Menopausal Disorders In Women Research Articles

КЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ НЕГОРМОНАЛЬНЫХ МЕТОДОВ ТЕРАПИИ ПАТАЛОГИЧЕСКОГО КЛИМАКТЕРИЧЕСКОГО СИНДРОМА У ЖЕНЩИН

The purpose of the study is to study the clinical effectiveness of the dietary supplement "Menophen" in comparison with β-alanine in the treatment of menopausal symptoms in women in the perimenopausal, menopausal and postmenopausal periods. Menopausal syndrome is a complex of vegetative-vascular, psycho-emotional, metabolic-endocrine, vaginal, sexual and other disorders. According to domestic authors, vasomotor disorders such as hot flashes, lability of blood pressure and pulse, increased sweating, chills, which significantly reduce the quality of life of patients and disrupt the circadian sleep-wake rhythm, come to the fore. Today, menopausal women continue to work actively, but hot flashes and sleep disturbances significantly reduce their level of performance and increase the number of absences from sick leave by 82%, compared to women without hot flashes. At the same time, 87.5% of women refuse to use and prescribe MHT, expressing doubts about the safety of their use; the main fears of patients are weight gain and the development of oncological pathology. Treatment with the dietary supplement Menofen leads to a decrease in the number and severity of psycho-emotional, metabolic-endocrine and neurovegetative disorders in menopausal women.

Relationship between personality traits and sexual function in symptomatic postmenopausal women

IntroductionFemale sexual function relies on a complex interplay of physical, psychosocial, and neurobiological factors. Over the last decades, increasing attention has been paid to the influence of personality traits on general health and many aspects of quality of life, including sexuality. ObjectiveTo assess whether dimensions of the personality are related to the domains of sexual function (desire, arousal, lubrication, orgasm, satisfaction, and pain) in symptomatic postmenopausal women. Mood was also investigated to explore its association with female sexual dysfunction (FSD). MethodsValidated questionnaires to assess sexual function [the Female Sexual Functioning Index (FSFI)], mood [the State-Anxiety Inventory (STAI), and Zung Self Rating Depression Scale (SDS)], and personality traits [the Tridimensional Personality Questionnaire (TPQ)] were filled in by 130 early postmenopausal women experiencing hot flushes (≥30/week). Results61.5 % (n = 80) of the women had an FSFI total score lower than 26.55, the standard cut-off for FSD. A clinical state of anxiety was present in 53.8 % (n = 70), whereas only 12.3 % (n = 16) showed clinically relevant depressive symptoms. According to the FSFI cut-off score, women with sexual disorders had statistically significantly higher levels of anxiety, depression (p < 0.001 for both), and harm avoidance (HA) (p = 0.004) than women without such disorders. Significantly higher levels of anxiety were found in women in the lower quartile (LQ) of the distribution of the total FSFI score than in women in both the interquartile range (IQR) and in the upper quartile (UQ) (p < 0.05). Moreover, women in the UQ had a lower grade of depression and HA than others (p < 0.05). The Sobel test showed that the personality trait HA significantly mediated the relationship between anxiety and FSFI total score (Z = -2.19, p < 0.05) and between depression and FSFI total score (Z = −2.35, p < 0.05). ConclusionsThe present data suggest the personality trait HA is relevant to sexual function and mediates the impact of mood on FSD in symptomatic menopausal women. In clinical practice, the use of validated psychometric tools for mood screening is useful to establish appropriate diagnosis and treatment of sexual disorders in menopausal women. Moreover, the assessment of personality traits could provide additional information that directs clinicians towards an increasingly tailored and multidimensional treatment of FSD.

The benefits of purified cytoplasm of pollen in reducing menopausal symptoms in peri- and post-menopause: an Italian multicenter prospective observational study.

