Menopausal Disorders Research Articles

D-hypovitaminosis in menopausal disorders clinic: Correction possibilities

Introduction. The postmenopausal period being a significant part of a modern woman’s life. The persistence of menopausal disorders clinic can be combined with the hypovitaminosis D state, which, in turn, can further aggravate the existing symptoms. Vitamin D supplementation may be one of the pharmacological approaches to correct menopausal disorders.Aim. To evaluate the contribution of hypovitaminosis D to the clinic of menopausal disorders; to determine the clinical efficacy of using cholecalciferol in late postmenopausal residents of Yekaterinburg.Materials and methods. During the period from 2018 to 2021, 144 late postmenopausal patients from 56 to 79 years old living in Yekaterinburg and do not need outside help in everyday life took part. The following parameters of anthropometry, the severity of modified menopausal index (MMI), hospital anxiety and depression scales (HADS), Mini-Mental State Examination (MMSE), an assessment of serum 25(OH)D level (chemiluminescent immunoassay; Access 2, Beckman Coulter, USA) were studied. Clinical efficacy of cholecalciferol was evaluated in 68 patients in the prospective cohort study design. Micellated water-soluble form of cholecalciferol in standard doses recommended by the Russian Association of Endocrinologists (RAE) was used.Results. Vitamin D deficiency and insufficiency are associated with increased parameters of body weight (p = 0.048), waist circumference (p = 0.018) and hips (p = 0.016), increased cases of decreased performance (p = 0.046) and subclinical symptoms anxiety (p = 0.033). Supplementation of standard therapeutic and maintenance doses of cholecalciferol for 6 months contributed to a significant reduction in neurovegetative component of modified menopausal index in 54.4% of cases (p = 0.035) and improvement in cognitive function parameters in 50.0% of cases (p = 0.023) in late postmenopausal patients.Conclusions. The use of cholecalciferol in adequate doses can be considered as an important component of complex therapy for women in late postmenopausal period.

Surgical menopause and its management. Analysis of literature data and own data

The article presents the main clinical variants of the surgical menopause syndrome (SMS), provides modern views on the treatment of this pathology.The purpose of the study was to identify the features of the clinical course of SMS compared to the typical climacteric syndrome, to present modern views on its management, and to determine ways of prevention.To achieve this goal, a literature search and analysis was conducted in the PubMed scientometric database for the last 15 years, and domestic scientific publications related to the mechanisms of development, clinical course, and management of SMS were selected. At the current stage, there is a significant increase in the prevalence of uterine leiomyomas, as well as a tendency to increase the frequency of this pathology in young women. Given that 50% of uterine leiomyomas have symptomatic course, the number of surgical interventions for leiomyomas is also increasing.Hysterectomy occupies a significant place among operative interventions for benign tumors of the uterus and ovaries. As a result of hysterectomy (with or without oophorectomy) in women, SMS occurs. The main pathogenetic mechanism of SMS is hypoestrogeny. As a result, a symptom complex of menopausal disorders develops: vegetative-vascular, neuropsychic, metabolic and urogenital disorders. Compared to the classic climacteric syndrome, the clinical condition in surgical menopause is more acute and progresses faster.The management of SMS depends on the volume of surgical intervention, the age of the patient, and concomitant pathology. Treatment of SMS should be individualized and include the use of menopausal hormone therapy, herbal preparations, multivitamin complexes against the background of lifestyle modification.The prevention of SMS consists in the wide use of modern conservative and minimally invasive operations in the case of surgical treatment of benign tumors of the uterus and ovaries, a balanced approach to determining the volume of operations.

Alternative non-hormonal methods for correcting menopausal disorders

Alternative non-hormonal methods for correcting menopausal disorders

Effects of Resistance Training, Estrogen Therapy, and Calcium Chitosan Supplement Containing Vitamin D on Bone Turnover in Ovariectomized Rats: An Experimental-Comparative Study

