Surgical menopause in women: current, how long lasts

Pathological changes in the female reproductive system caused by artificial means is a surgical menopause. Consider its causes, treatment methods and prognosis.

The stoppage of menstruation caused by surgical manipulation, radiation exposure or chemotherapy is an artificial menopause. The pathological condition is characterized by a sharp drop in the level of female sex hormones (estrogens) and the development of menopausal symptoms.

Premature stoppage of menstruation is most often associated with hysterectomy, that is, with the removal of the uterus, regardless of the status of the ovaries (complete or partial removal). After such an operation, 10-15% of women develop menopause within 1-2 months. In 35-40% in 1-3 years and in 50-65% in 4-7 years. The onset of menopause depends on the woman's age and the extent of the surgery. Many gynecological and inflammatory diseases can also lead to an early menopause.

[1], [2], [3], [4], [5], [6]

Epidemiology

Natural menopause occurs in women aged 45-55 years. Epidemiology of surgical menopause has no age dependence. Since this condition develops due to pathological processes in the body.

As a rule, premature termination of hormone production is associated with ovariectomy and hysterectomy. The operation to remove the ovaries and the uterus is performed with malignant lesions of these organs and many other gynecological diseases.

[7], [8], [9], [10], [11], [12], [13], [14], [15]

Causes of the surgical menopause

Forced termination of the work of the bodies responsible for the production of hormones is an artificial menopause. The causes of surgical menopause are most often associated with such factors:

• Ovariectomy (removal of the ovaries without removal of the uterus).
• Hysterectomy (removal of the uterus and preservation of one or both ovaries).
• Ovariectomy with hysterectomy (removal of ovaries and uterus).
• Uterine bleeding of different etiologies.
• Endometriosis.
• Myoma of the uterus.
• Fibroma.
• Polycystic.
• The initiated inflammatory processes.
• Oncological tumors.

Surgical menopause, in contrast to the physiological, is sudden. The body does not have time to adapt to changes in the hormonal background. That is, there is no premenopause, during which the body is reconstructed. The main cause of the violation is an operation intervention, after which a woman is expected to have disorders of varying severity from many organs and systems.

[16]

Risk factors

According to medical statistics, the number of gynecological operations associated with various kinds of diseases is steadily increasing. At the same time, the age of the operated ones decreases, most of which are in reproductive age. The risk factors for surgical menopause are associated with such diseases:

• Fibrosis or uterine myoma (with tumors of large size).
• Hormonal disorders caused by improper use of hormonal drugs.
• Ischemia of the myomatous node.
• Inflammation of the appendages and uterus.
• Endometriosis.
• Cysts on the ovaries.
• Complications after ectopic pregnancy.

Surgical intervention is also indicated in polycystic disease, malignant lesions, tuberculosis, advanced inflammatory processes in the genitals. The operation is aimed at removing the ovaries and / or uterus. After the procedure, menstruation stops, and the symptoms of menopause increase.

[17], [18], [19], [20], [21], [22], [23], [24], [25]

Pathogenesis

Natural menopause is characterized by a gradual decrease in the level of estrogens. This allows the body to adapt to the functioning without sex hormones. The pathogenesis of the artificial climax is associated with a sharp drop in estrogen to zero values within 1-2 days. Because of this, the body does not have time for restructuring. Within a week after the operation, 70-90% of women begin to experience a deficiency of sex hormones - postavariectomy syndrome.

The mechanism of the development of premature menopause after the cessation of the production of estrogens: the endometrium does not develop and there is no ovulation, eggs are not produced, menstruation is absent. This leads to the fact that pathological tissues do not receive make-up for growth, so they atrophy and die.

[26], [27], [28], [29], [30], [31], [32]

Symptoms of the surgical menopause

The time of appearance of symptoms of artificial menopause is individual for each woman. They can develop in a few days or months, or even years after surgery. But in most cases, metabolic-endocrine disorders develop and progress faster than with age-related menopause. 60% of women experience severe menopause, 25% have moderate and 15% have a mild post-ureaectic syndrome. At the same time, 20% of patients have persistent disability and disability.

