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Menopause or climacteric is one of the natural stages of a woman's life, following the climacteric period. Menopause is mostly observed between the ages of 48-52. It is characterized by the absence of menstrual bleeding for one year or more. From this point on, the woman's reproductive function is completed, and the ovarian function is reduced. The secretion of sexual hormones (estrogens, progesterone) and gonadotropic hormones is quantitatively altered, and the sexual organs perform their function partially. The presence of blood in the sexual organs is no longer normal and becomes unusual. The sexual organs undergo physiological aging and atrophy if not surgically removed. A perimenopausal period is distinguished, which precedes and follows menopause. Many and various changes occur in the woman's body, both general and local in nature: In the vagina, there is dryness of the mucous membrane, atrophic phenomena, and minor injuries. Urinary problems, such as incontinence, often arise. There may be pelvic muscle and ligament weakness, organ prolapse. Hot flashes, increased sweating, tachycardia, heart palpitations, sleep disturbances, nervous irritability, mood instability, and depression are common. Symptoms of anxiety, memory loss, vision deterioration, fluctuations in blood pressure, headaches, dry skin, hair loss, joint pain, weight changes, etc., may also occur. Bone tissue loss is often observed, increasing the risk of osteoporosis and fractures. Sexual function disturbances may also occur.Causes and Negative Factors of Menopause The course of this physiological stage in a woman’s life can be negatively affected by harmful habits, psychological factors, poor and unbalanced nutrition, a sedentary lifestyle, the presence of inflammatory and other diseases (including endocrine gland disorders), and others. Menopause may also occur due to: • Surgical removal of the ovaries and uterus. • Other medical interventions, such as radiation or chemotherapy. Main Approaches to Menopause Treatment It is very important to perform research and treatment for women in this age group. It is recommended to perform ultrasound, mammography, laboratory tests, and other examinations. Treatment depends on the presence and severity of symptoms and can be both pharmacological and non-pharmacological. Pharmacological treatment may include: • General, • Local, • Combined. This includes: • Hormone therapy, • Treatment of comorbidities, symptomatic treatment. A healthy lifestyle is also essential and plays a significant role. • Balanced diet, • Adequate physical activity, • Water procedures, • Regulation of blood pressure and weight, • Giving up harmful habits, • Positive emotions, • Avoiding stress. In some cases, physiotherapy is also used: • Reflexotherapy, • Electrophoresis of the lumbar region. Early Consultation with a Doctor — Individual Approach In all cases, it is essential to consult a doctor early, and an individual approach is crucial. Early treatment results in better health for the woman and makes this phase of life more tolerable. Thus, menopause is one of the natural stages in a woman’s life, which causes numerous changes in the skin, sexual organs, and psychological state. Take care of your health and consult a doctor in time to avoid severe consequences.

Cataract is an eye disease characterized by clouding of the lens, the biological lens of the eye, which interferes with the normal perception of images. As a result of this process, vision gradually worsens, which may eventually lead to complete blindness if not treated in time. The main symptom of cataract is the gradual decline in vision, and the disease often develops without pain. Initially, the deterioration of vision may be barely noticeable, but over time it progresses. The world around you starts to appear blurry, as if the person is looking through fogged glass or a screen of falling water. Colors become dull, and details become less sharp. Glasses do not help in this case, as the issue is not related to refraction. An important symptom is that, at the beginning of the disease, vision for nearby objects may even improve. This happens because cataract often causes myopia (nearsightedness), which improves the visibility of objects at a close distance. However, as the disease progresses, the situation worsens, and later, patients begin to suffer from vision loss both near and far. Other characteristic signs of cataract include: • The appearance of halos around bright light sources, such as street lamps or car headlights, especially at night. • Double vision. This is also often observed under bright light and in low-light conditions. • Reduced contrast sensitivity. Patients with cataract may have difficulty distinguishing shades of similar colors, such as blue and purple. • Increased sensitivity to light. Even ordinary daylight may irritate the eyes. • Difficulty reading, sewing, or working with small details. These difficulties are related to focus and clarity issues. The symptoms of cataract vary depending on its type and stage. For example, in nuclear cataract (clouding of the central part of the lens), vision for nearby objects may improve at first, but later, a loss of visual acuity occurs. In cortical cataract (clouding at the lens periphery), changes in vision occur more slowly, and the patient may not notice vision deterioration for a long