric Association, said some of the symptoms that can be a sign of the need for assistance from experts, among others:

* Feeling tense all the time, or afraid of things that are irrational or unreasonable.
* Feelings of sadness or depression that settled.
* Changes in mood or mood is significantly inconsistent with the previous character.
* Feeling difficult to deal with the condition or daily responsibilities.
* Experiencing delusions or thought unusual.
* Experiencing changes in diet and sleep habits.
* Divert attention to drugs or alcohol.
* Feeling very angry or prone to violence.
* Thinking about the possibility of suicide.
* If you feel these symptoms, immediately seek help.