Background: Hormone therapy is a highly effective method for treating menopausal disorders. However, its side effects may include an increased risk of cancer, heart disease, and pulmonary embolism. Previous research has demonstrated that both exercise and nutrition separately have positive effects on menopausal symptoms. Therefore, we suggest that combining exercise and nutrition interventions may provide a synergistic effect, yielding results at least similar to those of estrogen (Est) therapy. Objectives: This study aims to compare the independent and combined effects of resistance training (RT), Est therapy, and vitamin D calcium chitosan (Vit D + Ca++ + Chit) supplementation on markers of bone turnover in ovariectomized (OVX) rats. Methods: Forty-two female Wistar rats were randomly divided into seven groups (n = 6 per group): (1) healthy-control (He-Co), (2) OVX-Vit D + Ca++ + Chit + RT, (3) OVX-saline (Sal) + Est + RT, (4) Sal + RT, (5) OVX-Vit D + Ca++ +Chit, (6) OVX-Sal + Est, and (7) OVX-Control (OVX-Co). Bone samples were extracted 48 hours after the final session. Two-way ANOVAs were used to determine differences in intervention effects between groups. The alpha level was set to 0.05. Results: Ovariectomy (OVX) decreased bone tissue expression of alkaline phosphatase (ALP) and osterix (OSX) while increasing peroxisome proliferator-activated receptor gamma (PPAR-γ) gene expression. Ovariectomy also decreased the number of osteocytes and osteoblasts while increasing the number of osteoclasts. Resistance training (RT) and Vit D + Ca++ + Chit intake increased bone tissue expression of ALP, OSX, and PPAR-γ gene expression. Additionally, RT and Vit D + Ca++ + Chit supplementation increased the number of osteocytes and osteoblasts and decreased the number of osteoclasts. Conclusions: The combined interventions had synergistic effects compared to each intervention separately on ALP, osteocyte, osteoblast, and osteoclast observations. Therefore, combining RT with Vit D + Ca++ + Chit could be a non-pharmacological approach to address bone turnover alterations caused by OVX.

Protective effects of probiotics against menopausal symptoms in ovariectomized mice

With growing interest in the role of the gut microbiome in the pathogenesis of menopausal disorders, probiotic supplementation is emerging as a novel therapeutic strategy for postmenopausal women. In this study, we investigated the protective effects of several probiotic strains against menopausal symptoms using an ovariectomized (OVX) mouse model fed a high-fat diet, in comparison with the effects of 17β-estradiol (E2) replacement. Among the eight tested probiotic strains, we selected four (Limosilactobacillus fermentum MG901, Lactiplantibacillus plantarum MG4604, Ligilactobacillus salivarius MG4679, and Lacticaseibacillus reuteri MG5463) that showed superior estrogen-like activity in an uterotrophic assay. We then examined their effects in OVX mice. The probiotic MG4679 was tested in combination with MG5463. During the 12-week experimental period, oral administration of the four probiotics reduced blood glucose and body temperature and ameliorated depression-like behavior in OVX mice. In the Barnes maze test, MG901 and MG4604 improved the spatial memory deficits observed in OVX mice. Micro-CT analysis of mouse femurs revealed that MG5463 prevented the OVX-induced reduction in cortical bone mineral density and bone volume fraction. Importantly, similar to E2 replacement, most of the test probiotics increased Akt phosphorylation in skeletal muscle, estrogen receptor-α (ER-α) protein expression in the liver, and ERK phosphorylation in the brain of OVX mice. However, unlike E2 treatment, all probiotics did not affect uterine weight, uterine ER-α expression, and serum E2 concentration. These results indicated that the probiotics used in this study exhibited protective effects against menopausal symptoms, partly through estrogen-mimetic action, without unfavorable uterine stimulation in OVX mice.

Features of post-surgical menopause with concomitant primary hypothyroidism: A prospective single-stage clinical study