Purified cytoplasm of pollen (PCP) is a non-hormonal herbal remedy used to manage vasomotor symptoms (VMS), sleep and mood disorders in menopausal women not relying on Hormone Replacement Therapy (HRT). Many studies demonstrated its efficacy and safety in post-menopause but few data are available about peri-menopause. This is a multicenter prospective observational study on Italian symptomatic women in peri- and post-menopause referring to gynecology clinics of different areas of Italy, evaluating the effects of PCP therapy on hot flashes (HFs) and other parameters included in the Greene Climacteric Scale (GCS). We recruited 108 peri- and post-menopausal women (mean age 53.8±4 years), evaluating them at baseline (V0) and after 3 months of PCP treatment (V1). Basal median value of all items of GCS did not differ among all subjects. We found a significant improvement of HFs (P<0.0001) and night sweats (P<0.0001) between V0 and V1. Additionally, all items of GCS apart from loss of sensitivity to limbs (P=0.0746) significantly ameliorated after PCP therapy (P<0.05). According to these findings, PCP may be considered as an efficacious alternative non-hormonal treatment for the management of VMS as well as mood and sleep disturbances in both peri- and post-menopause.

Patterns of clinical presentation of climacteric syndrome and total body composition in women with menopausal metabolic syndrome

Introduction. Modern gynecological endocrinology widely discusses various disorders accompanying the onset of menopause. Metabolic disorders are one of the leading risk factors for the development of ischemic heart disease and vascular dystonia in menopausal women. That is why the drugs prescribed as part of menopausal hormone therapy are contraindicated for patients with severe metabolic disorders and predisposition to thrombosis. Women with a normal body mass index may develop the menopausal metabolic syndrome, since its presentations largely depend on the total body composition and the specific gravity of visceral adipose tissue.Aim. To assess the patterns of clinical presentation of menopause in women with metabolic menopausal syndrome.Materials and methods. In the furtherance of that aim, we examined 184 women who were in menopause 1 to 5 years at the age of 52 to 57 years (average age 54.2 ± 0.5 years). Of these, 87 were diagnosed with metabolic syndrome – they were included in the main group. The comparison group included 97 menopausal women without metabolic disorders.Results and discussion. We assessed the severity of clinical presentations and the total body composition of the patients in the selected groups. It has been established that the body mass index cannot serve as a criterion for evaluation of metabolic processes, despite the sufficient simplicity of its computation.Conclusions. The authentic view of the risks of metabolic disorders in menopausal women requires the study of total body composition.

Kamishoyosan potentiates pentobarbital-induced sleep in socially isolated, ovariectomized mice

Ethnopharmacological relevanceSleep disorders are among the most common symptoms in both peri- and post-menopausal women. Kamishoyosan (KSS) is a Kampo medicine prescribed for the treatment of sleep disorders in menopausal women in Japan. However, its precise mechanism of action remains unclear. Aim of the studyIn the present study, we developed a new animal model of menopausal sleep disorders by inducing social isolation stress in ovariectomized mice. Using pentobarbital-induced sleeping time as an index, we aimed to investigate the effects of KSS and involvement of the benzodiazepine receptors. Materials and methodsEight-week-old, female ddY mice were ovariectomized or subjected to a sham operation (control) and housed in social isolation or groups for 9 weeks. The animals were divided into four groups, group-housed sham-operated, isolated sham-operated, group-housed ovariectomized, and socially isolated ovariectomized. Pentobarbital (50 mg/kg) was administered intraperitoneally (i.p.). Sleeping time was considered the period between the loss of righting reflex and its return (up to 180 min). KSS was administered orally (p.o.) 60 min before the test. Diazepam and flumazenil were administered i.p. 30 and 45 min before the test, respectively. On the day after administration, the mice were euthanized, and their uteri were weighed. ResultsSocially isolated, ovariectomized mice had shorter sleeping times than mice in all other groups. In mice with intact ovaries, diazepam (1 mg/kg, i.p.) considerably prolonged the pentobarbital-induced sleeping time, but KSS (30–1000 mg/kg, p.o.) did not. However, KSS (100 mg/kg, p.o.) significantly prolonged the pentobarbital-induced sleeping time in socially isolated ovariectomized mice. The prolongation of sleeping time mediated by KSS was reversed by flumazenil (3 mg/kg, i.p.). ConclusionsKSS potentiated pentobarbital-induced sleep in socially isolated, ovariectomized mice, and the benzodiazepine receptors are possibly involved in its pharmacological mechanism. These findings suggest that KSS is beneficial for the treatment of menopausal sleep disorders.

