Особенности течения миомы матки в постменопаузальный период

Abstract

The objective: to study the clinical manifestations of uterine fibroids in the postmenopausal period. Materials and methods. 85 patients with uterine myoma in the postmenopausal period were examined. The average age of patients was 58±1.0 (47–80) years. Criteria of inclusion are all patients with uterine myoma of up to 12 weeks of gestation of various localization in the postmenopausal period .In all patients, the clinical and anamnestic manifestations of uterine fibroids were studied. The state of the hypothalamic-pituitary-ovarian system, the determination of the level of the CA 125 tumor. Results. In 47 (55.3%) patients, various clinical manifestations of uterine fibroids were noted: in 37 (78.7%) patients there was pain of varying intensity, in 22 (46.8%) of patients was bloody discharge, in 17 (36.2%) dysuric phenomena, 10 (21.3%) patients had bleeding and 10 (21.3%) patients had defecation disorders. In 34 (72.3%) patients, the presence of menopausal syndrome of varying severity was noted. At the same time, the frequency of mild menopausal syndrome was 23.4% (n=11), moderate climacteric syndrome was 21.3% (n=10), and the frequency of severe degree was 27.7% (n=13). In patients with uterine myoma in the postmenopausal period, there was a significant increase in Prl, DHEA-S, E1 and a significant decrease in the LH / FSH ratio, E2, and Ttot (P<0.05). The changes in the level of the CA125 tumor marker were insignificant and did not represent diagnostic value. Conclusion. Data analysis of the results of this study demonstrated that the main factors affecting the growth and development of uterine fibroids in postmenopause are the presence of hyperprolactinemia, hyperandrogenism of adrenal genesis and hyperestrogenia due to an increase in estrone level, which leads to an imbalance of apoptosis and proliferation mechanisms. Key words: uterine myoma, postmenopausal period, bleeding, hyperandrogenism, hypoestrogenism, climacteric syndrome.