climacteric

The title of this article is ambiguous. A description of fruit ripening under the influence of ethene can be found under climacteric (botany) .

The climacteric (from Greek climaktér "step ladder, critical point in life") describes the years of hormonal change in women (as well as in cows of pilot and killer whales ) , in German earlier also called step years , before and after menopause with the transition from the reproductive to the postmenopausal phase. This period of time associated with the decline in gonadal function is also known as menopause .

Beginning

Some women have menopause as early as 40, others only in their mid-50s. Most women have passed menopause by 58. If the ovaries are surgically removed, the climacteric starts immediately. If the menopause begins before the age of 40, one also speaks of the climacterium praecox ("premature menopause") in medicine .

The climacteric is divided into

• Premenopause, the decrease in the progesterone level leads to the appearance of the first irregular or occasionally missing menstrual cycles
• Menopause , the ovaries stop producing and menstruation ceases for good
• Perimenopause , the period between pre- and post-menopause
• Postmenopause , about twelve months after the last spontaneous menstruation

The most important hormonal change is the decrease in the amount of estrogen , which is produced in the ovaries and which regulates the menstrual cycle. At the onset of the menopause, the estrogen level drops significantly. The menopause often leads to fluctuations in the menstrual cycle : the bleeding becomes heavier or weaker, the intervals between smaller or larger, there may be intervals of a few months before the bleeding then stops. The fertile time in a woman's life ends with the permanent absence of the menstrual period.

complaints

Classification according to ICD-10
N95.8	Other specified climacteric disorders
ICD-10 online (WHO version 2019)

Symptoms that can occur during menopause are also summarized in medicine under the term climacteric syndrome. The most common symptoms during menopause are hot flashes , sweats , lack of libido , atrophy of the vaginal skin with corresponding dryness, which can lead to pain during intercourse , vaginal inflammation and bleeding. Even if the exact mechanisms are still unclear, the hormone estrogen appears to be a crucial messenger substance in hot flashes. In particular, hot flashes and sweats at night can lead to sleep disorders, which in turn can lead to psychological changes.

Other symptoms that can occur during menopause are dizziness , lighter fatigue, lethargy, palpitations , irritability, aggression, nervousness, increased vulnerability ( vulnerability ), mood swings to depression , decreased self-esteem, impaired memory , poor concentration, urinary incontinence , constipation , Diarrhea , dry skin, dry mucous membranes, heart problems, weight gain, joint and muscle pain, hair loss , increased hair growth on the face, prolonged menstruation (up to four weeks). In addition, the hormonal change, especially the decrease in estrogen, promotes the occurrence of osteoporosis . Changes in metabolism and associated diseases such as diabetes mellitus are also  observed. Many of the symptoms disappear again after the menopause, the increase in body mass, visceral fat, and abdominal and hip circumference still burden many women postmenopausally.

treatment

Plant preparations such as black cohosh , monk's pepper , red clover , yarrow , soy or Siberian rhubarb can be used to relieve vegetative complaints, such as hot flashes . Taking anticholinergics can also relieve menopausal sweats. Active ingredients such as bornaprine or methanthelinium bromide come into consideration here. There are scientific studies that indicate that melatonin can relieve the neurovegetative symptoms in menopause.

The benefits and harms of local or systemic hormone replacement therapy are controversial. Clinical studies showed that hormone replacement therapies for symptoms such as hot flashes and vaginal dryness had the best effects. On the other hand, hormone replacement therapies have been linked to an increased risk of various diseases such as breast cancer and heart attacks .

Studies on the lower frequency and severity of menopausal symptoms in Asian women showed that this difference is probably due to the type of diet, since Asian women who had emigrated who had adopted the Western diet suffered from menopausal symptoms in the same way. It is far from that in soy , tofu , green tea or Gojibeeren contained phytoestrogens associated with it. Asian women take around 50 mg of it daily, Western European women often only 5 mg daily.

Premature menopause

Up to four percent of all women enter menopause prematurely. Depending on the medical definition, this can mean that the climacteric occurs before the age of 35 or 40. Premature menopause can have natural causes, for example genetic or autoimmune diseases . On the other hand, they can often be traced back to medical interventions, such as chemotherapy or the removal of the ovaries . Especially when there is still an unfulfilled desire to have children and family planning has not yet been completed, premature menopause can have far-reaching consequences and be psychologically stressful for women.

literature

• Michael Stolberg : From the “gradual years” to “menopause”. The climacteric in the course of time. In: Würzburg medical history reports. Volume 24, 2005, pp. 41-50.
• Jürgen Klauber, Bernd Mühlbauer, Norbert Schmacke and Anette Zawinell: Menopause in hormone therapy - information sources and medical attitudes in practice , Scientific Institute of the AOK, Bonn 2005, ISBN 3-922093-37-X .
• Ludwig Weissbecker: The gonadal insufficiency. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition ibid 1961, pp. 1027-1032, here: pp. 1031 f. ( The climacteric ).

