Article number:1005-2216 (2003) 01-0023-02.
Physiological changes of women in different stages of life.
Cui Manhua Li Yuancheng Ma Haiou
China Library Classification Number: R7 1 Document Identification Number: A
Authors: Second Hospital of Jilin University (Changchun, 13004 1)
From birth to the end of life, women experience the function of reproductive system.
Energy and physiological changes closely related to the functions of other systems in the body,
Understanding the physiological characteristics of each stage is helpful to maintain women's physical and mental health.
According to the ups and downs of ovarian function and physiological characteristics, the following will be divided into female life.
These six stages are described as follows.
1 neonatal period
That is, within four weeks after birth. At this stage, the ovary is in a naive state, and there is no
Hormone secretion, but the vulva is full, the breast is slightly raised, and there may be a small amount.
Milk, there will be a small amount of vaginal bleeding and leucorrhea, which is mainly due to before delivery.
Under the influence of estrogen produced by placenta and maternal gonad, blood is released after birth.
The rapid decline of female hormone levels generally disappears within 1 week. for health reasons
Physiological adjustment and adaptability are not mature enough, so the morbidity and mortality are high.
Nursing should be strengthened.
2 childhood (childhood)
It means from 4 weeks of birth to 12 years old. At this stage, the growth of the body continues.
And the ovary and reproductive system are still in a relatively naive state.
It is easy to have thin skin, lack of glycogen in cells, low vaginal acidity and weak disease resistance.
Vaginitis. From the age of 10, the follicles in the ovary have developed and secreted to some extent.
Hormones, feminine characteristics began to appear, and breasts began to develop, but they still could not reach maturity.
Degree. At this stage, we should strengthen nutrition, pay attention to disease prevention and cultivate good moral quality.
And prevent mental, emotional and behavioral problems.
Puberty or adolescence
It refers to the development of sexual organs, the emergence of secondary sexual characteristics and the basis of reproductive function.
The period when the ovary is mature and the height stops growing, that is, the ovarian function is immature.
A period of transition to maturity. The World Health Organization stipulates that puberty is 10 ~
19 years old, but due to race, living environment, heredity, endocrine, disease and nutrition.
Affect the age at which puberty begins. The main changes at this stage are manifested in the body shape.
State change, secondary sexual characteristics (characteristics unique to other women except reproductive organs)
Elephant) and the development of reproductive organs, hormonal changes in the body and psychological changes.
According to the physiological characteristics of different periods, adolescence can be divided into: ① early youth.
Stage, that is, from the beginning of secondary sexual characteristics to menarche, is generally 9 ~.
12 years old, mainly physical growth; ② Middle adolescence refers to menarche, mainly
Priority should be given to the development of sexual organs and secondary sexual characteristics, also known as the developmental period of sexual characteristics, which generally lasts for several years.
The age range is 13 ~ 16 years old; (3) Late adolescence refers to the period from menstrual cycle to reproduction.
The stage of functional maturity and height stop is about 17 ~ 20 years old.
The physiological changes in adolescence are manifested in the following aspects.
The development of posture and secondary sexual characteristics: the rapid growth of height shows women.
Unique posture, such as gradually plump breasts, armpit hair and pubic hair, and breath.
Height increases, pelvis widens, and subcutaneous fat in chest, shoulders and buttocks increases.
Further development of internal and external genitalia: the external genitalia changed from a girl to an adult.
Type A, pubic mound uplift, labia majora, labia majora enlargement, pigmentation, vaginal mucosa.
Periodic changes under the influence of wrinkles and sex hormones; The uterus grows rapidly,
By the middle of puberty, the endometrium has periodic proliferation and shedding changes, and the cervix is sticky.
The secretion of liquid increases, and it also changes periodically. Rapid enlargement of ovary, ovarian cortex
Follicles with different developmental stages appear in follicles, and the surface is uneven, which changes with the follicular cycle.
Sexual development, maturation, ovulation and corpus luteum formation, constantly secreting estrogen and progesterone and a small amount.
Androgen.
Menstruation (menarche): It is an important indicator of adolescent development.
Pool. The age of menarche varies greatly among individuals, such as heredity, nutrition, weight and exercise.
Will affect the age of menarche. Because the ovarian function is not fully developed, menarche occurs.
Subsequent menstrual cycles are mostly irregular, often anovulatory menstruation.
Dysfunctional uterine bleeding is more common.
Endocrine changes: under the coordination of the central nervous system, various endocrine glands
Both of them secrete hormones and regulate the growth, development and physiological functions of various organs and tissues.
The axis of hypothalamus-pituitary-middle ovary is the main body and the center of endocrine changes in adolescence.
It is the main reason for the above physiological changes. Characterized by gonadotropin-releasing hormone.