time. As the disease progresses and the clouding of the lens continues, vision can decline to the point where the person loses the ability to distinguish objects and orient themselves in space. In mature cataract, vision is completely lost, and the pupil takes on a milky-white hue. Treatment of Cataract Currently, the only effective treatment for cataract is surgical intervention, as no other methods, such as medication or folk remedies, can restore the transparency of the lens. Surgical Treatment The main method of treating cataract is surgery to remove the cloudy lens and replace it with an artificial lens. This surgery is called phacoemulsification. In this method, ultrasound is used to break up the lens, after which the fragments are removed from the eye, and an artificial lens (intraocular lens, IOL) is placed in its place. Phacoemulsification is a modern and minimally invasive method that preserves vision and ensures a fast recovery period. The operation is performed through a small incision, only 2-3 mm, which minimizes the risk of complications and promotes quick healing. It usually takes 15 to 20 minutes and is performed under local anesthesia, making it accessible even for elderly patients. Moreover, after such an operation, stitches are not required, as the incision heals on its own. It is important that the postoperative period usually goes without complications, and patients often regain their vision within a few days. Artificial Lenses After cataract surgery, an artificial lens is placed in the eye. Today, there are several types of intraocular lenses: • Monofocal lenses, which provide clear vision at one distance (e.g., for distance or near vision). • Multifocal lenses, which provide good vision at different distances and can replace glasses for near and far vision. • Astigmatic lenses, intended for patients with astigmatism. The choice of lens depends on the patient’s condition and needs, as well as consultation with an ophthalmologist. It is important to note that even after successful cataract lens replacement surgery, patients may need additional glasses for certain tasks, such as reading.Conclusion Cataract is a common disease that impairs daily life and can lead to blindness if left untreated. However, with modern treatment methods, including cataract surgery with artificial lens implantation, most patients regain their vision and return to normal life. Early detection of the disease and consultation with an ophthalmologist are key to successful treatment and preventing the development of serious complications.

Esophageal reflux is a condition where stomach contents, including acid, digestive juices, or sometimes food remnants, rise up into the esophagus. The esophagus connects the mouth to the stomach, and normally, there is a special circular muscle at the lower end of the esophagus, known as the lower esophageal sphincter, which opens only during swallowing and then closes to prevent stomach contents from returning. When this muscle weakens or does not close fully for any reason, stomach acid can rise upward, causing irritation, heartburn, pain, or other discomforting sensations. Main Causes of Reflux 1. Weakening of the lower esophageal sphincter, which is the most common cause. 2. High stomach pressure, caused by excess weight, pregnancy, or consuming heavy food. 3. Certain foods and drinks, including coffee, alcohol, carbonated beverages, chocolate, fatty, and fried foods, that can increase the likelihood of reflux. 4. Smoking and alcohol, which weaken the sphincter. 5. Medications, such as certain anti-inflammatory drugs or blood pressure medications. 6. Stress and anxiety, which affect the digestive system and can contribute to the development of reflux. Main Symptoms • Chest burning, especially after eating or when lying down. • Bitter or sour taste in the mouth. • Itching or pain in the throat. • Hoarse voice or cough, especially in the morning. • Bloating or gas, nausea. • Rarely, difficulty breathing or throat pain that does not go away. If left untreated, the acid can damage the esophageal lining, leading to esophagitis, ulcers, and bleeding, Barrett’s esophagus, or even respiratory problems, such as asthma flare-ups and chronic cough. Diet and Lifestyle • Avoid overly spicy, fatty, and sour foods. • Do not eat before bedtime, as it can lead to excessive acid in the stomach. • Eat smaller portions more frequently, as consuming less food reduces the likelihood of reflux. • Reduce coffee, chocolate, and carbonated beverages. • Eat lighter foods, such as oats, bananas, vegetables, boiled meats, and soups with plain water. • Avoid eating before lying down to reduce the chances of acid rising. • Raise the head of the bed while sleeping, to help the sphincter stay closed and prevent stomach contents from rising. • Lose weight gradually if overweight, as excess weight can contribute to reflux. • Avoid tight clothing that can put pressure on the stomach. • Do not smoke or drink alcohol, as both weaken the lower esophageal sphincter. Treatment Esophageal reflux is a common but manageable condition. It requires a consistent treatment approach, which may involve medications and lifestyle changes. The treatment may include proton pump inhibitors, eliminating alcohol and smoking, as well as a reflux-friendly diet. If symptoms persist or frequently return, it is essential to consult a doctor for appropriate treatment options.

