Peri Women Research Articles

Short and long-term effect of polycarbophil vaginal gel on vaginal atrophy of peri- and post-menopausal women. The TRIPLE study

ObjectivesThis TRIPLE study was aimed to evaluate the efficacy of polycarbophil vaginal gel (PCV) in treating symptoms of vaginal atrophy (VA) of peri- and post-menopausal women. Materials and methodsSexually active women in peri- (n = 29) and post-menopause (n = 54) suffering from VA, were progressively enrolled and treated for 30 days with PCV. Those wishing to continue (n = 73) were treated for additional 180 days. PCV was administered as one application twice a week. The vaginal health index (VHI; range 5 to 25) and the visual analogue score (VAS range for 0 to 100 mm for each item) for vaginal dryness, irritation, and pain at intercourse, along with the global symptoms score (GSS; range 1 to 15) and treatment safety, were evaluated at baseline and after 30 days. In those continuing the treatment an evaluation was performed after additional 180 days. ResultsWomen in peri and post-menopause were of 48.7 ± 3.3 years and 57.5 ± 5.7 years old., respectively. At baseline all outcomes were significantly worse (p<0.002) in postmenopausal group, except the VHI (p < 0.056). After 30 days VHI increased (p < 0.001) of 4.1 ± 0.5 (mean ± SE), and 5.1 ± 0.4 in peri- and post-menopausal women respectively. VAS of vaginal dryness decreased (p < 0.001) of −24.4 ± 3.6, and −52.7 ± 2.6 (p < 0.001), VAS of irritation decreased (p<0.001) of −18.6 ± 4.4 and −47.8 ± 3.2, VAS of pain decreased (p < 0.001) of −26.2 ± 4.3 and −55.6 ± 3.1 and the GSS decreased (p < 0.001) of −3.9 ± 0.3, and −4.9 ± 0.2, in peri and post-menopausal women, respectively. All the modifications were significantly greater (p < 0.001)(p < 0.032 for GSS) in postmenopausal women, and after 30 days all outcomes were similar in the two groups of women. In comparison to baseline, after 210 days of treatment VHI increased of 7.7 ± 0.3 (p < 0.001), VAS of vaginal dryness decreased of –53.6 ± 1.9 (p < 0.001) VAS of irritation of −42.6 ± 1.4 (p < 0.001) VAS of pain of −46.7 ± 2.3 (p < 0.001) and the GSS of −6.5 ± 0.2 ± 0.2 (p < 0.001). All outcomes improved (p < 0.001) over the values observed after 30 days of treatment (p < 0.001). No side effect was reported. ConclusionsIn peri- and post-menopausal women PCV administration rapidly improves VA symptoms, and its prolongation up to 6 months further increases its efficacy.

Dietary Super-Doses of Cholecalciferol Fed to Aged Laying Hens Illustrates Limitation of 24,25-Dihydroxycholecalciferol Conversion

BackgroundOlder humans taking high concentrations of vitamin D3 supplementation for a prolonged time may be at risk of vitamin D toxicity. It is unclear how dietary super-doses (10,000 times greater than the requirement) can affect vitamin D3 status in aged animals. Aged laying hens could be a model to compare vitamin D3 supplementation effects with women in peri- or postmenopausal stages of life. ObjectivesWe investigated the dietary super-dose impacts of cholecalciferol (vitamin D3) on vitamin D3 status in aged laying hens in production. MethodsForty-eight 68-wk-old Hy-Line Brown laying hens were individually housed in cages with 8 hens per dietary treatment for 11 wk. Hens were randomly assigned to 1 of 6 treatment groups of dietary vitamin D3 supplementation and consumed ad libitum. Supplementation concentrations were 400, 800, 7400, 14,000, 20,000, and 36,000 IU D3/kg of feed. At the end of the study, all hens were sacrificed, and tissue samples and feces were collected. Plasma and egg yolk vitamin D3 metabolites, calcium and phosphorus composition of eggshells, ileal digesta, and feces were measured. Duodenal, ileal, liver, and kidney gene expression levels were also measured. ResultsWe observed that increasing dietary vitamin D3 increased plasma vitamin D3 and egg yolk vitamin D3 (P < 0.0001 for both sites). We also observed an increase in plasma 24,25-dihydroxycholecalciferol as dietary vitamin D3 concentrations increased (P < 0.0001). The plasma 25-hydroxycholecalciferol:24,25-dihydroxycholecalciferol ratio exhibited an asymptotic relationship starting at the 14,000 IU/kg D3 treatment. ConclusionsDietary super-doses of vitamin D3 led to greater plasma and egg yolk vitamin D3 concentrations, which shows that aged laying hens can deposit excess vitamin D3 in egg yolk. We suggest future research should explore how 24-hydroxylation mechanisms are affected by vitamin D3 supplementation. Further understanding of 24-hydroxylation can help ascertain ways to reduce the risk of vitamin D toxicity.