The main symptoms of surgical menopause:

• Rapid skin aging

Since estrogens are responsible for the production of elastin, collagen and other structural components of the skin, the decrease in hormone production triggers the process of skin withering. The elasticity and elasticity of the skin decreases, dryness and pigmentation appear. Fast wrinkles appear, dryness and fragility of hair, nails are observed.

• The cardiovascular system

Estrogens have a cardioprotective effect. They affect the level of glucose and cholesterol in the blood, prevent the appearance of thrombi and atherosclerotic plaques. With a decrease in their production, this protective mechanism ceases to function. Because of this, the incidence of cardiovascular diseases is increasing. For example, heart attacks and strokes are 4 times more likely to appear in women without gonads.

• Urological disorders

The lack of estrogen pathologically affects the work of the urinary tract. Gradually, the mucous membrane of the urethra and bladder becomes thinner, the ligaments and muscles of the perineum weaken. In 45% of women this provokes urinary incontinence and frequent urinary tract infections. There are also frequent urge to urinate, leakage of urine and pain.

• Osteoporosis

Premature menopause provokes rapid changes in the structure of bone tissue (within 1 year). The density of bones decreases, their fragility increases and, as a result, the risk of fractures increases. In order to prevent this symptom-complication, hormone replacement therapy, calcium and vitamin D intake, and regular physical activity are needed.

• Dryness and itching of the vagina

One of the main symptoms of deficiency of female sex hormones. Humidity of the vaginal mucosa depends on the amount of estrogens. Their reduction leads to thinning of the mucous membranes, itching, burning, painful sensations during sexual intimacy.

• Psycho-vegetative disorders

Hot flushes and night sweats, palpitations - these symptoms develop in 70% of women and only in every fifth they decrease one year after the operation. In addition, there are frequent headaches and dizziness, paresthesia, general weakness and fatigue, reduced ability to work.

• Psychoemotional disorders

There is irritability, emotional lability, sleep disturbances and decreased appetite, tearfulness. It is also possible partial or complete reduction of libido. Such symptoms lead to a depressive state, a feeling of fear and anxiety, of self-doubt.

• Decreased cognition

Female sex hormones are responsible for many metabolic processes in the body, including the brain. They are necessary for the normal functioning of memory and cognitive functions. At a menopause memory impairment and decrease in ability to training is observed.

First signs

In the postoperative period, the first signs of surgical menopause tend to develop gradually. In some women, the symptoms appear after a couple of days, and others only after a couple of months.

The first signs of artificial menopause:

• Increased sweating, especially in the evening and at night.
• Paresthesia and tingling of the skin caused by irregularities in estrogen and progesterone.
• Feeling of heat and its tides up to 10-15 times a day (with this symptom is encountered by about 90% of women).
• Frequent headaches, migraines and dizziness.
• Deterioration of general condition, frequent mood jumps, anxiety.

The above symptoms are manifested in all patients. Through time they become permanent. The second stage of surgical stoppage of menstruation is characterized by such signs:

• The frequency and number of tides increases to 20 or more per day.
• Increased body temperature.
• Sleep disturbances.
• Constant weakness and malaise.
• Frequent changes in blood pressure.
• Sharp set or weight loss.
• Burning, dryness and itching of the vagina.
• Rapid aging and wilting of the skin.

According to statistical data, about 50% of operated women, up to age 35 years old, have severe symptoms of menopause. 20% of patients under the age of 30 suffer from persistent severe complications that lead to disability.

[33], [34]

Stages

The natural climacteric period has three main stages: premenopause, menopause and postmenopausal period. The stages of surgical menopause do not have a preparatory stage, on which the body adapts to the gradual decrease in sex hormones. Instead, there is a sharp stop in the production of estrogens. This entails a number of pathological symptoms that disrupt the normal functioning of many organs and systems.

Stages of postavariectomy:

1. First - estrogens are not produced, there is no menstruation. Many different symptoms appear on the part of many organs and systems. The duration of this period depends on the selected hormone replacement therapy, the age of the patient and the individual characteristics of her body.
2. The second (postmenopause) - its duration depends on the ability of the body to adapt to changes in the endocrine system. The main danger of this stage is that it can significantly worsen the state of health. There can be exacerbations of chronic diseases, various pathologies from the side of the cardiovascular system, thyroid gland and others.

Depending on the stage of the pathological process, a woman is prescribed therapeutic and preventive measures aimed at improving overall well-being.