See also

• Menopause virile , period of life in men in which the testosterone level drops rapidly
• menopause

Web links

• German Society for Gynecology and Obstetrics: Consensus Recommendations for Hormone Therapy (HT) in the climacteric and in the postmenopause. ( PDF , 302 kB)
• www.wissenschaft.de: The two faces of estrogen.
• Olaf Ortmann , Claus Lattrich: Therapy for menopausal symptoms . In: Dtsch Arztebl Int . tape 109 , no. 17 , 2012, p. 316-324 ( review ).
• http://www.34-menopause-symptoms.com/early-menopause.htm
• http://www.endokrinologikum.com/fachgebiete/frauenheilkunde/praemature-ovarialinsuffendung.html
• stark- gegen-schwitzen.de

Individual evidence

1. ^ Heinrich Schmidt-Matthiesen, Dietrich von Fournier (ed.): Gynecology and obstetrics. Schattauer Verlag, Stuttgart 2004, ISBN 3-7945-2260-5 , p. 81 ff. (Excerpt from Google Books) .
2. ^ F. Kronenberg: Menopausal Hot Flashes: A Review of Physiology and Biosociocultural Perspective on Methods of Assessment. In: Journal of Nutrition. 140, 2010, p. 1380S, doi: 10.3945 / jn.109.120840 .
3. ^ Sarah Bedell, Margaret Nachtigall, Frederick Naftolin: The pros and cons of plant estrogens for menopause. In: The Journal of Steroid Biochemistry and Molecular Biology. 139, 2014, p. 225, doi: 10.1016 / j.jsbmb.2012.12.004 .
4. ^ S. Khosla: Pathogenesis of Age-Related Bone Loss in Humans. In: The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 68, 2013, p. 1226, doi: 10.1093 / gerona / gls163 .
5. ^ SR Davis et al .: Understanding weight gain at menopause. Climacteric. 2012 Oct; 15 (5): 419-29. doi : 10.3109 / 13697137.2012.707385
6. ↑ Carrie Karvonen-Gutierrez, Catherine Kim: Association of Mid-Life Changes in Body Size, Body Composition and Obesity Status with the Menopausal Transition. Healthcare 2016, 4 (3), 42. doi : 10.3390 / healthcare4030042
7. ↑ Agnieszka Dmitruk et al .: Body composition and fatty tissue distribution in women with various menstrual status. Rocz Panstw Zakl Hig. 2018; 69 (1): 95-101. ( online )
8. ^ R. Sergi, A. Massone, S. Moretto, C. Oggerino, F. Bertolotto, L. Losio, M. Ottonello: Hyperhidrosis treatment with bornaprine in the acute phase of spinal cord-injured patients. In: Spinal Cord. 46, 2008, p. 571, doi: 10.1038 / sc.2008.12 .
9. ↑ Martina Hund, Ronald Sinkgraven, Berthold Rzany: Randomized, placebo-controlled double-blind clinical study on the efficacy and tolerability of oral therapy with methanthelinium bromide (VagantinR) in focal hyperhidrosis. Randomized, placebo-controlled, double blind clinical trial for the evaluation of the efficacy and safety of oral methanthelinium bromide (VagantinR) in the treatment of focal hyperhidrosis. In: Journal of the German Dermatological Society . 2, 2004, p. 343, doi: 10.1046 / j.1439-0353.2004.04765.x .
10. ↑ G. Bellipanni, F. Di Marzo, F. Blasi, A. Di Marzo: Effects of melatonin in perimenopausal and menopausal women: our personal experience. In: Annals of the New York Academy of Science. 1057th volume, December 2005, pp. 393-402. PMID 16399909
11. ↑ N. Parandavar, K. Abdali, S. Keshtgar, M. Emamghoreishi, S. Amooee: The Effect of Melatonin on Climacteric Symptoms in Menopausal Women; A Double-Blind, Randomized Controlled, Clinical Trial. In: Iranian journal of public health. Volume 43, Number 10, October 2014, pp. 1405-1416. PMID 26060703 , PMC 4441894 (free full text).
12. ↑ Guideline Hormone Therapy in Menopause of the AkdÄ 2003 (PDF; 822 kB).
13. ↑ Olaf Ortmann , Claus Lattrich: The treatment of climacteric symptoms. In: Deutsches Ärzteblatt international. Volume 109, number 17, April 2012, pp. 316–323, doi: 10.3238 / arztebl.2012.0316 . PMID 22611453 , PMC 3355503 (free full text) (review).

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !