Sudden increase in vaginal discharge after menopause

When women have menstruation, it means that their reproductive system functions relatively well. If they have symptoms of amenorrhea, it means that some physiological changes have occurred in the body. However, this change does not necessarily mean that there is some disease in the body. Because when women enter menopause, due to changes in hormone levels in the body, ovarian function declines, leading to menopause. However, if the amount of vaginal discharge suddenly increases after menopause, you need to be alert to whether there is a problem with the reproductive system.

Amenorrhea is an external manifestation of pathophysiological changes in the female body caused by a variety of diseases. It is a clinical symptom rather than a disease. According to the location of reproductive axis lesions and dysfunctions, it is divided into hypothalamic amenorrhea, pituitary amenorrhea, ovarian amenorrhea, uterine amenorrhea and amenorrhea due to lower reproductive tract developmental abnormalities. The World Health Organization classifies amenorrhea into three types: Type I: no endogenous estrogen production, normal or low follicle stimulating hormone (FSH) levels, normal prolactin (PRL) levels, and no evidence of organic hypothalamic and pituitary lesions; Type II: endogenous estrogen production, normal FSH and PRL levels; Type III: elevated FSH levels, indicating ovarian failure.

Amenorrhea can also be divided into primary and secondary, physiological and pathological. Primary amenorrhea refers to the age >14 years, the secondary sexual characteristics have not developed; or the age >16 years, the secondary sexual characteristics have developed, but the menstruation has not yet occurred. Secondary amenorrhea refers to the cessation of menstruation for more than 6 months after the normal menstrual cycle is established, or the cessation of the original menstrual cycle for more than 3 cycles. Physiological amenorrhea refers to the absence of menstruation during pregnancy, lactation and after menopause. Pathological amenorrhea is amenorrhea caused directly or indirectly by functional or organic lesions in various links of the central nervous system-hypothalamus-pituitary-ovarian axis and the target organ, the uterus.

1. Hypothalamic amenorrhea

Hypothalamic amenorrhea is amenorrhea caused by various functional and organic diseases of the hypothalamus. This type of amenorrhea is characterized by defective or insufficient synthesis and secretion of gonadotropin-releasing hormone (GnRH) by the hypothalamus, which leads to low secretion of pituitary gonadotropin (Gn), namely follicle-stimulating hormone (FSH) and luteinizing hormone (LH), especially LH, so it is a type of hypogonadotropic and hypoestrogenic amenorrhea. Clinically, the disease can be divided into three categories according to its cause: functional, genetic defect or organic, and drug-induced.

1. Functional amenorrhea

This type of amenorrhea is caused by various stress factors inhibiting the secretion of hypothalamic GnRH, which can be reversed with timely treatment.

(1) Stress-induced amenorrhea Mental shock, environmental changes, etc. can cause stress-induced increases in the levels of endogenous opioids, dopamine, and adrenocorticotropic hormone (ACTH)-releasing hormone, thereby inhibiting the secretion of GnRH in the hypothalamus.

(2) Sports-induced amenorrhea Athletes may experience amenorrhea after sustained strenuous exercise. It is related to the psychology, stress response level and body fat loss of amenorrhea patients. Amenorrhea will occur if the body weight is lost by 10% to 15%, or if the body fat is lost by 30%.

(3) Amenorrhea caused by anorexia nervosa is caused by excessive dieting, which leads to a sharp drop in body weight, eventually causing a decrease in the secretion levels of multiple neuroendocrine hormones in the hypothalamus, causing a decrease in the secretion levels of multiple trophic hormones in the anterior pituitary, including LH, FSH, ACTH, etc. The clinical manifestations include anorexia, extreme weight loss, low-Gn amenorrhea, dry skin, hypothermia, hypotension, low blood cell counts and plasma protein levels. Severe cases can be life-threatening.

(4) Nutrition-related amenorrhea Chronic wasting diseases, intestinal diseases, malnutrition, etc. that lead to excessive weight loss and emaciation can all cause amenorrhea.

2. Genetic defects or organic amenorrhea

(1) Genetic defect amenorrhea is a congenital GnRH secretion defect caused by a genetic defect. The main types are Kallmann syndrome with olfactory dysfunction and idiopathic low-Gn amenorrhea without olfactory dysfunction. Kallmann syndrome is caused by a defect in the KAL-1 gene on chromosome Xp22.3, and idiopathic hypogonadism is caused by a mutation in the GnRH receptor 1 gene.

(2) Organic amenorrhea includes hypothalamic tumors, the most common of which is craniopharyngioma; other causes include inflammation, trauma, chemotherapy, etc.

3. Drug-induced amenorrhea

Long-term use of drugs that inhibit the central nervous system or hypothalamus, such as antipsychotics, antidepressants, contraceptives, metoclopramide (Metoclopramide), opium, etc., can inhibit the secretion of GnRH and cause amenorrhea, but menstruation can generally resume after stopping the drug.

2. Pituitary amenorrhea

Pituitary amenorrhea is amenorrhea caused by decreased Gn secretion due to pituitary lesions.

1. Pituitary tumors

Tumors can occur in various glandular cells in the pituitary gland located in the sella turcica. The most common ones are adenomas that secrete PRL. The degree of amenorrhea is related to the degree of inhibition of PRL on hypothalamic GnRH secretion. If it occurs before puberty, it can cause primary amenorrhea. Depending on the nature of the tumor, clinical symptoms unique to the tumor may include galactorrhea, gigantism, hypercortisolism, etc., as well as symptoms of nerve compression such as headache, visual impairment, and visual field loss.

What to do after menopause

1. Have a full body check-up at least once a year, which can not only prevent diseases, but also detect and treat them early. It is recommended that women over 40 years old have a full body check-up every six months.

2. Take calcium tablets or eat foods rich in calcium.

3. After menopause, you should develop a habit of exercising regularly to improve your body's immunity.

4. Tell your doctor honestly about your menopausal symptoms.

5. Quit smoking, drinking, coffee and caffeinated foods.

6. Strictly control your weight. Don’t be too thin but not too fat either.

7. Keep yourself in a good mood every day and don’t be nervous or stressed.

8. Eat nutritious foods and less high-fat foods.

9. Be interested in new things. You might as well develop one or two hobbies in your spare time. This will not only increase your interests but also make your life more fulfilling.

10. Have a positive attitude towards life, don’t be depressed or negative.

Menstruation is a treasure for a woman's health and beauty throughout her life, so after menopause, female friends should pay attention to taking care of themselves. Good maintenance is good for their health and will also delay skin aging and a series of other physical problems. But now women who have not reached menopause should also pay attention to dietary restrictions during menstruation, otherwise it will cause great harm to the body.