[35], [36], [37], [38]

Forms

Operational menopause has several types, which depend on what operation was performed. Consider the main types of surgical menopause:

• Ovariectomy without hysterectomy

Removal of ovaries without uterus. A rare, but radical method, in which the ovaries are completely excised. It is most often performed in women of reproductive age with tubo-thoracic formations, oncological tumors in the ovaries, mammary glands or uterus. The consequences of the operation are irreversible, restoration of the functionality of the ovaries is impossible.

• Hysterectomy with oophorectomy

Removal of the uterus with ovaries. A fairly common form of surgical stoppage of menstruation. It is performed with oncologic alertness, cystic changes in the ovaries.

• Hysterectomy

In this operation, the uterus is completely removed, with the preservation of one / both or part of the ovaries after resection.

In addition to the above-described species, there is a radiological climax. It arises from the impact on the ovaries of x-rays (performed with malignant tumors). The pathological condition can arise with radiation therapy, prescribed for pathologies of blood or organs of the pelvic region. With the right approach to treatment, the functionality of the ovaries can partially recover.

Another type of artificial menopause is medical menopause. It belongs to the most sparing and arises from the use of certain drugs. After the treatment, the production of estrogen and the work of the ovaries are completely restored.

[39], [40], [41], [42]

Complications and consequences

The removal of internal genital organs entails certain consequences and complications. In the first days after the operation there is increased sweating, frequent hot flashes, tachycardia. Over time, these symptoms are aggravated. There is nervousness, dryness and itching of the vagina, various skin problems, weight changes, urinary incontinence and much more.

Consequences and complications of stopping the synthesis of hormones:

• Metabolic disorders, decreased hemoglobin levels, aggravation and development of autoimmune diseases.
• Anemia due to a decrease in the level of red blood cells in the blood
• Development of diabetes mellitus.
• Various diseases of the urogenital system (cystitis, colpitis and others).
• Heart ischemia, increased cholesterol, formation of thromboses, arterial hypertension.
• From the musculoskeletal system, the development of osteoporosis is very often observed and the brittleness of bones increases. The destruction of bone tissue after removal of the ovaries reaches 4% per year.
• Various psychoemotional disorders: depression, increased tearfulness, frequent mood swings, irritability.

In addition to the above pathologies, women complain of increased sensitivity of the abdomen, bloody scarlet secretions, changes in the biochemical composition of the blood. Low or no hormones increase the risk of many diseases, which often take a chronic condition.

The possibility of complications depends on the ability of the body to restructure for hormone replacement therapy. In this case, the effects of induced menopause in women 20-30 years old are much heavier than in older patients.

[43], [44], [45], [46], [47], [48], [49], [50]

Diagnostics of the surgical menopause

Menopause is not a disease, but requires medical supervision. Diagnosis of surgical menopause consists of:

• Collection of anamnesis and analysis of the patient's complaints (reasons for the artificial stop of menstruation, the presence of pregnancies, abortions, chronic diseases).
• Gynecological examination, taking swabs, bapsoseva from the vagina. Inspection of mammary glands.
• Laboratory tests (blood test for hormones, biochemistry, analysis for syphilis and HIV).
• Instrumental diagnosis (ultrasound of pelvic organs and mammary glands, measurement of bone density, electrocardiography).

Diagnosis is necessary to determine the stage and state of the body after a complete stop of the synthesis of hormones. Surveys are carried out with differentiation of various pathologies, for the detection of diseases and complications associated with hormonal imbalance, as well as before the appointment of hormone replacement therapy.

[51], [52], [53], [54], [55]

Analyzes

To determine the climax stage and its course, laboratory diagnostics is shown. The tests consist of a biochemical blood test (glucose, cholesterol, calcium, phosphorus), hormone determination, detection of syphilis, and HIV.

To determine the level of hormones, the blood is examined for FSH. Menopause is characterized by a decreased level of estrogen and an elevated concentration of FSH. In surgical menopause, in many patients the estradiol content in the blood is less than 80 pmol / L, the concentration of estrone is higher than estradiol, and the testosterone level is lowered.

An additional cholesterol test may also be performed. At its high values, correction of risk factors of diseases of the cardiovascular system is carried out. In addition, a Pap smear is performed (reveals precancerous or cancer cells in the vagina and cervix), and assess the function of the thyroid gland and coagulogram (blood coagulability).

