Можливі шляхи корекції тяжких форм клімактеричного синдрому у жінок на тлі ендометріозу

Abstract

Modern demographic changes in society are accompanied by an increase of women of the older age group in the general population. During this age period, along with the elimination of reproductive function in women, a complex of pathological symptoms often develops – climacteric syndrome (CS), which displays the maladaptation of various organs and systems that have estrogen receptors. An extremely topical problem of climacteric syndrome is for patients with endometriosis whose quantity is about 50% of the population. The objective: the determination of the effectiveness of the complex of medical therapy developed by us in women with severe forms of COP in the context of endometriosis. Materials and methods. Within 3 months we actively observed 60 women with an endometriosis in the anamnesis and manifestations of severe CS. By randomization, the women were divided into 2 groups depending on the chosen therapy: group 1 consisted of 30 women who, taking into account the above mentioned advantages, received the transdermal estrogen Estrogel, group 2 – 30 patients, whom a therapy by estrogen, phenibut and mebicar was assigned. Patients of both groups were given an intrauterine system with levonorgestrel. In order to conduct a comparative assessment of the clinical effectiveness of various treatment methods, the integral pathology index (IPI) was used in dynamics – before treatment, after 1, 2 and 3 months of therapy. The improvement degree (ID) of the disease clinical picture was also determined. Statistical analysis of the data was carried out on a personal computer using the programs SPSS 2000 (SPSSInc., USA) and Exel 2000 (MicrosoftInc., USA). Results. Our analysis found that as a result of the therapy received, a significant improvement in the scores was observed among patients of both subgroups. During the first two months, the effectiveness of combining menopausal hormone therapy with anti-stress medications in women with severe CS was almost 2 times greater than monotherapy with menopausal hormone therapy (Coefficient of Efficacy 1 = 2.68, Coefficient of Efficacy 2 = 1.62), indicating a faster elimination rate of CS’ symptoms using this combination. The overall effectiveness of the combination of phenybut with mebikar against the background of the use of Estrogel with an intrauterine system with levonorgestrel was 1.41 times higher compared to effectiveness of Estrogel and the levonorgestrel intrauterine system only use. Conclusion. Administration of anti-stress drugs Fenibut&Mebikar combination along with use of menopausal hormone therapy allows to reduce quickly the severity of CS manifestations, especially psychoemotional disorders almost to their full elimination in a relatively short period of time. The proposed scheme of treatment helps to eliminate quickly the symptoms of menopausal syndrome in women with endometriosis, improve and stabilize their psychological profile, restore working capacity, improve adaptation and quality of life. Key words: climacteric syndrome, endometriosis, anti-stress therapy, phenibut, mebicar, transdermal estrogen, Estrogel, intrauterine system with levonorgestrel.