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J. Pressel (1982) provides data on the age of the cessation of menstruation in women in different countries: in Finland - 49 years, in Denmark and Switzerland - 49.2 years in the GDR-49,3-51,4 year, in Holland - 51,4 years, Czechoslovakia was 51.2 years. Decisive factors the author believes climatic and social conditions.
This increase in the duration of functioning of the reproductive system is a consequence of the improvement of nutrition, living conditions of women, sports, and also conducting of preventive measures on prevention of various diseases. These provisions can be used as criteria to determine the tactics of the doctor for medical observation for women in menopause.
These data are the basis to not be considered a late menopause pathology (of course, in the absence of organic changes in the reproductive system). However, women who have menstrual function is not stopped in 52-53 year, subject to dispensary observation and constitute a high risk of cancer of the genital organs. In the literature, there is also evidence that in some women, menopause occurs later 60 years. These women need special clinical examination to detect or exclude a tumor diseases of the genital organs, mainly the ovaries.
Data on the relationship menarche and time of menopause contradictory. Most of the observations suggests that women with late menarche menopause occurs before. This view is also confirmed by our observations. Later menarche is noted in women with undeveloped genitals, mild secondary sexual characteristics and hypofunction of the ovaries, so they used is exhaustion of the ovaries. We fix the attention on these data, because they are important in the diagnosis, the choice of treatment tactics and forecasting its efficacy in women with pathological course of climacteric period.
It is also appropriate to recall that 15-20 years ago cessation of menstruation in women over 48-50 years was seen as a manifestation of the pathology of the reproductive system, and often even with regular cycle produced diagnostic scraping and even removal of internal genital organs. Currently, as mentioned above, the age of menopause increased, which was the basis for reconsideration of tactics of treatment of women in menopause.
The third phase of menopause - post-menopause (49,5-60 years - the period of menopause to persistent termination of hormonal function of the ovaries. In this phase menopause, continuing in 5-10 years, appear more pronounced age-related changes of appearance and the reproductive system.
In the bodies that have receptors that are sensitive to hormones, gradually progressing gipotermicescoe changes. Pubic hair thinning the skin of the labia majora becomes flabby, vaginal wall smooth, pale pink, and then whitish. The size of the uterus decrease vaginal flattened arches.
The number of mucous discharge from cervical canal is reduced and it eventually disappears. The phenomenon of " maybe " gradually becomes negative, sometimes even to premenopausal, and then the cervix becomes dry. The gradual disappearance of the phenomenon of "maybe", then it is a persistent lack is one of the indicators respectively hypoestrogyny, and then and lack of estrogen. Endometrium in premenopausal and early postmenopausal is in the stage of proliferation. In the subsequent unfolding gipotermicescoe changes of the endometrium, and about 55-60 years it scraping not find.