Background. In recent decades, the frequency of surgical interventions on reproductive system organs has been steadily increasing. In gynecological practice, preference is given to minimally invasive surgery and precision treatments, especially involving ovaries. Despite the modern approach, it is not always possible to preserve this endocrine organ, which leads to post-surgical menopause (PSM). The relatively high incidence of total hysterectomy-associated PSM and primary hypothyroidism in late reproductive age often leads to their combination. Clinical manifestations aggravating each other form an unfavorable vicious circle. Aim. To study the features of the PSM course with concomitant primary hypothyroidism. Materials and methods. A prospective clinical study included 130 women aged 45 to 55 years with a history of PSM. The main group consisted of 70 patients with PSM with subclinical primary hypothyroidism. A control group included 60 PSM patients without thyroid disorders. We assessed the effect of hypothyroidism on the PSM course by comparing several indicators in the main and control groups. Results. It was found that in the main group patients, severe 26.5% and moderate 38.8% menopausal syndrome prevailed, while in the control group patients, such forms were twice as common. In the women of the main group, the levels of triglycerides were higher than those in the control group by 1.3 times (2.6±0.86 mmol/L and 1.43±0.33 mmol/L, respectively). The total serum alkaline phosphatase activity in patients in the study groups was 29.8% higher than in healthy women. Conclusion. It can be concluded that the severity of menopausal disorders depends on the thyroid status, with more severe in patients of the main group with hypothyroidism. In addition, in patients of the main group with hypothyroidism, dyslipidemia is more pronounced, which predisposes them to severe diseases in the future, in particular cardiovascular disorders, the unfavorable course of metabolic syndrome, and the development of postmenopausal osteoporosis.

ADHD in a women during (peri)menopause: missed diagnoses and cardiac complaints

Introduction(Abstract for the accepted case-based workshop by the NDAL section at EPA)Women with ADHD are underdiagnosed in mental health care, and although ADHD starts in early childhood, the symptoms and impairment of women with ADHD may only be recognised for the first time during (peri)menopause.ObjectivesThe relationship between decreasing levels of estrogen and the interaction with dopamine function in the brain in women with ADHD will be discussed and illustrated by a clinical case vignet of Mary, age 54.MethodsMary presents with a history of repeated burnout episodes, mood swings, lifetime difficulty concentrating, planning and organising daily life, restlessness, sleep problems, and cardiac complaints.Mary has been working hard her whole life to overcome all difficulties, but her problem is she can never stop, leading to getting burnout several times. This time she is exhausted and can no longer cope; she is visiting the cardiologist for palpitations, hypertension and a recent myocardial infarction.ResultsAfter a positive screening for ADHD, based on her lifetime symptoms of inattention, restlessness and impulsivity, as well as mood swings, she is referred to a psychiatrist for assessment of ADHD, mood and sleep problems. The pathophysiology behind this cluster of disorders during (peri)menopause, as well as the treatment options will be discussed based on Mary’s case.ConclusionsBoth ADHD in women, (peri)menopausal mood disorders as well as the heart complaints in women during menopause are underrecognised and undertreated, leading to unneccesary suffering and cardiac death in women. It is time for psychiatry to join forces with cardiology and gynaecology for better recognition, sharing knowledge and multidisciplinary treatment of women with mental disorders such as ADHD during menopausal transition (see www.h3-netwerk.nl).Disclosure of InterestNone Declared

Quality of life as an indicator of connective tissue condition in women with metabolic syndrome without estrogen support

In modern medicine, the relevance of the problem associated with the aging of the female body is undeniable. Due to the decrease in the intensity of secretion of sex steroids, the addition of metabolic syndrome is accompanied by processes which can worsen women quality of life. Under conditions of hypoestrogenemia, their physical condition suffers, which directly depends on the structure of the connective tissue that forms the basis of the skin, blood vessels, kidneys, bones, joints and ligaments. This literature review presents current data on reversible and irreversible clinical manifestations of climacteric syndrome. Reversible processes are based on changes that can be corrected: vasomotor, psycho-emotional, urogenital, sexual and musculoskeletal. Late manifestations of menopause on the part of metabolic disorders in the connective tissue determine the greatest severity of the course, and therefore represent a serious public health and health problem. The literature review shows in detail the features of the immune regulation of collagen metabolism, the characteristics of changes in bone modeling markers under conditions of estrogen deficiency. Clinically proven efficacy of phytoestrogens in menopausal disorders and metabolic disorders in women. This review shows the mechanism for reducing vasomotor symptoms, slowing down the process of bone tissue destruction in patients under the influence of this group of drugs. In addition, phytoestrogens provide the correction of lipid metabolism, thereby depressing atherogenesis and promoting prevention of cardiovascular complications. It is necessary to develop a strategy to normalize the vital functions of perimenopausal patients with symptoms of menopause with the introduction into clinical practice of measures to maintain the quality of life of women.