[56], [57], [58], [59], [60], [61]

Instrumental diagnostics

Instrumental diagnostics are shown to control the woman's condition in the surgical climax. This method consists of:

• Ultrasonic examination of genital organs by means of an intravaginal sensor.
• Mammography for the definition of diseases of mammary glands.
• Cytology is a smear from the cervical canal and the cervical surface.
• Transvaginal ultrasound and endometrial biopsy.
• Osteodensitometry (measurement of bone density).

Particular attention is paid to osteoporosis screening. To do this, ultrasound of the calcaneus is performed. With a low tissue density, the patient is referred for dual-energy X-ray absorptiometry (DEPA). If significant deviations are detected, then a complex of drugs and minerals that restore tissue density is prescribed. Instrumental studies are shown every 2 years to assess the condition of the body.

Differential diagnosis

A complete stop of the synthesis of hormones, caused by surgery requires careful monitoring of the body. Differential diagnosis of surgical menopause is carried out with such pathologies:

• Myocardial dystrophy (occurs with a lack of estrogens and IHD).
• Diseases of the thyroid gland, which are accompanied by various endocrine and immune disorders (weight change, constipation, increased anxiety, increased libido, chronic fatigue).
• Autoimmune disorders and infectious diseases.
• Hyperprolactinemia (increase in the concentration of prolactin in the blood).
• Hyperplasia of the adrenal cortex.
• Pheochromocytomas (hormonal-active neoplasms).
• Psychopathy with panic attacks.

Consultation with an endocrinologist, neurologist and psychoneurologist is mandatory.

[62], [63], [64], [65]

Treatment of the surgical menopause

After the operation to remove the uterus and / or ovaries, a woman faces painful symptoms of the restructuring of the body. Postavariectomy syndrome significantly impairs the quality of life. The treatment of surgical menopause depends entirely on the nature of the operation and the reason for it. All medicines and medicamentous complexes are selected by the attending physician.

For treatment, hormonal and non-hormonal drugs can be prescribed. Hormone replacement therapy is used to prevent and reduce the impairment of the functions of organs and systems associated with a deficiency of sex hormones. This method has a number of absolute contraindications:

• Estrogen-dependent malignant tumors.
• Pathological bleeding from the genital tract of unknown etiology.
• Diseases of the kidneys and liver, violations of the functions of these organs.
• Acute thromboembolic diseases of veins.
• Autoimmune diseases.

In addition to the above prohibitions, therapy with hormones can cause a number of negative reactions. Increased risk of heart attack, stroke, Alzheimer's disease, thromboembolism. There is a possibility of formation of gallstones and the development of breast cancer.

In surgical menopause, combined therapy is most often used. Such treatment involves the use of hormonal and non-hormonal drugs, vitamin complexes and even homeopathy.

Medications

There are different in the effectiveness, composition and form of release of drugs used to treat the deficiency of the synthesis of hormones. Medicines are chosen by the doctor, individually for each patient. It takes into account the age of the woman, the causes of menopause, the presence of chronic diseases. The most commonly prescribed oral tablets, vaginal creams and suppositories, it is also possible to use subcutaneous implants.

If menopause is associated with the removal of the uterus, then prescribe estrogen-containing drugs that restore and maintain a normal state of health.

1. Divigel

Estrogenic agent used for replacement therapy. It consists of endogenous estradiol, which is similar in structure and action to the human. Compensates for estrogen deficiency in women after ovariectomy / hysterectomy. Prevents osteoporosis and other pathological consequences of menopause.

• Indications: elimination of symptoms associated with estrogen deficiency. Artificial and natural menopause. Preventive maintenance of an osteoporosis and a lack of female sexual hormones of any etiology.
• Method of use: the drug is used transdermally for a long continuous or cyclic therapy. The gel is applied to the lower part of the anterior wall of the abdomen or buttock. It is forbidden to apply to the chest, face, genitals or damaged skin. The frequency of application and duration of therapy is determined by the attending physician, individually for each patient.
• Side effects: puffiness, changes in body weight, headaches and migraine, increased blood pressure, emotional lability, decreased libido, breast pain and its malignant lesions, various allergic reactions, nausea, vomiting, decreased liver function.
• Contraindications: hypersensitivity to drug components, hormone-dependent neoplasms in history, vaginal bleeding of unknown etiology, acute thromboembolism of arteries, liver disease. With special care is prescribed for women with endometriosis, disorders of cerebral circulation, pathologies of the cardiovascular system and endometrial hyperplasia.
• Overdose: may occur pain in the mammary glands, flatulence, increased irritability. To eliminate painful symptoms, you need to reduce dosage or stop using the drug.

