Hormones and gynecological diseases
Perhaps this topic lies a little away from the main subject of our conversation. But there is one caveat: more than half of the pathologies of the genitourinary system occur in a latent form. That is so hidden that the patient for decades may not even realize that he is sick. This applies to both infections and malignant tumors, and other types of degeneration of parts included in this system. And they all have a “fashion” to aggravate with the onset of menopause or immediately after it.
Meanwhile, we agree, during such a radical restructuring, we have so many new symptoms that it becomes simply impossible to distinguish between normal and pathological ones. Even if we learn the list of both of them by heart, our heroism will still not clarify the picture. Indeed, in one period we can leaf through our list and decide that we are sick with such and such a pathology. And all this is only in order to delve into the memory again a few days later with an equally firm belief that we were mistaken, for we have different symptoms.
Let’s start with the pathologies most strongly associated with the hormonal background. These include uterine fibroids, cysts, all types of mastopathy. As well as prostate adenoma and prostatitis. Another, incomparably more dangerous type of pathology, the probability of which only increases during menopause, is cancer – malignant tumors of the organs of the reproductive system, but, by the way, not only.
Fibromyoma is a benign proliferation (hyperplasia) of various layers of the uterine wall in women. Such a tumor can reach enormous size, and its body can be located both in the uterine cavity, and in the thickness of its wall, and even outside. It is almost impossible to detect a small fibromyoma – in itself it almost does not give symptoms. They begin, as a rule, when the tumor reaches such a size that it begins to put pressure on the surrounding organs, stretch the walls of the uterus, and descend through its neck. The most dangerous scenario, observed just with large fibroids, is the onset of necrosis in their tissues due to the inability of the circulatory system to provide blood supply to such a mass of excess tissue.
Myoma, like any benign tumor, is dangerous with the probability of either decay or malignant transformation. Of course, in case of pregnancy, the myoma, which takes up a lot of space in the uterus, leaves no room for the fetus. Therefore, pregnancy with her is possible, but not always. This tumor is highly dependent on hormonal levels – on the level of estrogen in the blood. She herself can accumulate or produce this hormone. Myoma is treated with various types of surgical intervention – ligatures are applied, a sclerotherapy drug is administered, etc. If it suddenly begins to show alarming signs (necrosis without injury or infection, rapid growth), it is usually removed along with the entire uterus. Because the removal of one tumor is possible only in exceptional cases. And if she also shows signs of rebirth, preservation of part of her tissues for the sake of preserving the uterus can be life threatening.
Fibromyoma, which occurred during menopause, is a rather rare phenomenon. But it often appears after the first birth – in the form of a reaction to hormonal changes during pregnancy and injuries sustained during childbirth. As mentioned, many patients are unaware of its existence for years. And it is discovered by chance – say, during an examination about pregnancy or, conversely, sustained infertility. So, a considerable proportion of episodes of the sudden detection of fibroids occur just in the period of menopause. Usually because during this period the tumor can begin to grow rapidly, while delaying the onset of menopause.
A large or rapidly growing fibromyoma can be felt by a feeling of heaviness in the lower abdomen, a “foreign object” in the vagina or abdomen. With its external location, a steady violation of bowel movement may occur, pressure on the bladder may appear. In addition, this tumor increases the background of estrogen during puberty and creates it – with menopause. And therefore it is logical that she, as it were, hints at her presence by an increase in the duration of critical days, the pain of the cramps that accompany them. Often, it is a myoma that we owe to the increase in ovulation and, therefore, critical days, bright and long PMS, and bloody discharge in the period between menstruation.
As for menopause, the myoma can significantly smooth out its manifestations – stretch the cycle disorders in time, make them less noticeable. And also to extend the period of menstruation, to make them more plentiful. Often, it is during the menopause that the necrosis of the tumor tissue and its degeneration is triggered. The breakdown of fibroids makes itself felt by fever, fever, sharp, pulling pains in the lower abdomen. In this case, discharge usually appears with blood clots and its admixture from the vagina, anemia and signs of poisoning of the body by the products of tissue destruction quickly progress. This is an emergency requiring immediate hospitalization.
By the way, malignant degeneration of fibroids, as a rule, begins with an increase in its volume, a change in the color of the tissues. But the process quickly ends with the formation of a necrotic focus. Only this focus grows more slowly than with the cessation of blood supply, and can hardly hurt. However, it is useless to stop it – the growth of a malignant ulcer cannot be stopped either by ligation or antibiotics. We should pay attention that vaginal discharge in cancer will be more scarce, but probably with the smell of rotting meat. A malignant tumor grown from fibroids produces estrogen and proteins similar to it are much more active than a benign one. Therefore, we should not always take the delay in the onset of menopause as a gift of nature or a manifestation of our excellent health …
What is a cyst, is known to all. This is an egg that tried to sink into the uterus, but got stuck halfway to it. Alternatively, a cyst is formed in cases where the egg has sank into the uterus, attached to its wall, but for some reason its subsequent detachment has not occurred. Perhaps the egg itself turned out to be defective and the body did not take it for the object to be excreted. Perhaps her life was prolonged by a defect in the uterine mucosa. It may also be that a malignant process has begun in the egg and it has begun to secrete additional portions of estrogen. And since it is he who maintains the existence and nutrition of the eggs, this synthesis, although it is abnormal, allowed her to “linger on this world.”
The uterine cyst does not always affect the schedule of critical days. Indeed, several eggs can freely be attached to the wall of the uterus. And if the rest are healthy, they will be displayed in the usual manner – we will not notice the “healed” among them. As for the cysts of the fallopian tubes, then here we will not get a significant malfunction. There are two pipes. And even if the cyst completely blocks one of them, this will not affect the cycle.
The risks from the presence of a cyst coincide with those of fibromyoma. This neoplasm was benign initially – the egg was delayed by a mechanical obstruction, hormone deficiency, uterine wall defect. But it has a tendency to develop into cancer over time. And if it did not go through the normal cycle at all because of the malignant potential (it releases more estrogen than it should be), the development of a full-fledged tumor is all the more inevitable.
In addition, cysts can decay, they create a mechanical obstacle in the way of other, healthy eggs and greatly increase the background of estrogen in the blood. And it follows from this increase in the background and other balancing hormones, all the growing failures of the cycle. It is impossible to say in advance which direction they will occur. Everything will depend on the response of the hormonal regulation system to the resulting failure. And it can be different. The fact is that a cyst will also noticeably stretch our menopause in time: our periods will remain for a longer period, they can become more frequent and become more painful.
Intermediate bleeding, suspicious discharge and pain of the cyst, as a rule, does not. However, we should certainly pay attention to the external signs of a growing imbalance. In particular, to aggravate premenstrual syndrome, mood swings (especially in a clear dependence on the stages of the cycle), increased headaches and increased libido. With a cyst, the mammary glands usually swell more strongly – especially during ovulation. And this swelling subsides more slowly than before, which directly indicates an increase in prolactin levels.