Effectiveness and safety of the combination drug "Femo-Klim" evaluated in patients with former cancer and moderate menopausal disorders

Aim: to assess effectiveness and safety of a combination phytoestrogen-based product “Femo-Klim” in treatment of moderate climacteric disorders in gynecological cancer patients.

Prospects of application of non-hormonal drug Femo-Klim in complex therapy of menopausal disorders of medium severity in patients with cancer in anamnesis

Objective. To study the possibility of using Femo-Klim preparation in the treatment of menopausal disorders of medium severity in gynecologic oncologic patients. Material and methods. Seventy-eight female patients with menopausal syndrome of moderate severity participated in the study. The patients were randomly divided into 2 groups: the main group (n=40) – patients received Femo-Klim preparation; the comparison group (n=38) – patients did not receive the examined preparation. Results. After 6 months of the study the dynamics of menopausal manifestations in the main group amounted to -0.9, in the comparison group – -0.7, somatic manifestations – -0.55 and -0.15 respectively, psychoemotional manifestations – -0.8 and -0.5 respectively (p<0.05). The level of anxiety in the main group decreased by 60% compared to the comparison group. Bone mineral density increased by 2.6% in the main group and decreased by 1.4% in the comparison group (p<0.05).

The estrogen receptor and metabolism.

Across the globe, metabolic syndrome, hyperuric acid, and their related diseases, such as cardiovascular disease, diabetes, and insulin resistance, are increasing in incidence due to metabolic imbalances. Due to the pathogenesis, women are more prone to these diseases than men. As estrogen levels decrease after menopause, obesity and metabolic disorders are more likely to occur. Men are also affected by hyperuric acid. To provide ideas for the prevention and treatment of metabolic syndrome and hyperuricemia, this article reviews and analyzes the relationship between estrogen receptors, metabolic syndrome, and hyperuricemia.

Возможности коррекции гормонального статуса, репродуктивной функции и нейровегетативных расстройств у пациенток с преждевременной недостаточностью яичников

Background: nowadays reproductive health condition tends to worsen. One of the problems is a decrease in the ovarian reserve, manifested in the form of premature ovarian insufficiency (POI), which initiates the infertility problem on the one hand, and the issue of premature menopause with all its accompanying socio-psychological aspects on the other Aim: to study the therapeutic possibilities of the bovine epiphyseal cartilage polypeptide in POI and anovulation in female patients aged 30–45 years old. Patients and Methods: the study included 40 female patients aged 30–45 years with a BMI of 18.5–29.9 kg/m2 and POI signs, determined by the following indicators: follicle-stimulating hormone (FSH) concentration ≥12 IU/L; anti-müllerian hormone (AMH) 0.2–1.2 ng/mL; antral follicle count (AFC) ≤5 during ultrasound on the 7th±2 day of the menstrual cycle; decreased serum estradiol concentration and anovulation lasting 1 to 5 years or with failed IVF. The female cohort was randomized into 2 groups of 20 persons: for two menstrual cycles, the main group received a drug for menopausal hormone therapy (MHT) containing 2 mg of estradiol and 10 mg of didrogesterone (per os 1 tablet daily in a cyclic regimen from day 1 to day 28) and the bovine epiphyseal cartilage polypeptide (lyophilizate for the preparation of a solution for intramuscular administration, 10 mg intramuscularly daily for 10 days from the 5th to the 14th day of the cycle). The control group received only MHT in the same regimen for two menstrual cycles. During the study, the changes of endometrial thickness and follicle growth, ovulation markers (corpus luteum), FSH, estradiol and AMH concentrations, the number of female patients with a normalized menstrual cycle and spontaneous conception were evaluated in both groups Results: in the main group there was a statistically significant (p<0.05) decrease in FSH and luteinizing hormone (LH) levels relative to the baseline, an increase in estradiol concentration, an increase in the AFC and endometrial thickness, whereas the similar indicator changes were statistically insignificant in the control group. Besides, complete relief of neurovegetative symptoms was noted in the main group, and restoration of the ovulatory cycle was observed in 6 (30%) cases. There were no adverse events or complications during the drug regimen. Conclusion: the results obtained indicated the efficacy of the bovine epiphyseal cartilage polypeptide in the treatment of female patients with POI and anovulation and allowed to recommend the developed treatment regimen for practical use. KEYWORDS: premature ovarian insufficiency, follicle-stimulating hormone, anti-müllerian hormone, infertility, anovulation, menopausal disorders FOR CITATION: Khardikov A.V., Netyaga O.A. Correction of hormonal status, reproductive function and neurovegetative disorders in female patients with primary ovarian insufficiency. Russian Journal of Woman and Child Health. 2024;7(2):116–122 (in Russ.). DOI: 10.32364/2618- 8430-2024-7-2-5.