Analysis of bone metabolism mechanisms in postmenopausal females with type 2 diabetes and DKK1 gene polymorphisms and the effects of polymer nanomaterials on wound infection in patients

Diabetic patients are prone to abnormal bone metabolism. Menopausal women exhibit reduced estrogen secretion and bone absorption exceeds the rate of bone formation. Therefore, postmenopausal women with diabetes are even more likely to suffer from osteoporosis. Identifying the specific mechanism of abnormal bone metabolism in diabetic menopausal women will help reduce the risk of bone fractures. This study explored the specific mechanisms of bone metabolism disorders in menopausal women with type 2 diabetes in relation to genetic polymorphisms. We found that the distribution frequency of the CA genotype and A allele at the rs1373004 locus of the DKK1 gene in menopausal women with diabetes and abnormal bone mass were significantly lower compared with that in normal bone. The distribution of the GG genotype at the rs1528877 locus was also less frequent compared with those exhibiting normal bone mass. This suggests that the genotype and allele frequency distribution in the DKK1 gene at rs1373004 and RS1528877 in postmenopausal T2DM women is associated with glucose metabolism and bone metabolism. To analyze the efficacy of polylactic acid (PLA)/gelatin nanofibers on T2DM patients with infectious fractures, we compared various aspects of wound healing in patients treated with conventional therapy versus PLA/gelatin nanofibers. The results indicated that the number of days required for wound healing and the frequency of incisions in patients treated with PLA/gelatin nanofibers were significantly lower compared with those treated with conventional therapy (P &lt; 0.05). The wound healing rate of patients treated with PLA/gelatin nanofibers was significantly higher compared with that of patients treated with conventional therapy on days 7, 14, 21, and 28 of treatment. Our findings indicate that PLA/gelatin nanofiber treatment can significantly promote fracture wound healing.

Promising directions of medical technologies for the correction of sleep disorders in menopausal women of various ethnic groups

ethnic groups.&#x0D; Materials and methods.The objects of the study were menopausal women of Russian and Buryat ethnic groups (n=466), who were divided into a control group (without sleep disturbances) and main subgroups (with insomnia and comorbidity of insomnia with obstructive sleep apnea syndrome). All women underwent clinical and anamnestic examination, genotyping for3111T/C Clock gene polymorphism, determination of the circadian profile of melatonin secretion, parameters of lipid metabolism and the system lipid peroxidation antioxidant protection.&#x0D; Results.In Caucasians with sleep disorders, a higher prevalence of the3111T/T genotype and theClockgene3111Tallele was revealed as compared to the control (p0.05). Perimenopausal Caucasians showed a shift in the peak of melatonin secretion to the morning hours; in Mongoloids, both peri- and postmenopausal women, a decrease in melatonin total levels was revealed. Dyslipoproteinemia is characteristic of both races patients who have comorbidity of insomnia and obstructive sleep apnea syndrome, and it is more pronounced in postmenopausal Caucasians. Oxidative stress in sleep disorders is more pronounced in Mongoloids. The medical technologies directions for correction of sleep disorders are proposed: the use of melatonin drugs in the evening and light therapy in the early morning hours in Caucasians who are carriers of the3111T Clockgene allele; melatonin drugs to increase its total level in Mongoloids; personalized prescription of antioxidant therapy in all patients; specific therapy to eliminate breathing disorders during sleep in those who have obstructive sleep apnea syndrome.&#x0D; Conclusions.Presence of insomnia, chronobiological rhythms of melatonin secretion, lipid peroxidation processes in sleep disorders are ethnospecific.