(GnRH) pulse release is increased, which is the key to puberty initiation; gonadotrophic hormone
Hormones, including follicle stimulating hormone (FSH) and luteinizing hormone (LH), began to appear.
The frequency and amplitude of pulse secretion gradually increase. youth
Although the estrogen level reached a certain height in the early stage, it was not enough to cause corpus luteum.
The peak of vegetarianism, so the menstrual cycle is irregular and mostly anovulatory, to green.
The positive feedback effect of estrogen has been established in the Spring Festival Evening, and ovulation and pregnancy shock appear.
Hormones began to change periodically, and the function of hypothalamus-pituitary-ovary axis was coordinated.
Regulation, due to the periodic positive feedback of estrogen to hypothalamus-pituitary,
Periodic changes of GnRH secretion and peak values of FSH and LH in middle menstruation
Now ovulation is induced, gonadal function is gradually mature, and menstruation appears regularly. other
Such as adrenocortical hormone, growth hormone, thyroxine, prolactin, insulin, etc.
There have also been corresponding changes.
Characteristics of psychological changes: adolescence is a sudden leap in physical development and intellectual development.
Aggressive, energetic, innovative, observation, memory, thinking and reasoning skills.
Constantly strengthening, rich imagination, strong curiosity, changeable mood and strong self-control.
Poor strength. Because of the confusion about the development of secondary sexual characteristics and the confusion about body shape, height and thinness
Anxiety, as well as curiosity and understanding of sexual problems due to the maturity of sexual psychology.
Desire, prone to psychological disorders, abnormal menstruation, puppy love and premature sexual behavior. , it should be
Correct guidance, because adolescence is psychological, intellectual,
China Journal of Practical Obstetrics and Gynecology, Vol. 19,No. 1, June 2003.
A critical period of morality and world outlook.
4. Sexual maturity
Also known as sexual maturity, it begins at the age of 18 and lasts for about 30 years. This stage
The closed-loop feedback system of the central nervous system, hypothalamus-pituitary-ovary axis has been
After full maturity, the ovary ovulates periodically and secretes sex hormones to ensure internal division of women.
Normal secretory and reproductive functions.
The function of gonadal axis is regulated by nerve and hormone feedback.
It's realized. The neural activity of hypothalamus must be controlled by cerebral cortex,
Changes in the internal environment of the body and external stimuli (such as emotional changes) make brain cells
Secrete adrenergic and cholinergic substances as neurotransmitters.
It affects the secretory activity of hypothalamic nerve cells, thus affecting ovulation and menstrual cycle.
In the early stage, estrogen and progesterone secreted by ovary affect hypothalamus through positive feedback mechanism.
And the secretion and release of pituitary gonadotropin and gonadotropin releasing hormone.
For example, when regulating the menstrual cycle, a woman becomes pregnant after premature ovarian corpus luteum atrophy.
Decreased hormone secretion relieves the inhibition of hypothalamus and pituitary gland. hypothalamus
The secretion of GnRH increases the secretion of pituitary FSH, and the follicles gradually develop and mature.
Under the synergistic effect of a small amount of LH, follicles secrete estrogen. With the increase of estrogen,
Addition and negative feedback increase, FSH level decreases, and female stimulation occurs when follicles mature.
The peak of hormone triggered a large release of GnRH and a steep peak of LH.
At the same time, more FSH is released to ovulate mature follicles. Because of ovulation,
The posterior corpus luteum secretes a large amount of estrogen and progesterone, which has negative feedback effect on hypothalamus and pituitary.
Function, so that FSH and LH secretion decreased, corpus luteum began to shrink, estrogen and progesterone are the same.
With the decrease, the endometrium can not be supported by sex hormones, and necrosis and shedding occur.
Menstruation With the periodic changes of ovaries, female reproductive organs also occur.
A series of periodic changes, of which endometrial changes are the most significant, as follows.
Alternating changes of endometrial proliferative phase and secretory phase and regular menstrual cycle
During ovulation, vaginal mucosa, cervical mucus and fallopian tubes also appear with the ovarian ovulation cycle.
Characteristic changes in the influence of estrogen and progesterone. The proportion of this period in female sexual life
The largest proportion, women will face marriage, family, childbirth, work.
Problems, family burdens and social pressures should be prevented and cared for.
5 Perimenopausal period
It refers to the period before and after menopause (once called menopause), that is, the ovary.
The function gradually declined, and the reproductive organs began to atrophy and decline. one
It started at the age of 40 and lasted for more than 10 years. That is, from the symptoms of ovarian dysfunction
Trillion begins and lasts until after the last menstruation 1 year. Divided into three stages:
(1) menopausal transition period: refers to a period before menopause, that is, from the clinical characteristics,
Endocrinology and biology didn't begin to show signs of menopause until the last one.