Особенности применения витамина D в комплексе с менопаузальной гормональной терапией у женщин

Background: A multitude of population-based studies have investigated the prevalence of vitamin D deficiency in various ethnic and age groups, with a notable association observed between vitamin D deficiency and the duration of postmenopause and age. Menopausal hormonal therapy (MHT) is widely regarded as the gold standard for the treatment of menopausal disorders. The addition of vitamin D metabolites to complex therapy has been demonstrated to improve certain metabolic parameters and clinical outcomes in elderly and postmenopausal women. However, data on the interaction of vitamin D metabolites and different MHT options when administered together as part of complex therapy are scarce. Aim: to compare the severity of changes in vitamin D serum levels in women receiving MHT. Patients and Methods: the study included 60 women aged 45–55 years in surgical postmenopause (duration 1 to 5 years). Prior to the commencement of the study, all women were diagnosed with vitamin D deficiency, defined as a serum level below 20 ng/mL. The women were then divided into two groups, each comprising 30 individuals. Group 1 was prescribed 17β-estradiol transdermal gel, while group 2 was prescribed a combined oral estrogen-progestagen MHT (1 mg 17β-estradiol + 5 mg dydrogesterone). In addition to MHT, all women received colecalciferol (vitamin D) 6,000-8,000 IU/day for 8 weeks. Results: women who received combined MHT exhibited a more pronounced increase in serum vitamin D levels than those who received monotherapy, despite receiving equal doses of drugs and presenting with similar baseline vitamin D deficiency. Conclusion: it is recommended that all women undergo vitamin D deficiency screening prior to initiating MHT. In cases of low vitamin D levels, combined estrogen-progestagen MHT is the preferred option. KEYWORDS: menopause, menopausal hormone therapy, vitamin D, colecalciferol. FOR CITATION: Muradova D.K., Esedova A.E., Mamedov F.S., Magomedova T.S. Vitamin D in combination with menopausal hormonal therapy in women. Russian Journal of Woman and Child Health. 2024;7(2):123–126 (in Russ.). DOI: 10.32364/2618-8430-2024-7-2-6.

АЛЬТЕРНАТИВНАЯ КОРРЕКЦИЯ КЛИМАКТЕРИЧЕСКИХ СИМПТОМОВ У ЖЕНЩИН ПРИ ЕСТЕСТВЕННОЙ ИЛИ ХИРУРГИЧЕСКОЙ МЕНОПАУЗЕ

One of the effective mechanisms for reducing the development of pathologies at menopause is the search for significant alternative means of reducing the severity of menopausal manifestations. In order to identify the correction of the severity of climacteric symptoms a study of 154 patients was conducted, the patients were divided into three groups: 53 women at natural menopause, 50 women at surgical menopause, the same patients (n=53 and n=50) 6 months after taking flaxseed oil and 51 control patients. Thus, it was found out that operated women develop more often extragenital pathology and more frequently consult medical specialists than those at natural menopause and healthy participants. Comorbidity in the main groups is more than two nosologies with a predominance of arterial hypertension. According to the Green scale menopausal severesymptoms in female patients with oophorectomy and moderate biological menopause symptoms of vasomotor and emotional-mental statusare leading. After daily use of flaxseed oil in operated women and those at natural menopause the severity of menopausal symptoms decreased equaling moderate and mild severity, respectively, along with the frequency of patients’visits to specialists to a greater extent in patients at natural menopause. The effectiveness of taking flaxseed oil by women at surgical or natural menopause for menopausal disorders of varying severity makes it possible to use it as an alternative for correction during the period of estrogen deficiency.

