Abstract
Objective. To compare the clinical efficacy of monotherapy with menopausal hormonal therapy (climonorm) in the treatment of genitourinary syndrome of menopause with the effectiveness of monotherapy by M-anticholinergic mirabegron (betmiga) and a combination of these drugs. Materials and methods. The randomization method was used to form 3 groups of 30 persons each, to whom various types of treatment were applied: mirabegron exclusively, climonorm exclusively, and a combination of these drugs. To determine the severity of menopausal symptoms and its dynamics in the treatment process, the Menopause Rating Scale was used. The Barlow scale was used to assess the impact of vulvovaginal symptoms on the quality of life. To objectify complaints, an assessment of the vaginal mucosa was made in accordance with the vaginal health index. Uroflowmetry was performed on a Dantec installation: Urodyn 1000. Surveys of the subjects, evaluation of the vaginal health index and uroflowmetry were carried out before the start of treatment, as well as during 1, 3, 6 months of therapy. Study results. The combination of menopausal hormonal therapy with mirabegron gave the highest rate of reduction of symptoms of climacteric syndrome – from 36.03 ± 0.35 to 11.61 ± 1.57 MRS points (p <0.05) for 3 months of treatment, and was also better reflected duration of urination (from 6.8 ± 0.5 to 8.6 ± 0.2 s) (p <0.05), volume of urination (from 103 ± 3.5 to 140.1 ± 4.1 ml) ( p <0.05) and the maximum flow rate of urine (from 36.1 ± 0.4 to 30.5 ± 0.4 ml/s) (p <0.05) for 1 month. Conclusion. Systemic administration of combined menopausal hormonal therapy in combination with M-anticholinergics is effective in the treatment of genitourinary menopause syndrome. Algorithms for treating urinary incontinence and overactive bladder in perimenopausal women with genitourinary menopause syndrome as part of climacteric syndrome by prescribing systemic menopausal hormonal therapy require further development.
Highlights
The relevance of the women’s life quality problem is due to the fact that approximately 10% of the population is females aged 40+
STUDY RESULTS AND ITS DISCUSSION First of all, it should be pointed out that the selected groups are similar in terms of comparative initial data, which corresponds to the principles of evidence medicine and ensures the reliability of the findings
Regarding the effect on the pathological manifestations of climacteric syndrome (CS) according to the Menopause Rating Scale (MRS) scale, the best results, as expected, were obtained in the groups that used menopausal hormonal therapy (MHT) as systemic therapy
Summary
Інтенсивність симптому Мінімальні порушення, які не впливають на повсякденне життя. Дискомфорт, що періодично впливає на повсякденне життя Помірні рецидивуючі порушення, що впливають на повсякденне життя Виражені порушення, що постійно впливають на повсякденне життя.
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