Counseling in menopausal women: How to address the benefits and risks of menopause hormone therapy. A FIGO position paper.

Menopause marks the end of menstrual cyclicity and, depending on individual vulnerability, has several consequences related to gonadal steroid deprivation, especially if it is premature. Menopause may be more burdensome for some women than for others. Individual factors, such as personal history, socioeconomic status, ethnicity, and current health conditions, affect symptomatology and, thereby, the menopausal experience. In addition, some menopausal symptoms, such as severe hot flashes, sleep disorders, and depression, are markers of future health risks. Counseling is a fundamental part of health care in the peri- and postmenopause periods. It must include an assessment of the patient's symptoms, needs, desires, and risk profile to address the benefits and risks of menopausal hormone therapy (MHT) on an individual basis and promote a healthy lifestyle. Indeed, healthcare practitioners can and must protect the health and lives of mid-life women by increasing awareness of menopausal symptoms and ensuring healthcare options, especially MHT. The type and duration of MHT should be tailored based on the patient's history, menopausal age, physical characteristics, and current health status so that the benefits always outweigh the risks. This FIGO position paper focuses on the benefits and risks of MHT on health domains, target organs, and systems, and on systemic and vaginal MHT regimens, to provide indications that can be used in the clinical practice for menopausal counseling. Moreover, it offers insights into what FIGO considers the mainstay for the healthcare management of women in peri- and postmenopause, worldwide.

Compression microvibration: Experience of using the method for the physiotherapeutic treatment of cellulite

BACKGROUND: Cellulite treatment and figure correction are among the most demanded requests in aesthetic medicine centers, which determines the high social and medical and economic significance of the problem, stimulates the active use of modern medical technologies.&#x0D; AIM: evaluation of the effectiveness of the non-invasive method of compression microvibration in the treatment of cellulite in women of peri- and postmenopausal age.&#x0D; MATERIAL AND METHODS: A single center prospective cohort study was conducted in which 27 female volunteers with mild to moderate gynoid lipodystrophy took part. All participants completed the Endospheres Therapy course according to the standard protocol: 12 procedures for 60 minutes twice a week using the Endospheres Therapy Body compression microvibration apparatus. Before and after the completion of the course of procedures, anthropometric parameters (linear and weight dimensions of the body) were measured, fat, lean, active cellular and skeletal muscle mass, specific basal metabolism, total and extracellular fluid, bioimpedance phase angle were evaluated using bioimpedancemetry. To obtain a subjective assessment of the effectiveness and quality of the procedures received, all participants underwent anonymous testing.&#x0D; RESULTS: Under observation were 27 women, who made up 3 clinical groups of 9 women each in accordance with age criteria: group 1 ― before menopause (age 4049 years); group 2 ― menopause (5059 years) and group 3 ― postmenopause (6069 years). After the Endospheres Therapy course, the mean group body mass index values did not change, however, a weight loss of 3.47.4 kg, a decrease in waist and hips by 2.23.02.5 cm, 4.15.36.3 cm in the respective age groups. In the first group of participants, the fat mass index decreased by 16.4% (p 0.005), active cell mass increased by almost 15% (p 0.005), skeletal muscle mass ― by 13% (p 0.005), the specific basic metabolism ― by 10% (p 0.005), the value of phase angle after the course Endospheres Therapy increased statistically significantly by 16% (p 0.05). In other age groups, bioimpedance measurements were similar, but less pronounced. After the procedures, in some cases, study participants reported a slight tingling/squeezing sensation, slight muscle soreness, reminiscent of the state after exercise, and temporary slight redness of the skin.&#x0D; CONCLUSION: The results obtained allow us to state the effectiveness and safety of the use of Endospheres Therapy in the treatment of cellulite, as a pathogenetically substantiated method of physiotherapy that affects the improvement of the skin condition, the transformation of the fat component, the increase in cell metabolism, muscle tone, stimulation of lymphatic drainage and tissue trophism.