Функциональное состояние сосудистой стенки и плазменного звена гемостаза у женщин раннего постменопаузального периода на фоне длительной менопаузальной гормональной терапии

Цель исследования: оценка изменений функциональной активности сосудистой стенки и плазменного звена гемостаза у женщин раннего постменопаузального периода на фоне длительной низкодозовой менопаузальной гормональной терапии (МГТ). Материалы и методы: Обследовано 162 женщины в ранней постменопаузе. В основную группу вошли 84 пациентки, которым была назначена низкодозовая МГТ: 1 мг 17β-эстрадиола (E2) и 2 мг дроспиренона (ДРСП) — препарат Анжелик® (Байер Фарма, Германия). Контрольную группу составили 78 женщин, не получавших МГТ. Длительность наблюдения составила 5,2 [4,8; 5,7] лет. Исследовали антитромбогенную активность сосудистой стенки, лабораторные маркеры эндотелиальной дисфункции. Результаты: Несмотря на увеличение агрегационной активности тромбоцитов и более низкие значения активности антитромбина III у женщин на фоне МГТ, не было отмечено увеличения риска развития венозного тромбоза и эмболий, ишемического инсульта и случаев острого коронарного синдрома. К окончанию наблюдения установлено снижение антиагрегационного потенциала сосудистой стенки, более выраженное у женщин группы кон-троля. У женщин, принимавших МГТ, выявлено снижение концентрации фибриногена крови к окончанию исследования. На фоне МГТ отмечено значимое возрастание уровня метаболитов оксида азота, снижение уровней эндотелина-1 и асимметричного диметиларгинина к 12 мес наблюдения, но в дальнейшем отмечено повышение их уровней, не достигшее исходных значений. Заключение: Изменения функциональной активности эндотелия свидетельствуют об отсутствии негативного влияния на эндотелий сосудов длительной низкодозовой МГТ (1 мг E2/2 мг ДРСП). Objectives: to assess changes in the functional activity of the vascular wall and plasma hemostasis in women of early postmenopausal period under long-term low-dose menopausal hormone therapy (MHT). Patients/Methods: We examined 162 women in early postmenopause. The main group included 84 patients; they were prescribed a low-dose MHT: 1 mg of 17β-estradiol (E2) and 2 mg of drospirenone (DRSP) — Angelique® (Bayer Pharma, Germany). The control group consisted of 78 women did not taking MHT. The duration of observation was 5.2 [4.8; 5.7] years. Antithrombogenic activity of the vascular wall and laboratory markers of endothelial dysfunction were examined. Results: In women taking MHT we found increasing of platelet aggregation activity and lower antithrombin III activity, but did not reveal increased risk of venous thrombosis and embolism, ischemic stroke, and cases of acute coronary syndrome. By the end of observation decreasing of antiplatelet potential of the vascular wall, more expressed in women of the control group, was noted. In women taking MHT, blood fi brinogen concentration decreased by the end of the study. After 12 months of observation in women taking MHT we revealed significant increasing of nitric oxide metabolites, decreasing of endothelin-1 and asymmetric dimethylarginine; later their levels increased but did not reach the initial values. Conclusions: Changes in endothelial functional activity showed no adverse effect of long-term low-dose MHT (1 mg E2/DRSP 2 mg) on the vascular endothelium.

Carbohydrate metabolism in women with metabolic syndrome with multimodal non-drug correction of menopausal disorders

Purpose of workTo study the effect of non-pharmacological correction on carbohydrate metabolism in women with menopausal disorders against the background of metabolic syndrome. Materials and methods330 women 45–50 years old with menopausal disorders during the menopausal transition and metabolic syndrome (MS) are ranked in 5 groups. Group I used: basic treatment, physiotherapy, balneotherapy, multivitamins and minerals, as well as physiotherapeutic factors (vibration therapy, chromotherapy, melotherapy, aromatherapy, aeroionotherapy). In group II, chromotherapy was excluded from the above methods, in group III - vibration therapy, in group IV physiotherapy was not used, in group V only basic treatment was used. The levels of glucose, serum insulin, and the HOMA-IR index (Homeostasis Model Assessment-Insulin Resistance) were determined. ResultsThe inclusion of physical factors in the treatment complex significantly improved carbohydrate metabolism. The simultaneous use of all these physical factors allowed the most significant decrease in the HOMA-IR index after 6 months of therapy in patients with mild climacteric syndrome by 56,2 %, in patients with moderate climacteric syndrome by 57,2 %, respectively (p < 0,0001). The decrease in the total Green test score was 55,3 % and 39,9 %, respectively (p < 0,0001). ConclusionNon-drug complex programs with physiotherapy improve carbohydrate metabolism and contribute to the regression of menopausal disorders in women with metabolic syndrome during the menopausal transition. The priority is the simultaneous use of vibration therapy, chromotherapy, melotherapy, aromatherapy and aeroionotherapy.