Гормональная коррекция менопаузальных расстройств у больных раком яичников

Aim. To provide clinicians with a systematic review of the available information regarding the use of menopausal hormone therapy in women with induced menopause due to combined treatment of ovarian cancer. Key points. Ovarian cancer is the eighth most common and seventh leading cause of cancer death. Menopausal hormone therapy is effective in correcting menopausal disorders, but its safety for patients who have had ovarian cancer is questioned. Conclusion. In patients with a history of ovarian cancer, menopausal hormone therapy is currently thought to improve overall survival and has little to no effect on progression-free survival. However, due to the lack of information, the reliability of the results obtained requires further research in this area. Keywords: ovarian cancer, epithelial ovarian cancer, serous ovarian cancer, iatrogenic menopause, hormone replacement therapy.

Biotransformation of Δ1-Progesterone Using Selected Entomopathogenic Filamentous Fungi and Prediction of Its Products' Bioactivity.

This research aimed at obtaining new derivatives of pregn-1,4-diene-3,20-dione (Δ1-progesterone) (2) through microbiological transformation. For the role of catalysts, we used six strains of entomopathogenic filamentous fungi (Beauveria bassiana KCh J1.5, Beauveria caledonica KCh J3.3, Isaria fumosorosea KCh J2, Isaria farinosa KCh KW1.1, Isaria tenuipes MU35, and Metarhizium robertsii MU4). The substrate (2) was obtained by carrying out an enzymatic 1,2-dehydrogenation on an increased scale (3.5 g/L) using a recombinant cholest-4-en-3-one Δ1-dehydrogenase (AcmB) from Sterolibacterium denitrificans. All selected strains were characterized by the high biotransformation capacity for the used substrate. As a result of the biotransformation, six steroid derivatives were obtained: 11α-hydroxypregn-1,4-diene-3,20-dione (3), 6β,11α-dihydroxypregn-1,4-diene-3,20-dione (4), 6β-hydroxypregn-1,4-diene-3,11,20-trione (5), 6β,17α-dihydroxypregn-1,4-diene-3,20-dione (6), 6β,17β-dihydroxyandrost-1,4-diene-3-one (7), and 12β,17α-dihydroxypregn-1,4-diene-3,20-dione (8). The results show evident variability of the biotransformation process between strains of the tested biocatalysts from different species described as entomopathogenic filamentous fungi. The obtained products were tested in silico using cheminformatics tools for their pharmacokinetic and pharmacodynamic properties, proving their potentially high biological activities. This study showed that the obtained compounds may have applications as effective inhibitors of testosterone 17β-dehydrogenase. Most of the obtained products should, also with a high probability, find potential uses as androgen antagonists, a prostate as well as menopausal disorders treatment. They should also demonstrate immunosuppressive, erythropoiesis-stimulating, and anti-inflammatory properties.

Modern ideas about the consequences of sympathoadrenal hyperactivation in hypertensive patients with metabolic disorders: modulation possibilities

The prevalence of hypertension (HTN) in the Russian Federation and the world continues to grow. This is largely due to the epidemic of obesity and related conditions — metabolic syndrome and type 2 diabetes. The most common and proven hypothesis of the relationship between hypertension and obesity is the activation of the sympathetic nervous system. However, modern research shows that the consequences of sympathetic hyperactivation are not limited only to hemodynamic effects, but extend to many organs and systems. Long-term sympathetic hyperactivation can lead to insulin resistance and type 2 diabetes. Neurotransmitters affect fat cells by increasing lipolysis and leading to increased fatty acid release, the liver by increasing gluconeogenesis, and pancreatic β-cells by decreasing insulin secretion. The sympathetic nervous system plays an important role in energy management by regulating metabolic rate. Obese individuals have significantly less pronounced postprandial thermogenesis, despite a higher insulin response, while the hemodynamic response to isometric or heterometric exercise is reduced. Chronic stress serves not only as a trigger for behavioral disorders, but also directly leads to various physiological disorders, including through sympathetic activation. However, the choice of antihypertensive agents affecting the sympathetic activity in patients with obesity and metabolic disorders is very limited. According to current guidelines, β-blockers are not the drugs of choice in patients with uncomplicated HTN, since it has a weaker evidence base compared to other classes of drugs and have metabolic and other side effects. Therefore, selective I1-imidazoline receptor agonists, and in particular, moxonidine may be the drugs of choice in this category of patients. Moxonidine in combination therapy of patients with HTN and metabolic disorders, including metabolic disorders in menopause, as well as with a physiological estrogen decrease, significantly improves the effectiveness of antihypertensive therapy and increases the achievement of target blood pressure. In addition, its metabolic effects improve prognosis of such patients.

