Post Date August, 05 2023
Amenorrhea is a normal physiological change of women, but there are also abnormal cases of amenorrhea that need attention and Curative care according to their own conditions.
Classification of menopause
1. Natural amenorrhea: The follicles in the ovary are used up, and the rest of the follicles lose their response to Gonadotropin. The follicles no longer develop and secrete estrogen, which cannot stimulate the growth of the endometrium.
2. Artificial amenorrhea: refers to the surgical removal of both ovaries or other methods to stop ovarian function.
Causes of early amenorrhea
1. Amenorrhea caused by environmental factors is a temporary endocrine dysfunction, and menstruation below 6 months can generally recover naturally.
2. Preoperative fear of excessive mental tension and anxiety, fear of abortion, and the burden of not being able to conceive and have children, especially the shame of getting pregnant before marriage. This emotional state cannot be changed after surgery, which may lead to amenorrhea.
3. Women who prematurely cohabit and bathe after surgery may cohabit with their husbands a few days later, or do not follow the doctor's instructions to bathe. Bacteria may invade the vagina and uterus, and uterine infections may cause menstrual irregularities and amenorrhea.
4. Ovarian amenorrhea and other amenorrhea are very common, such as withdrawal syndrome, Ovarian cyst, ovarian tumor, polycystic ovary syndrome, ovarian anovulation caused by endocrine dysfunction caused by various reasons of premature ovarian failure.
5. The longer the breastfeeding time, the later the amenorrhea, which is related to the length of breastfeeding. This is because women's ovulation is inhibited during lactation, with longer lactation time and fewer ovulation times, resulting in later amenorrhea. Conversely, shorter lactation time leads to earlier amenorrhea.
6. Women who frequently undergo induced abortions have their endometrium scraped thin several times a year and cannot recover in a short period of time. If the endometrial base is completely damaged, it can lead to permanent amenorrhea, while partial damage can lead to temporary cessation of menstruation.
7. In addition to amenorrhea, patients such as pituitary amenorrhea also have Sheehan's syndrome caused by postpartum hemorrhage. In addition to amenorrhea, they are also accompanied by hair loss and atrophy in special parts. In addition to amenorrhea, patients with pituitary Prolactinoma are also accompanied by breast milk.
8. Related to fertility status, the older the age of the first pregnancy, the fewer the number of pregnancies and the earlier the amenorrhea. This is because the older the age of the first pregnancy, the fewer pregnancies, the more ovulation times a woman experiences throughout her life, and the earlier amenorrhea occurs.
9. Uterine amenorrhea has not yet been implemented for congenital absence of uterus or complete damage to the endometrium. Patients with intrauterine adhesions should explore the uterine cavity and undergo separation surgery based on the condition of the adhesions. Intrauterine devices should be placed for a few months after the surgery to prevent further adhesions.
Amenorrhea treatment
1. Etiology Sex therapy: the changes of blood estrogen cycle in fertile women, participation in coordinating physiological activities of the body, become an important factor in stabilizing the body environment of women. After menopause, due to the continuous decline of estrogen, women's physical and mental functions are disrupted, and this series of pathological changes can affect women's health. These estrogen deficiencies can cause health problems and must be Curative care.
2. Physiological supplementation: In order to ensure the physiological operation of various organs in the body of postmenopausal women, maintain their health, and restore their endocrine status to the level of the reproductive ovarian cycle, it is not a physiological supplement. Physiological supplement advocates the use of natural estrogen, that is, the chemical structure is estrone, estradiol and Estriol. The dosage should be controlled within a blood E2 concentration of around 220pmol/L, or within a comparable range of estrogen activity, and should not exceed 550pmol/L. Exceeding this level may lead to an increase in side effects. Due to the large dose of estrogen and Progestogen in the contraceptive pill, its strong activity and chemical structure are non physiological, so it is not suitable for physiological supplementation in HRT.
3. During the menopausal transition period, HRT should mainly supplement progesterone: during the menopausal transition period, the growth and development obstacles of follicles gradually increase, and finally functional follicles disappear from the ovaries. The corresponding changes of estrogen and Progestogen in this period are: first, there is a relative deficiency of Progestogen, and then there is a deficiency; Estrogen lacks periodic changes, although there may be a temporary relative high, the total amount gradually decreases, and eventually becomes insufficient, forming a relatively excessive or single non antagonistic estrogen stimulation for a long time. Some women may experience varying degrees of proliferative changes in the endometrium, leading to malignancy. Therefore, in this period, pregnancy hormone is mainly supplemented regularly to adjust the Menstrual cycle and prevent endometrial hyperplasia. With the deficiency of estrogen, supplement with estrogen, etc.
4. In the late stage of amenorrhea, HRT is mainly supplemented with estrogen: in the early stage of amenorrhea, follicular activity in the ovary basically stops. The concentration of estradiol in the blood decreases from about 150-1500 pmol/L during the reproductive period to below 80 pmol/L within 1-2 years, which is lower than the basic level for maintaining the physiological function of the body's organs. Endometrial atrophy is completed within 2-3 years after amenorrhea, with the fastest rate of bone loss occurring within 1-3 years, and corresponding degenerative changes occur in various organs of the body. Therefore, in order to prevent postmenopausal degenerative diseases, it is necessary to immediately and long-term supplement estrogen to combat the side effects of estrogen on endometrial hyperplasia. Uterine patients must add pregnancy hormone.
Menopausal precautions
1. Wear multiple layers of clothing, with cotton products being the best: when getting hot, take off the outer clothes. Also, at the beginning of hot flashes, drink a glass of cold water or cold fruit juice.
2. Wear cotton pajamas to keep the bedroom cool: lay several layers of sheets on the bed. When hot flashes occur, wet the bed sheets on top and remove them.
3. Pay attention to diet: Do not drink alcohol or eat spicy food.
4. Persist in exercise: Some women have found that persisting in exercise can reduce the impact of moisture and help sleep.
5. Eat more tofu: Beans contain substances similar to estrogen, which may help alleviate symptoms such as dampness. You can also drink cold soybean milk at the beginning of hot flashes.
6. Patience: The symptom of menopause is' rabbit tail cannot grow '. It will disappear within 3-5 years at most.
7. Dealing with vaginal dryness: The decrease in desire seems to be related to vaginal dryness. Because vaginal dryness can cause desire pain. There are two types of vaginal lubricants available on the market, estrogen containing and estrogen free water-soluble, which can lubricate the vagina and solve the problem of vaginal dryness in couples' lives.