Фитотерапия климактерических нарушений

A study to examine the efficacy and safety of drug Menomedin in patients with climacteric disorders of mild to moderate severity in late reproductive period was performed. The average menopausal index, according to a Menopause Rating Scale (MRS), was significantly lower after treatment (8.6±0.1) than before treatment (23.2±0.5). In all examined women hormone levels corresponded to perimenopausal values. Side effects and individual intolerance reactions were not observed. Antiatherosclerotic effect was detected during treatment Menomedin. Author of the study conclude that a good level of efficacy and safety Menomedin allows to use it at the earliest manifestations of menopausal disorders in women in the late reproductive period (perimenopause). Key words: climacteric syndrome, perimenopause, Menomedin.

Possibilities of non-drug correction of menopausal disorders in women with metabolic syndrome: focus on prothrombogenic potential of the blood and pro-inflammatory status

Aim. To study the dynamics of hemostasis, markers of systemic inflammation on the background of non-drug correction of menopausal disorders in women with metabolic syndrome (MS).Material and methods. Three hundred thirty women 45-50 years old with MS and menopausal disorders are divided into 5 groups. Basic treatment received all women. In the study group and comparison groups, the following were included in the treatment program: physiotherapy exercises, drinking balneotherapy, oral multivitamins and minerals, as well as physical factors in various combinations (vibrotherapy, chromotherapy, melotherapy, aromatherapy, aero ionotherapy). The concentration of fibrinogen, C-reactive protein (CRP), hemostasis parameters were determined in dynamics.Results. After 6 months of use of all medical complexes with physiotherapy in patients with menopausal syndrome of mild severity, a significant increase in the level of international normalized ratio (INR) was observed from 0,99 to 1,04, fibrinogen level regressed by 14,6-15,4%, CRP by 16,3-20,5% (p&lt;0,05). In patients with climacteric syndrome of moderate severity, the best results were achieved when using the complex with a full set of all the listed factors: an increase in the INR level from 0,97 to 1,01, a decrease in the level of fibrinogen by 14,6%, and the CRP level — by 19,6% (p&lt;0,05).Conclusion. Polymodal programs, including physiotherapy, improve hemostasis, provide reducing the level of inflammatory markers. In moderate climacteric disorders, the priority is given to the program with simultaneous use of vibrotherapy, chromotherapy, melotherapy, aromatherapy and aeroionotherapy.

Performance of Metabolic Parameters in Formation of Sleep Disorders in Menopausal Women

Background. It is known that menopausal women suffer from sleep disorders. As additional diagnostic methods, it is possible to use the equations of linear classification functions.Aim: to determine the most informative parameters among the lipid profile, the “lipid peroxidation – antioxidant protection” system parameters and the melatonin secretion chronobiological rhythms in menopausal women with sleep disorders.Materials and methods. 56 perimenopausal women and 70 postmenopausal ones in accordance with the inclusion criteria participated in this study. Diagnoses of insomnia and obstructive sleep apnea syndrome were made according to the results of specialized somnological questionnaires and polysomnographic monitoring. Spectrophotometric methods for studying of lipid metabolism and the “lipid peroxidation – antioxidant protection” system parameters, an enzyme immunoassay method for determining melatonin were also used. A multidimensional discriminant analysis to reveal the most informative parameters among the parameters studied was used.Results. The most informative indicators of the metabolic system for sleep disorders in perimenopausal women with insomnia are melatonin 06.00–07.00 h, melatonin 18.00–19.00 h, melatonin 23.00–00.00 h, ketodienes and conjugated trienes, oxidized glutathione; with insomnia and OSAS – melatonin 06.00–07.00 h, melatonin 12.00–13.00 h, melatonin 23.00–00.00 h, substrates with conjugated double bonds, total cholesterol; in postmenopausal women with insomnia – diene conjugates, α-tocopherol, total antioxidant capacity, active products of thiobarbituric acid, reduced glutathione; with insomnia and OSAS – total antioxidant capacity, α-tocopherol, substrates with conjugated double bonds.Conclusions. The results obtained indicate a great strain in the antioxidant protection system in menopausal women with sleep disorders in response to changes in free radical homeostasis.