The knee joint is subjected to heavy daily stress. It is a fairly large joint, surrounded inside and outside by ligaments and tendons that ensure its stability. In fact, the articular cartilage itself has no nerve supply. With age, as cartilage wears down and body weight increases, the strain on the ligamentous apparatus also increases, leading to inflammation and destructive joint processes. At this stage, the patient feels pain in the knee joint. According to global statistics, every 10th person over the age of 55 suffers from gonarthritis, and one in four of them becomes disabled and requires knee joint endoprosthesis surgery. Causes of knee pain: • Osteoarthritis, mainly caused by cartilage wear, • Arthritis or joint inflammation, which can occur in rheumatoid arthritis, reactive arthritis, psoriatic arthritis, septic or infectious arthritis, periodic disease, gout, and other inflammatory joint conditions, • Excess weight or obesity, which increases the load on the knees, • Vitamin D deficiency, • Impaired blood circulation in the lower limbs, for example due to varicose veins, pronounced lymphostasis, or obliterating arterial diseases of the legs, • Certain types of anemia, • Excessive physical exertion. When to see a doctor: • if the pain is persistent and gradually worsening, with only temporary relief from painkillers, • if there is redness and localized warmth, • if movement in the knees becomes difficult, especially when climbing up or down stairs, • if a cracking or grinding sound (known as crepitus) is heard or felt in the knees, • if there has been a wound or insect bite on the skin over the knee, followed by inflammation with redness and warmth. Patients with gonarthritis (inflammation of the knee joint) may also have anemia. This may be a manifestation of the main disease or, in some cases, anemia itself may provoke joint inflammation. For example, in rheumatoid arthritis, blood tests may show anemia, thrombocytosis, and elevated ESR — indicators of disease activity. In such cases, it is not necessary to treat anemia with iron supplements; rather, proper anti-inflammatory therapy to control disease activity and flare-ups is sufficient, and laboratory markers will normalize on their own. Anemia during inflammatory joint diseases may also be caused by prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, ibuprofen, aertal, or indomethacin, which can lead to gastritis or peptic ulcers. One possible manifestation of these complications is anemia. Knee pain can also be occupational. For example, knee injuries are very common among football players, since football involves fast running, sudden stops and turns, jumping, and kicking. Players may stretch or tear cruciate ligaments, damage the menisci, dislocate the kneecap, or develop inflammation or muscle strain. A deficiency of vitamin D and magnesium can also cause knee and muscle pain. It is particularly important to replenish magnesium deficiency, as all enzymes involved in vitamin D metabolism require magnesium as a cofactor. Even when magnesium levels in bone tissue decrease, its concentration in the blood may remain within the normal range — this is known as chronic latent magnesium deficiency.

