Women in menopause are turning to a gynecologist because of urogenital disorders. Urinary tract: vagina, urethra, bladder and the lower one-third of the urinary tubes have the same embryonic origin and develop from urogenital sinus.
Identical origin of embryonic structures of the urogenital tract explains the presence of receptors for estrogen, progesterone and androgens in virtually all of its structures: muscles heath, blood -vascular system of the vagina, bladder and urethra, and muscles and connecting apparatus of the pelvis. However, the density of receptors for estrogen, progesterone and androgens in the structures of the urinary tract was significantly lower than in the endometrial.
Consequence of the termination of proliferate processes in the vaginal epithelium is the disappearance of glycogen and vaginal biotope of partial or complete elimination of its main component - lactobacilli.
This biotope colonization of vaginal microorganisms from both exogenous and endogenous flora of the increases is the role of conditionally - pathogenic microorganisms. Under these conditions increases the risk of infectious vaginitis and development of ascending urinary infections.
Regardless of the distortion of the vagina content, including the development of ischemia as a consequence of estrogen deficiency was observed breach of the terms of vaginal wall changes in its muscle and connective tissue structures. As a result of violations of blood flow dramatically reduces the amount of vaginal transuded, develops and dryness of the vagina.
As a result of progressive atrophy of muscle structures of the vagina wall, the muscles of the pelvic floor, and loss of elasticity of the collagen composition of the coupling apparatus of the pelvis, is developing the provision of the walls of the vagina, which can give rise to an unjustified increase in the incidence of surgery. Diagnosis of vaginitis, complaints about: o dryness and itching in the vagina ; o difficulties in sexual intercourse ; o unpleasant repetitive movements, often measured as recurrent. In drawing up the medical history is necessary to take into account their relationship with the onset of climax.
Symptoms can occur in isolation or combined with the development as genuine spontaneous leakage urine in tension, and mixed when the true spontaneous leakage of urine when tension is added and mandatory reserve occur spontaneous leakage of urine in the reserve or incontinence. Spontaneous leakage urine True spontaneous leakage tension in urine and urinary incontinence are severe pathology of high socio- economic importance, reflecting the negative terminal is on quality of life of women in the climacteric. Influence of estrogen deficiency on sexual activity in postmenopausal women Sexual function is a combination of biological, interpersonal and socio- cultural factors. Before the onset of menopause in the majority of people is established structure of sexual behaviors, which are balanced sexual desire, activity and responses. Physiological changes occurring in postmenopausal sexual activity is often reduced because the woman dispareuniya, spontaneous leakage of urine, lack of sexual desire and orgasm. As a result of this sexual dysfunction in the last third of their lives women can develop psychological disorders, depression, leading to conflicts within the family and subsequent degradation.
Ovarian hormones - estrogen, progesterone, and androgens play an integral role in the physiology of sexual desire and behavior. The effects of estrogens on neurophysiology, cardiovascular tone, growth and metabolism of cells of urogenital system gives biological explanation of changes in sexual activity in the absence of postmenopausal. The reasons for these changes are:
o decrease in blood supply of the vulva and vagina ; o changes in the vagina and developing dispareuniya ; o loss of tone of the urethra ; o reduce vaginal transuded ; o reduction or absence of Bartholin's gland secretion ; o retardation of the clitoris during reaction ; o insufficient increase in breast size during sexual stimulation ;
The most common specific complaints of postmenopausal women: o reduce sexual desire o dryness and itching in vagina o reduce the frequency and intensity of orgasm.
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