Ethnic features of sleep disorders in climacteric women

To evaluate the features of sleep disorders in Caucasian and Asian menopausal women. Five hundreds and forty-two menopausal women, aged 45 to 60 years, were divided into Caucasians (Russians (n=342)) and Asians (Buryats (n=200)). All women were examined by an obstetrician-gynecologist. Also, a general clinical examination and an analysis of medical documentation were conducted. Diagnoses of insomnia and obstructive sleep apnea syndrome (OSAS) were made according to the results of specialized somnological questionnaires and polysomnographic monitoring. The frequency of sleep disorders in Caucasian women in perimenopause was 61.2%, in postmenopause 65.5%; in Asian women it was 63.5% in perimenopause, 72.9% in postmenopause. Difficulties in falling asleep (69.4%) and difficulties in morning awakenings (63.5%) were found in perimenopausal Caucasian women and frequent nightly awakenings (83.5%) and OSAS (48.9%) were found in postmenopausal ones. There were no differences in the structure of sleep disorders depending on the menopause phase in Asian women. The most common complaints were frequent nighttime awakenings (69.5% in perimenopause, 76.9% in postmenopause). Ethnic differences in the sleep complaints were found only in the perimenopause. The decrease in sleep efficacy and changes in the rapid eye movement sleep were found in Asian women as compared to Caucasians. Moreover, apnea-hypopnea index was higher and oxygen saturation was lower in Asian women compared to Caucasians. The formation of sleep disorders in menopausal women has ethnogenetic features.

N-3 Polyunsatured Fatty Acids in Menopausal Transition: A Systematic Review of Depressive and Cognitive Disorders with Accompanying Vasomotor Symptoms.

Depression is one of the most important health problems worldwide. Women are 2.5 times more likely to experience major depression than men. Evidence suggests that some women might experience an increased risk for developing depression during “windows of vulnerability”, i.e., when exposed to intense hormone fluctuations, such as the menopause transition. Indeed, this period is associated with different symptoms, including vasomotor, depressive, and cognitive symptoms, which have all been shown to worsen as women approach menopause. Even though hormonal therapy represents the most effective treatment, side effects have been reported by several studies. Therefore, an increased number of women might prefer the use of alternative medicine for treating menopausal symptoms. N-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs) are included among these alternative treatments. We here provide a review of studies investigating the effects of n-3 LCPUFAs on hot flashes and depressive and cognitive disorders in menopausal women. The reported results are scattered and heterogeneous. In conclusion, a beneficial role of n-3 LCPUFAs in hot flashes, and depressive and cognitive symptoms related to menopausal transition is still far from conclusive.

ОСОБЕННОСТИ СНА У ЖЕНЩИН В КЛИМАКТЕРИЧЕСКОМ ПЕРИОДЕ (ОБЗОР ЛИТЕРАТУРЫ)

The article reviews the literature of domestic and foreign researchers devoted to the somnological aspects of the menopausal period in women. Age-related changes in the structural organization of sleep are shown with a deficiency of sex steroids, also and in the gender aspect. A high frequency of sleep disorders in menopausal women, reaching 60 %, has been revealed. However, the results of studies on complaints of sleep disorders depending on the climacteric phase are ambiguous, which may be due to ethnicity. Data on some pathogenetic mechanisms of the formation of the most frequent sleep disorders in menopausal women - insomnia, obstructive sleep apnea syndrome and fibromyalgia - are described. The results of polysomnography in these pathological states are presented, indicating a decrease in sleep efficiency, a change in its "architecture", and a longer waking time during the night with insomnia; a significant increase in the apnea/hypopnea index, a delay in the phase of fast sleep, a decrease in the duration of deep stages of sleep and a decrease in its effectiveness - in obstructive sleep apnea syndrome. The social and medical consequences of sleep disorders and their comorbidity with such pathological conditions as mental disorders, obesity, cardiovascular diseases, oncology, disorders of carbohydrate metabolism, bronchial asthma, mortality are noted.