2. Estrofem

The drug is based on 17-beta-estadiol, that is, natural estrogen produced by the ovaries. Stimulates the normal work of female genital organs. Increases bone density, prevents osteoporosis and bone fractures.

• Indication and method of application: deficiency of estrogen in the climacteric period, after various gynecological operations. Tablets are taken orally. The recommended dosage is 1 tablet once a day, after three months the dosage is revised. 
• Side effects: headaches, hypersensitivity of the mammary glands, swelling. Disorders from the digestive tract, attacks of nausea and vomiting, weight gain.
• Contraindications and overdose: malignant lesions of the mammary glands, bleeding from the vagina of unknown etiology, thrombophlebitis of deep veins, disturbance of baking and porphyria. With special care is used in endometriosis, diabetes, epilepsy, otosclerosis. In case of an overdose, symptoms of digestive disorders occur.

3. Proginova

Hormonal estrogen-containing remedy. Contains a synthetic analogue of human endogenous estradiol - estradiol valeriate. Performs an excellent prophylaxis of postmenopausal osteoporosis and restores hormone levels after ovarian excision.

• Indications for use: hormone replacement therapy after removal of the ovaries and in the climacteric period. Before taking the drug, you need to undergo a gynecological examination and other diagnostic procedures. Packing is designed for 21 days of treatment, 1 capsule per day.
• Side effects: metabolic and pathological disorders on the part of the gastrointestinal tract, tachycardia, blood pressure disorders, headaches, decreased visual acuity, uterine and vaginal bleeding, various allergic reactions, changes in libido.
• Contraindications: individual intolerance of the components of the medication, lactase deficiency, glucose-galactose malabsorption syndrome, hormone-dependent malignant neoplasms.
• Overdose: development of uterine bleeding, vomiting, bouts of nausea. There is no specific antidote, therefore symptomatic therapy is indicated.

4. Ovestin

Pharmaceutical in the composition, which includes the natural female hormone estriol. Helps restore the epithelium of the vaginal mucosa and the pH of the natural microflora, increases local immunity.

• Indications for use: premature menopause, age-related atrophic changes in the vaginal mucosa, urogenital pathologies, prevention of complications after surgeries with access, infertility caused by the cervical factor.
• Method of administration: the preparation is available in the form of tablets, cream and vaginal suppositories. Regardless of the form of release, it should be taken once a day. The course of treatment depends on the medical indications and characteristics of the woman's body.
• Side effects and contraindications: local irritation, itching and burning in the vagina, headaches and increased blood pressure. The drug is not allowed for hypersensitivity to its components, for oncological diseases, liver damage, vaginal bleeding, unspecified etiology.
• Overdose: nausea, vomiting, vaginal bleeding. There is no specific antidote, symptomatic therapy is indicated.

5. Klimen

Combined estrogen-containing drug based on antiandrogen, estradiol valerate and cyproterone acetate.

• Indications for use: replacement treatment of disorders in menopause, psycho-vegetative disorders, prevention of osteoporosis, estrogen deficiency, atrophic processes on the skin and increased dryness of the mucous membranes of the genital organs. Tablets take independently of the cycle phase 1 capsule per day for 21 days followed by a seven-day break.
• Side effects: pain in the mammary glands and the epigastric region, changes in body weight, headaches, frequent mood swings, changes in libido.
• Contraindications: hypersensitivity to the components of the remedy, violations of the liver function, liver tumors, any malignant neoplasms, inflammatory diseases, otosclerosis, diabetes mellitus, thromboembolic processes, lipid metabolism disorders.

6. Divina

A drug for the treatment and prevention of menopause of different origin, as well as disorders of the menstrual cycle. It is used for the prevention of osteoporosis, in the period of postmenopause and with various climacteric disorders. The drug is taken before bedtime, one capsule per day. The duration of therapy is determined by the attending physician.

