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CNAA / Theses / 2005 / June /

The correlation of the hormonal decline and psycho-vegetative disorders while menopause


Author: Liliana Profire
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2005
Scientific adviser: Valentin Friptu
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Ion Moldovanu
doctor habilitat, professor,
Institution:
Scientific council:

Status

The thesis was presented on the 21 June, 2005
Approved by NCAA on the 22 September, 2005

Abstract

Adobe PDF document0.27 Mb / in romanian

Thesis

CZU C.Z.U.:618.176-02:616.89-092

Adobe PDF document 0.56 Mb / in romanian
112 pages


Keywords

menopause, perimenopause, postmenopause, psychoneuroendocrinology, vegetative nervous system

Summary

During the last decades increase of menopause incidence is determined with the pathological evolution that varies from 25 % to 65 % and even to 92,2 %. This phenomenon is favored by biological disturbances produced in the inner medium of the organism occurring under the influence of unfavorable factors of ambient medium and demographics, lamentable state of health and socio-economic crisis, pre-morbid features of the personality and other ominous aspects of the life period prior to menopause. The present study was initiated by absence of studies that would analyze relations of these factors with the hypothalamus-limbicus-reticulum complex (HLRC) dysfunctions that appear simultaneously with the beginning of the menopause period. The aim of the research is to examine clinically patients having Supra-Segmentary Vegetative Disturbances (S/SVD) in Climacteric Syndrome (CS), to estimate the role of hormone disturbances occurring during the menopause period, and evolution of vegetative and affectemotional disturbances.

Specific features of psycho-vegetative profile of the patients that were examined within the framework of the study were determined with the help of a S/SVD questionnaire and psychological tests, particularly the Spilbergher’s Anxiety Test and Minnesota Multiphase Personality Inventory (MMPI). Results obtained were confronted with the test results of hyperventilation and latent neurogenic tetany’s evidence test (Chvostek’s symptom, Trousseau-Bonsdorf Test). Hormonal secretion perturbations of the menopause patients were considered after the sequential dosages of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and progesterone. These researches also helped to evaluate decision and efficiency of treatment measures applied to improve immediate symptoms characteristic to menopause syndrome.

Emotional and behavior disturbances, disturbances in thermoregulation, cerebral of the vascular genesis, cerebral of the general genesis, respiration and behavior, motor and dyspnoea disturbances represent basic symptoms of the psycho-vegetative syndrome characteristic to menopause patients. The adaptation processes’ extension with the growth of S/SVD apparition risk is a principal characteristic feature for all women in menopause. However, only considerable instability of vegetation balance caused by compensatory systems’ insufficiency, determines the evolution and severity of permanent affective-emotional and vegetative clinic manifestations, and predispose to paroxysmal states of menopause.

Ovarian function’s disturbances conditioned by the E2 secretion diminution and the progesterone in menopause, cessation of its secretion in postmenopause, and central secretion modifications of FSH and LH are the decisive factors of adaptation mechanisms’ perturbations (result of the feedback disturbance in the hypothalamus-hypophysis-ovary system) and conditions polyform psycho-vegetative aspects of the menopause syndrome. Taking into consideration similar pathogenic mechanisms of hormone profile disturbances of menopause patients, clinic aspect of psycho-vegetative syndrome, its evolution and severity are determined by hypophysis tropes and steroid hormones concentration, this being an important fact in treatment strategy selection that, unquestionably, justifies the involvement of ample therapeutic programs when treating the patients with the menopause syndrome.

Present study has confirmed high efficiency of the three methods applied to treatment: hormonal replacement therapy (HRT), HRT in association with psycotropic medications and solely psychotropic remedies. HRT reduses S/SVD in case of one typical vegetative CS pattern. S/SVD with atypical SC evolution are efficiently strangled by symptomatic application of psychotropic and vegetotropic remedies, HRT being associated with precaution.

Priority of psychotropic remedies’ use in comparison with HRT in vegetative and affective-emotional disturbances improvement is evident. These medications are to be prescribed to the women having menopause with pathologic evolution to improve the organism’s process of adaptation to hormone modifications, initially avoiding HRT prescription. Psychotropes are also prescribed to the women having prolonged pathologic evolution of menopause (during the postmenopause period) to improve disturbances of homeostasis, metabolic and psychological processes of central nervous system (C.N.S) and vegetal nervous system (VNS). In this case according to our study results, remedies are more efficient in association with HRT.

Thus, study realized has determined new CS pathologic aspects that can be used in medical practice with the view to avoid diagnosis and treatment errors; it has also showed the importance and necessity of the preliminary research of VNS state on the basis of simple and informative examination methods.