Prediction of heavy degree of flow of menopausal disorders for women with hyperproliferative processes of reproductive system using a mathematical model

Objective. Prognostication of heavy degree of flow of menopausal disorders in women with hyperproliferative processes of reproductive system.Materials and methods. For the exposure of factors, related to severity of flow of climacteric syndrome (CS) and estimation of degree of their influence on development of heavy degree of flow of menopausal disorders, the method of construction and analysis of multivariable mathematical models was utilized. The results of investigation of 19 indexes from 124 women aged 45 to 79 with menopausal disorders (climacteric syndrome) and with signes of hyperproliferative processes of reproductive system according to the data of ultrasound survey of uterus and the results of histology investigations of uterine mucosal scrapings were used for construction of model.Results of the study. On the basic of analysis of coefficients of logical model of regress the result was determined. Presence in women operation on the appendages of uterus promotes the risk of development of heavy degree of flow of disorders in menopause (p = 0.006) with odds ratio (OR) = 7.6 and the 95% confidence interval (CI) 1.8–32.8. Presence of chronic inflammatory diseases of privy parts (p = 0.004, OR = 27.6, 95% CІ 2.8–269.7), presence of hypermenstrual syndrome (p = 0.009, OR = 7.0, 95% CI 1.6–29.7), presence of diseases of liver and bilious ducts (p = 0.001, OR = 9.9, 95% CI 2.5–40.1), presence of stomach and intestine diseases (p = 0.010, OR = 5.9, 95% CI 1.5– 23.0) promotes the risk of development of heavy degree of flow of menopausal disorders.Conclusions. Presence for women with hyperproliferative processes of the reproductive system an operation on the appendages of uterus, chronic inflammatory diseases of genitals, hypermenstrual syndrome, diseases of liver and bilious ducts, stomach and intestine promotes the risk of development of heavy degree of flow of menopausal disorders.

Treatment of disorders in menopausal women with hyperproliferative processes of reproductive system

Objective. Evaluate the effectiveness of treatment of disorders in menopausal women with hyperproliferative processes of reproductive system (HPPRS).Materials and methods. The treatment was performed in 36 women after hormone prevention (HP) of neurovegetative and psycho-emotional disorders in menopause (NVPDM) and in 31 women after naturally menopause aged 48 to 60 with the signs of HPPRS according to the data of ultrasound uterine and the results of histology investigations of mucosal scrapings from the uterus. The control group consisted of 35 healthy women of the same age category. The treatment was carried out by the appointment of elaborated complex of preparation, which included a combined homeopathic preparation, a preparation from the microalgae Spirulina platensis, pectin and an anxiolytic agent with the active substance mebicar. To assess the effectiveness of therapy, hormonal homeostasis was studied before and after treatment.Results of the study. In 31 women with menopausal HPPRS after naturally menopause the increase of FSH was observed in 1.4 times, estradiol – in 1.4 times, compared with healthy women. After HP use in 36 women the level of FSH decreased in 2.2 times, but the level of estrogens increased in 1.9 times, progesterone level increased in 1.4 times compared with healthy women. After treatment in women with naturally menopause the levels of FSH increased on 36%, estradiol – on 29%. In women after HP and treatment the level of estrogens decreased in 3.2 times, the level of FSH increased in 1.4 times but it level decreased on 35% compared with healthy women. But most of the symptoms of NVPDM in women of both subgroups disappeared.Conclusions: In women with HPPRS was observed a greater level of sex hormones than healthy ones, which is provided by the increased production of gonadotropic hormone and is accompanied by the development of NVPDM. The use of HP and treatment reduces the intensity of NVPDM on account of gonadotropins level reduction compared with healthy women.