Subacute thyroiditis is an inflammatory disease of the thyroid gland. Women are affected much more often than men. It usually occurs between the ages of 30 and 50. Causes The disease may develop after viral infections such as coxsackie virus, influenza, or adenoviral infections. General Symptoms • Fatigue • Weakness • Headache • Muscle pain • Joint pain Stages of the Disease Subacute thyroiditis generally progresses through three stages. Stage 1 – Hyperthyroidism During this phase, the following symptoms are observed: • Palpitations • Weight loss • Nervousness • Tremor • Enlargement of the thyroid gland • Pain in the thyroid area radiating to the neck, occiput, ears, or lower jaw • Sometimes difficulty swallowing • Enlargement of lymph nodes • Fever Over time, hyperthyroidism is replaced by the second (euthyroid) stage, during which the clinical symptoms subside. A third (hypothyroid) stage may also occur, which is usually temporary. The course of the disease lasts from several weeks to a few months. Diagnosis Diagnosis includes: • Laboratory tests – complete blood count, C-reactive protein level, and thyroid hormone tests. • Thyroid ultrasound (US) – the gland appears heterogeneous and hypoechoic. • Thyroid scintigraphy – damaged areas may appear as “cold nodules.” • Fine-needle aspiration biopsy – performed for histological examination. Treatment Subacute thyroiditis usually resolves spontaneously within up to 12 months. • For mild pain symptoms, nonsteroidal anti-inflammatory drugs (NSAIDs) are used. • In more severe cases, glucocorticoids are prescribed and must be taken only according to a medical regimen. • During the hyperthyroid phase, beta-adrenergic blockers are indicated. • In the hypothyroid phase, replacement therapy with thyroid hormones is rarely necessary. Conclusion The course of the disease is generally favorable. Only in 2–5% of cases can persistent hypothyroidism develop. If such symptoms appear, it is necessary to consult an endocrinologist at Dalimed Medical Center.

Adrenocorticotropic hormone (ACTH), or corticotropin, is a peptide hormone composed of 39 amino acids. It is produced in the anterior pituitary gland as part of the precursor molecule proopiomelanocortin (POMC). Through tissue cleavage, ACTH and several other related peptides are formed. ACTH stimulates the synthesis and secretion of glucocorticoids (especially cortisol) by the adrenal cortex. The production of glucocorticoids is regulated by various factors. After stimulation (for example, by physical activity or internal biological mechanisms), the hypothalamus secretes corticotropin-releasing hormone (CRH, corticoliberin). CRH acts on the pituitary gland, which in turn synthesizes and secretes ACTH. ACTH stimulates the adrenal glands to secrete glucocorticoids. Elevated glucocorticoid concentrations in the blood inhibit the synthesis of CRH and ACTH through negative feedback. Clinical significance of ACTH testing 1) Measuring ACTH levels in plasma helps assess adrenal and pituitary function in cases of cortisol production disorders. 2) A high ACTH level with high cortisol suggests Cushing’s disease (an ACTH-producing pituitary adenoma). 3) A high ACTH level with low cortisol suggests primary adrenal insufficiency (Addison’s disease). 4) A low or normal ACTH level with low cortisol suggests secondary or tertiary adrenal insufficiency due to pituitary or hypothalamic dysfunction. ACTH that is not produced by the pituitary gland is known as ectopic ACTH. This condition is often associated with small-cell lung carcinoma. In rare cases, ectopic ACTH may arise from thymic tumors, pancreatic adenocarcinomas, or bronchial tumors. These tumors often secrete ACTH precursors (POMC and pro-ACTH).

Biorevitalization is a modern and highly effective method of deep skin hydration and rejuvenation. During the procedure, microinjections of hyaluronic acid are delivered into the dermis (the middle skin layer). This activates natural cell renewal, stimulates collagen and elastin production, improves microcirculation, and restores the skin’s firmness, freshness, and glow. No cream can provide the same deep moisturizing and restorative effect as biorevitalization — that’s why it’s often called the “injection of youth”.How the Procedure Works Before the session, the skin is thoroughly cleansed, and a topical anesthetic may be applied if needed. Then, the doctor injects hyaluronic acid using an ultra-fine needle. Small papules (tiny bumps) may appear after treatment, disappearing within 2–4 days. The procedure takes about 30–60 minutes, depending on the treated area (face, neck, décolleté, hands, knees, etc.). When to Expect Results Visible improvements can be seen within a few days — the skin becomes smoother, more hydrated, and radiant. With each session, the effect builds up: fine lines are reduced, the skin tightens and looks fresher and younger. After a full course, your body starts producing its own hyaluronic acid, and the results last for six months or longer. Who Can Benefit Ages 25–35: Prevents early signs of aging and dryness. Ages 40+: Improves elasticity, combats sagging, and evens skin tone. Ages 50+: Reduces deep wrinkles, restores firmness, and reverses sun damage. Also beneficial for tired or stressed skin, after sun exposure, or following laser and peeling treatments. What Issues It Solves • Fine and deep wrinkles • Dryness and dullness • Loss of firmness and tone • Hyperpigmentation and sun spots • Acne, enlarged pores, uneven texture • Scars and stretch marks Can It Be Combined with Other Treatments? Absolutely! Biorevitalization pairs perfectly with botulinum therapy, chemical peels, laser rejuvenation, and other aesthetic treatments for enhanced results. Safety and Comfort The procedure is completely safe, performed by qualified cosmetic doctors, and suitable for all skin types all year round. At Dalimed medical center, biorevitalization is performed by certified specialists using advanced products and personalized protocols tailored to your skin’s needs. Our doctors will design the ideal rejuvenation plan based on your age, skin condition, and desired outcome.Give your skin health, radiance, and youth — book your biorevitalization session at Dalimed today!