Side effects are manifested as headaches, discomfort in the mammary glands, tension of the lower extremities. The main contraindication is hypersensitivity to active components, deep vein thrombophlebitis, vascular obstruction, acute and chronic liver damage, estrogen-dependent tumors. It is not prescribed for patients with heart failure, hypertension and endometriosis.

7. Tricequence

Combined drug based on estrogen. It is used for hormone replacement therapy. Normalizes estrogenic insufficiency during menopause, prevents osteoporosis. The medicine is taken 1 capsule per day, the treatment plan and the duration of therapy are determined by the attending physician.

The drug can cause side effects: irregular spotting, tenderness of the mammary glands. Also, headaches, various skin allergic reactions, visual disturbances, thromboses, alopecia, increased blood pressure are possible. The main contraindication is hormone-dependent tumors, violations of liver function, uterine bleeding, porphyria, thromboembolism.

If surgical menopause is associated with endometrial cancer, hormonal medications are not prescribed. For treatment phytopreparations and homeopathic remedies are used. In severe disorders of the genitourinary system, gels, creams and vaginal suppositories are used. All of the above drugs are used only by medical authorization. Independent therapy can exacerbate painful symptoms and worsen a patient's condition.

Medications are taken according to a specially developed scheme. This may be a short-term treatment aimed at preventing menopausal syndrome (urogenital disorders, psychoemotional disorders, hot flashes, headaches). The duration of such therapy is from 3 to 6 months with the possibility of repeated courses. Another treatment option involves long-term use of drugs, for 5-7 or more years. The purpose of such therapy is to prevent late menopause disorders (osteoporosis, Alzheimer's disease, cardiovascular pathology).

Not hormonal drugs in surgical menopause

Despite the effectiveness of hormone replacement therapy, it has a number of prohibitions on the use and side effects. Non-hormonal drugs with a surgical climax have a moderate effect, but they have a minimum of contraindications. Such funds are prescribed by a doctor who selects the dosage and makes a regimen of admission.  

By nonhormonal means plant and homeopathic remedies. Consider the most effective of them:

1. Climacoplane

A homeopathic remedy with active components that have a receptor-modulating effect on estrogens. Normalizes the autonomic functions of the central nervous system, stabilizes the state of the cardiovascular and endocrine systems.

The drug contains a plant extract of tsimicifuga, which affects the hypothalamus, reducing nervous excitement, hot flashes with menopausal disorders. Normalizes the hormonal balance in the adrenal cortex, pituitary gland and genital organs. Another component of the drug is Ignatiya, stops excessive sweating, improves overall health, eliminates headaches, redness of the skin and hot flushes.

• Indications for use: menopause with increased sweating, hot flashes, palpitations, nervous excitement, headaches, insomnia and other climacteric disorders.
• The medicine is released in the form of tablets. In a day, take 1-2 tablets 30 minutes before meals or an hour after eating. The duration of therapy is determined by the attending physician, but if after 2 months the patient's condition does not improve, then the withdrawal of the drug is indicated.
• The main contraindication is intolerance of active components. Side effects and symptoms of overdose occur extremely rarely and manifest as allergic reactions. Adverse symptomatology does not require the abolition of treatment and passes by itself.

2. Klimadion

Herbal remedy with special extract BNO 1055 - tsimitsifuga. Has a complex estrogen-like activity. Organoselective and highly specific phytoestrogens have a pronounced estrogen-like and dopaminergic effect.

• Indication for use: surgical and natural menopause, psychoemotional and vegetovascular disorders, excessive sweating, hot flashes, sleep disorders, irritability and sweating, depression.
• The drug is released in the form of drops and tablets. Drops are dripped into a glass of water or a piece of sugar, the tablets are taken orally. Scheme of therapy and its duration is determined by the attending physician. The course of treatment depends on the severity of menopausal symptoms.
• Side effects: abdominal pain, discomfort and soreness in the mammary glands, weight gain, spotting.
• Contraindications: individual intolerance of active ingredients, allergic reactions, estrogen-dependent diseases.