Menopausal disorders in obese women

Aim. To study menopausal disorders in women suffering from obesity. &#x0D; Methods. The study included 165 women in physiological postmenopausal state. Women were divided into two groups: group 1 (study group) included 87 women with obesity, group 2 (control group) consisted of 78 women without obesity. With the use of modified menopausal index (the Kupperman index) the severity of climacteric disorders was assessed. Severity of neurovegetative, metabolic-endocrine and psychoemotional symptoms was assessed according to 4-point scale (from 0 to 3 points). The number of points in each group was summarized and a modified menopausal index was obtained. &#x0D; Results. It was revealed that in women with obesity severe (in 24 females, 27.5%) and moderate (in 39 patients, 44.5%) climacteric syndrome was prevalent, in patients from the control group such forms were 1.5-2 times less frequent - in 11 (14.2%) and 28 (36.2%) patients, respectively. A deeper analysis of the entire symptom complex of climacteric syndrome revealed that severe and moderate forms of neurovegetative manifestations were 2 times more common in patients with obesity, in contrast to healthy women (in 7.8% and 4.5%, 21.5% and 12.3%, respectively). Severe forms of psychoemotional manifestations were also observed 2.6 times more often in women with obesity. &#x0D; Conclusion. Severity of menopausal disorders depends on obesity presence, the data obtained demonstrated that, against the background of obesity, climacteric syndrome tends to have prolonged course with predominance of severe and moderate forms.

Maintaining the quality of life and social activity of women in the post-reproductive period

Taking into account the increase in the proportion of women in the post-reproductive age in society and the increase in the retirement age, it becomes necessary to preserve their professional and social activity. As of 2016, in the structure of the female population of Ukraine, women over 50 years are 46.7%, respectively, the number of women over 45 years is more than half. However, today the problems of women of post-reproductive age are paid insufficient attention both by society, and by the media and social organizations.The issue of maintaining the life quality and social activity of women in the post-reproductive period was discussed on April 5, 2017 in Kiev at an expert council meeting in which leading experts in obstetrics and gynecology, cardiology, family medicine and oncology participated. As noted at the meeting, the relevance of this topic is primarily due to the deterioration of the life quality due to the cessation of ovarian function and the appearance of symptoms of menopause, along with an increase in the incidence of cardiovascular diseases, oncological pathology, and type II diabetes at post-reproductive age.In this regard, at the meeting of the expert council it was proposed to implement the social and information project “Femininity of the future”, within the framework of which in the next 3 years (2017–2019) in 18 regions of Ukraine a number of measures aimed at preserving the life quality and social activity of women in the post-reproductive period. In particular, among them is the development of methods that reduce the risk of developing diseases, increase the level of knowledge of patients and doctors of different directions on modern approaches to the prevention, diagnosis and treatment of menopausal disorders in women, a large-scale educational program on the preservation of life quality, social activity of women in the post-reproductive period and with respect to methods for reducing the risk of cardiovascular pathology, oncological diseases.

The modern approach to the correction of menopausal disorders in women with physiological menopause and after ovariectomy

The problem of menopause attracts attention for many decades of not only gynecologists, but urologists, cardiologists, psychiatrists and other doctors. This is related to systemic complications of estrogen deficiency. The objective of our work is to establish clinical and hormonal changes in women of menopausal age with physiological menopause and after ovariectomy and also assess the effectiveness of the offered treatment. During the examination and treatment the women were divided as follows: I – main group – 48 women with physiological menopause: Ia (n=27) – within three months received a complex of non-hormonal treatment, Ib (n=21) – hormone replacement therapy (HRT); II group – 34 women after total ovariectomy: IIa (16) with therapeutic purpose received a complex of non-hormonal treatment for three months, IIb (18) – HRT. The offered complex of non-hormonal treatment included Cimicifuga, Menopace, Noophen. This treatment was used in women with early menopause who have contraindications to HRT or refused to take hormones. The degree of severity of menopausal syndrome was judged according to the menopausal index of Kuperman. In the study of hormonal status the determination of a set of hormones by immunochemical method was performed. During study we obtained results that indicate the inverse dynamics of menopausal disorders in both study groups. For the prevention and treatment of individual selection of treatment of climax manifestations it is appropriate the dynamic definition of hormonal mirrors of the patients.