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Because the hypothalamus is the regulator gonadotropic and other genotype functions of the pituitary gland and the Central link of the integration of the autonomic processes, age changes its functional state can occur diverse metabolic, endocrine, vegetative-vascular, trophic violations.
With the termination of a natural cyclic processes, in the rhythm of whom lived in the female body for more than 25-30 years, significantly changes the activity of the reproductive system. To these changes, the body must adapt to the subsequent active life. Age-related changes in the reproductive system of the menopause in women is mentioned in the works of E. I. Quater (1967), V. G. Baranov (1979), E. M. Valeevoj (1980), D. F. Chebotarev and centuries of Frolkis (1982) and other Complex nature of these changes was the basis for the creation of a number of classifications menopause [Quater E. I., 1967; Baranov Century BC, 1979, and others]. In 1980, who proposed the following classification of menopause: the period of menstrual function until the last menstruation is invited to refer to the pre-menopausal women, last menstruation - menopause, the next period, to complete extinction of ovarian function, the postmenopause.
The first phase is the pre-menopausal women - the period of a woman's life from the end of the reproductive period before menopause. In this phase begins to manifest age menopausal dysfunction reproductive system. The duration of phase I of menopause varies widely - from 2 to 6 years. Depending on the clinical features are two options for the current period premenopause: physiological and pathological.
The first option is observed in 65% of women (figure 2). Our long-term observations and literature data suggest that the most often violations of menstrual function in premenopausal at physiological development of menopause are manifested in the gradual increase in the interval between periods up to 40-90 days or more, up to menopause. Less frequent are scarce, characterized by a gradually reduce the amount of blood up to a complete stop bleeding, but more prolonged menstruation with preservation of rhythm. Still for some time, on average 6-12 months remain "hidden cycles", i.e. women do not stop feeling that preceded menstruation or noted in the menstrual days.
Climacteric disorders of menstrual function in premenopausal can manifest itself in the form of gradually decreasing in intensity and duration of bleeding in the days of menstruation, which within 6-12 months cease. After the cessation of menstruation women practically do not have changes in overall condition. Relatively rare at physiological course of menopause there is a sudden cessation of menstruation, which, as a rule, is not a pathology.
Changes in the menstrual functions that are not typical for physiological premenopause, should attract the attention of the doctor of any field, especially in terms of cancer, even when the General good health of the woman. This primarily relates to increased bleeding after they were poor, increasing the duration of bleeding, decreased intervals between periods, the emergence of bleeding after a period of amenorrhea. The tactics of the doctor when these violations, we will discuss below.
In premenopausal in healthy women (variant I) expressed gipotermiceski changes genitals is not observed. However, during examination on tests of functional diagnostics detect gradually progressive failure of hormonal function of the ovaries. Dynamic examination determine defective two-phase or monophasic rectal temperature, positive or slabopolozhitelnym the phenomenon of " maybe", low cervical and low karyopyknotic index (KPI).