Secondary menstruation; ② Menopause: refers to the last menstrual period in a woman's life, indicating the ovary.
The inner follicle naturally fails, or the remaining follicles lose pituitary gonadotropin.
Reaction. This stage can only be determined retrospectively. The average age of menopause in China is?
49 15 years old; ③ Postmenopausal period: postmenopausal 1 year. This is further ovarian failure.
Contraction, endocrine function gradually subsided, and reproductive organs began to shrink. broad sense
Generally speaking, the late menopause is from the last menstruation to life.
End this whole period. Not only after the last menstruation in perimenopausal period,
1 year includes the whole life process after menopause 1 year, that is, the old age.
5 1 1 Characteristics of endocrine changes in perimenopausal period
Due to the decline of ovarian function, ovarian hormone secretion is reduced and ovulation function is impaired.
Obstruction, manifested as the relative lack of progesterone symptoms, this phenomenon appeared the earliest, and
Continue to develop to a complete lack. Estrogen began to decline, and then
Modern compensation rises, and then enters the state of estrogen deficiency. Follicle stimulating hormone may be a little
Rise or stay at a normal level.
Clinical characteristics of 5 12 perimenopausal period
Menstrual changes: amenorrhea (about 10% ~ 15%) and menstruation.
Rare (about 65%) or irregular bleeding (about 10% ~ 20%).
Menopausal dysfunctional uterine bleeding: often anovulatory, characterized by irregular menstruation.
Then, prolonged menstruation, increased menstrual flow, continuous dripping or massive bleeding will all cause poverty.
Blood or other complications.
Climacteric syndrome: once called climacteric syndrome, it is a condition in which women are in menopause.
The function of autonomic nervous system is caused by the fluctuation or decline of estrogen level.
A group of syndromes with disorders and neuropsychological symptoms. Lasts 2 ~ 10
Different years. About13 women achieve a new balance through neuroendocrine regulation.
No conscious symptoms, 2/ 3 women have a series of symptoms caused by hormone reduction, table.
At present: ① Vascular systolic and diastolic dysfunction: flushing, sweating, palpitation and chest tightness, precordial area.
Discomfort and pseudoangina. ② Neuropsychiatric symptoms: irritability, irritability, insomnia and anxiety.
Lack of concentration, anxiety, poor memory, decreased work efficiency, fatigue, etc. ③ Secretion
Urogenital symptoms: vaginal dryness, sexual pain, recurrent vaginitis and
Urinary tract infection, etc. Others such as back pain or joint muscle pain. Should be approved.
Heart education, understanding, comfort and knowledge of perimenopausal health care, and according to personal situation
Conditions for supplementing sex hormones.
6 aging (aging)
It is the gradual aging of female body, the decline of ovarian function and the further development of reproductive organs.
Atrophic period. Generally around 60 years old. Characteristics of endocrine changes: gonadotropin
Hormones are maintained at a high level, the ovaries no longer secrete sex hormones, and there are few in the circulating blood.
The amount of estrogen (estrone) mainly comes from the precursor of extrasexual adrenal androgen.
Transformation.
Characteristics of reproductive system: pubic hair shedding, narrow vaginal opening, large and small yin.
Under the resistance of reproductive tract, lips atrophy, vaginal folds and glycogen content in epithelium decrease.
Healthy, uterus and cervix atrophy, pelvic floor tissue relaxation.
Clinical features: decreased libido, recurrent infection of genitourinary system and dysuria.
Difficulty, urinary incontinence, uterine prolapse, bladder protrusion, rectocele, dry skin, skin
Lose elasticity, facial wrinkles increase and deepen, and blue veins appear on the neck and back of the hand.
Jumping, chapped breasts, etc. Then there will be different degrees of senile diseases, such as extinction.
Postmenopausal osteoporosis, cardiovascular diseases and Alzheimer's disease, namely Alzheimer's Harmo's disease.
Alzheimer's disease is characterized by memory loss, aphasia, unconsciousness and sexual dysfunction.
Abnormal behavior and emotional changes. The key to prevent these changes and diseases should be
In the early treatment of menopausal syndrome, because the occurrence of menopausal syndrome is
Signs that senile diseases are about to happen, although the symptoms of menopausal syndrome are
The human body will die after slowly adapting, but senile diseases will not be caused by menopause.
Symptoms improve and stop, so early treatment of menopausal syndrome.
Will greatly reduce the incidence of senile diseases, and this kind of health care and treatment can
Throughout the late menopause.
(Received in September 2002-10)
China Journal of Practical Obstetrics and Gynecology, Vol. 19,No. 1, June 2003.