Menopause: not hormonal correction of disorders, as a personalized approach to improving a woman's quality of life

Annotation. A review of scientific sources concerning the problem of menopausal syndrome and conditions associated with menopausal and perimenopausal disorders are presented below. Increasing the duration of life is important medical and socioeconomic significance for the country Menopausal hormone therapy (MHT) remains the most effective therapy for menopausal disorders. The vast majority of menopausal women remain alone with the existing manifestations and risks of this period for the rest of their lives. The goal of our work was the search, analysis and systematization of relevant scientific sources regarding the functional correction of peri- and postmenopausal disorders in women. We conducted a systematic review and analysis of relevant literature sources over the last ten years. The search was conducted in PubMed and Google Scholar databases. During the research, the following terms were used: “menopause”, “menopausal hormone therapy”, “menopausal symptoms”, “hormonal changes in menopause”, “functional correction of disorders in menopause”. It was found that the problem of management of women with manifestations of menopausal disorders and their non- hormonal correction is very relevant. In the conditions of war, these are women who cannot be examined and examined for the appointment of MHT. The presence of contraindications to therapy and refusal of it by some women requires a personalized approach. Functional therapy of the pathological manifestation of menopause makes it possible to help this category of women.

Genitourinary syndrome of menopause and intestinal microbiota.

Genitourinary syndrome of menopause (GSM) is one of the pathological symptoms of menopause, which causes significant physical, psycho-emotional, and sexual discomfort to a woman. The study describes an examination of 65 middle-aged women, who were divided into 2 groups. Group I included 39 patients with GSM, who, depending on the duration of symptoms (3-5 years, more than 7 years), were divided into subgroups Ia and Ib. Group II included 26 patients who did not have clinical manifestations of GSM. All patients underwent general clinical studies. Bacteriological examination of faeces was used to assess the state of the intestinal microbiota. It was found that menopause occurred in women with GSM earlier, compared with patients without manifestations of urogenital disorders. Also, the women with GSM were more likely to be diagnosed with type 2 diabetes mellitus, metabolic syndrome, overweight, and iron deficiency anaemia. When analysing the results of a bacteriological study in this group of patients, a statistically significant decrease in the colonization of Bifidobacterium and Lactobacillus, as well as excessive bacterial growth of such conditionally pathogenic bacteria as Escherichia coli with reduced enzymatic activity, and Klebsiella and Streptococcus was revealed. Conclusions: Conducting a fundamental study on the characteristics of the intestinal microbiota in menopausal disorders will be an important step towards understanding the pathogenetic mechanisms of their formation, and correction of intestinal metabolism can become an important condition for effective prevention and treatment.

Patients Are Using Dietary Supplement for the Treatment of Their Diseases without Consultation with Their Physicians and Pharmacists.

Inappropriate use of dietary supplements by patients might exacerbate their diseases. The aim of this study was to clarify the situation of dietary supplement use for disease treatment among patients. A cross-sectional online questionnaire survey was conducted between 18 and 30 November 2022. A preliminary survey revealed that the proportion of patients who used dietary supplements to treat their disease ranged from 7.7% (cancer) to 28.2% (menopausal disorder). In the actual survey, across all diseases, patients who used dietary supplements for treatment purposes were satisfied with their therapeutic effects. Information obtained via the internet was the most common reason given for starting to use supplements. The proportions of patients who used supplements concurrently with medicine ranged from 25.4% (liver disease) to 72.2% (mental disorder). Most users of supplements did not consult with their physicians or pharmacists about them. However, patients preferred face-to-face consultation with a physician or pharmacist when discussing the concomitant use of medicines. In conclusion, the role of pharmacists is important for the appropriate use of dietary supplements among patients, especially concomitant use with medicines. More awareness about dietary supplements is needed for healthcare professionals to consult with their patients.