Adrenarche is a natural developmental phase in childhood when the adrenal glands begin to produce increased amounts of the hormone dehydroepiandrosterone (DHEA). This process usually occurs between the ages of 6 and 8 and precedes true puberty, known as pubarche, by about two years. DHEA is a precursor hormone, meaning that the body converts it into stronger hormones such as androgens (testosterone, androstenedione) and estrogen. These hormones play an important role in initiating puberty, supporting reproductive health, and influencing body growth and development. In the bloodstream, DHEA mostly circulates as DHEA-sulfate (DHEAS), and its presence in blood tests indicates that adrenarche has begun. However, since adrenarche is a normal stage, this test is not routinely ordered for children. What Happens During Adrenarche? During adrenarche, the adrenal cortex—the outer layer of the adrenal gland—undergoes further maturation, especially in its innermost zone (zona reticularis). This development triggers the production of DHEA, which then transforms into androgens responsible for stimulating various glands and bodily changes, such as: • Sebaceous glands: These glands in the skin produce sebum, a protective oily substance that helps retain moisture and contributes to body odor. • Apocrine glands: Located in the underarm and genital regions, these glands remain inactive until activated by adrenal hormones. It’s important to distinguish adrenarche from gonadarche, the stage when the ovaries or testes mature and start producing major sex hormones like estrogen or testosterone. Adrenarche and gonadarche are separate but complementary processes, each marking different aspects of development. Premature Adrenarche Premature adrenarche refers to the early appearance of pubic or underarm hair and body odor—before age 8 in girls or age 9 in boys. In most cases, this early onset is not harmful, but it can sometimes be confused with precocious puberty, which involves early breast or genital development. Common symptoms include: • Pubic and/or underarm hair growth in young children. • Noticeable body odor that may require deodorant use. Children with premature adrenarche are often taller than average for their age. Although the exact cause remains unclear, girls experience it more frequently than boys. To rule out other possible conditions such as congenital adrenal hyperplasia, hormone-secreting tumors, or external hormone exposure, a pediatrician may recommend physical and laboratory examinations. About 90% of early pubic hair cases are due to premature adrenarche rather than disease. Is It Dangerous or Treatable? Premature adrenarche is generally not dangerous and usually doesn’t require medical treatment. However, research suggests a slightly increased risk of conditions such as obesity, insulin resistance, polycystic ovary syndrome (PCOS), and mood disorders later in life. Emotional well-being can also be affected—children who mature earlier than peers may experience embarrassment or social discomfort. There is no medication to reverse or slow adrenarche-related hair growth, and prevention is not typically possible. Some studies associate early adrenarche with factors such as low birth weight, premature birth, or past brain injury. Final Note Adrenarche and pubarche are natural, healthy stages in a child’s growth. While premature adrenarche can be concerning for parents, it’s rarely a sign of illness. If your child shows early signs of puberty or experiences emotional distress related to these changes, consulting a pediatrician or child psychologist can help ensure healthy development and support their confidence during this transition.