3. Remens

Homeopathic remedy, whose action is aimed at normalizing the hypothalamus-pituitary-ovary system. It restores the hormonal balance, reduces the severity of menopausal syndrome.

Indications for use: pathological menopause, dysmenorrhea, PMS, adnexitis, endometritis, amenorrhea, algodismenorea. The drug is taken on a special schedule: 1-2 days for 1 tablet / 10 drops 5-8 times a day, with 3 days of therapy for 1 tablet / 10 drops 3 times a day. The duration of treatment depends on the severity of the pathological condition. Side effects are manifested in the form of allergic reactions. Remens is contraindicated in case of intolerance to one of its components.

4. Climact-Hel

Herbal preparation, whose action is directed to the elimination of pathological symptoms of complete stopping of hormone synthesis. Contains several active components: sepia, zedron, metallic tin, ignition, Canadian sanguinaria and others. It reduces painful sensations, has a sedative and anti-inflammatory effect.

• Indications: complex therapy of autonomic disorders during menopause (hot flashes, headaches, increased nervous excitability). The drug is taken 1 tablet 3 times a day before meals or an hour after eating. Duration of therapy is 1-2 months, if necessary, therapy is prolonged.
• Side effects: skin allergic reactions, increased liver activity. Contraindications: hypersensitivity to components, glucose-galactose malabsorption, lactose intolerance.

5. Sigetin

Similar to synestrol in structure and with estrogen by activity means. It is used for various menopausal disorders in women and as a preventive agent in prenatal fetal asphyxia. Available in ampoules and tablets. When menopause, apply 50-100 mg twice a day or 1-2 ml of 1% solution once a day. Duration of therapy is 30-40 days. In case of hypersensitivity to components, the drug is contraindicated.

6. Estrovel

BAA based on plant extracts, vitamins and amino acids of natural origin. Used for non-hormonal support of the female body in the menopause. It is used during the menopause and with its complications, post-stress and pre-menstrual syndrome and as an anti-aging prophylaxis.

Biologically active additive reduces the frequency of hot flashes, reduces attacks of headache and dizziness, improves mood, reduces nervousness and irritability. Not applicable for phenylketonuria and intolerance of active substances. Tablets take 1 pc. 1-2 times a day, if necessary, the dosage can be increased to 3-4 tablets per day. The course of treatment should not exceed 2 months.

The above medications prevent neuropsychiatric and vegetovascular manifestations of menopause, pathologies on the part of the bone, cardiovascular and urogenital systems. To eliminate hot flashes, irritability and headaches, antidepressants (Paroxetine, Fluoxetine), pressure and hot flushes (Clonidine), and various anticonvulsants (Gabapentin) can be prescribed.

Another option for non-hormonal therapy for surgical menopause is an alternative treatment. Unconventional medicine provides for the use of various decoctions and infusions to improve health and speed recovery after surgery. For treatment most often used: hawthorn, valerian, cones of hops, sage, lemon balm.

Do not forget about the intake of vitamin-mineral complexes, which help to smooth the hormonal background and improve overall well-being. During postovarectomy, Vitatress, vitamins and minerals Alphabet, Menopace, Ladys (the formula of menopause) and other complexes can be used.

Prevention

The main cause of artificial menopause is an operation to remove female genital organs. Prevention is aimed at preventing diseases and symptoms requiring surgical intervention.

Basic preventive recommendations:

• Timely and systematic treatment of any disease, especially chronic.
• Physical activity and regular exercise.
• Healthy eating, eating foods rich in phytoestrogens (soy, red clover, flax seeds).
• Maintaining the water balance - 2 liters of clean water a day.
• A full rest, a minimum of stress and worry.
• Regular preventive examinations at the gynecologist (2 times a year).

All methods of prevention are based on a healthy lifestyle. Surgical menopause is much easier to prevent than cure, because this pathology imposes a significant negative impact on later life.

[66], [67], [68], [69], [70], [71], [72], [73]

Forecast

Surgical menopause leads to irreversible consequences. The forecast in most cases is negative. It is impossible to restore the functionality of the ovaries, as well as restore the normal hormonal balance. The prognosis is influenced by the age of the patient. If the pathological condition occurs in women whose age is closer to natural menopause, the consequences will be minimal. Young patients may have severe complications, disability and even disability.

[74], [75], [76], [77]