Факторы риска и качество жизни женщин в периодах пери- и постменопаузы в городе Ереван, Армения

INTRODUCTION: Menopause is associated with various somatic, vasomotor, sexual and psychological symptoms that adversely affect the quality of life of women in peri- and postmenopausal periods. AIM: To assess the quality of life (QoL) of women in peri- and postmenopausal periods, to identify factors producing a negative effect on him during these periods. MATERIALS AND METHODS: А cross-sectional study was conducted through a survey of 353 women above 40. To assess QoL, the SF 36 questionnaire was used. Sociodemographic factors and peculiarities of health status of the participants were considered risk factors. The data were introduced and analyzed using SPSS 23 statistical package. Statistical significance of the results was evaluated by Kruskal–Wallis test with the subsequent a posteriori analysis, and Mann–Whitney test. RESULTS: Peri- and post menopause had negative impact on the parameters of physical component of QoL and all its domains. Participants with regular menstruation had a reliably higher score of physical component of QoL compared to peri- and postmenopausal women (p &lt; 0.001). The scores of physical component of QoL were higher in women at the age under 50 compared to women of older age groups. The scores were higher in women with higher and secondary special education compared to participants with general secondary education (p &lt; 0.05). Higher scores of physical and psychological components of QoL were recorded in working women compared to the retired group (p &lt; 0.05). The parameters of psychological component of QoL were the highest among married and single women. Parameters of physical and mental components of QoL were higher in groups with the income above and at the level of the living minimum compared to those who reported the income below the minimum wage (p &lt; 0.001). A reliably higher scores of physical and mental components of QoL were recorded in participants with favorable microclimate in families compared to the group with an unfavorable one (p &lt; 0.01). A reliable relationship was found between the evaluation of the health and parameters of both components of QoL by the participants. Higher scores were recorded in women who evaluated their health as excellent and above average compared to all other groups (p &lt; 0.05). The presence of chronic diseases had a negative impact on both components of QoL. CONCLUSION: The factors producing negative effects on QoL of women in peri- and postmenopausal periods were the older age, general health status, low educational level, retirement, unfavorable family status and family microclimate, low family income.

Assessment of the quality of life in peri- and postmenopausal women living in Yerevan based on Women's Health Questionnaire

Objective: To assess the impact of peri- and postmenopause and some social-demographic and medical factors on scales of the quality of life (QoL) of women living in Yerevan. Material and methods. Across-sectional study was conducted among 353 women in the &gt;40 age group. WHQ (Women Health Questionnaire) was used for the assessment of quality of life. Results. Negative indicators in peri- and postmenopausal women compared to women with a regular cycle were revealed on the scales "Vasomotor disorders" (0.46±0.05 and 0.51±0.03 vs. 0.17±0.03, p&lt;0.001) and "Anxiety/fears" (0.40±0.04 and 0.38±0.02 vs. 0.27±0.03, p=0.013). The difference only between the groups of postmenopausal women and those with a regular cycle was registered on the scales "Somatic symptoms" (0.53±0.02 vs. 0.49±0.04, p=0.003), "Memory and concentration of attention" (0.47±0.03 vs. 0.39±0.04, p=0.015), Sexual Behavior (0.43±0.03 vs. 0.21±0.03, p&lt;0.001) and "Attractiveness" (0.37±0.03 vs. 0.24±0.04, p=0.015). The presence of chronic diseases had a negative impact on QoL. From socio-demographic characteristics, negative was impact of age, low level of education, lack of employment, unfavorable family and financial status. Conclusions. There was a deterioration in all indicators of the QoL, except "Depressed mood", "Sleep problem", "Menstrual symptoms", in women of peri- and postmenopausal age. Age, low level of education, lack of employment, unfavorable family and financial status, the presence of chronic diseases had a negative impact on the QoL of the study participants.

Determination of the relationship of visphatin and homocysteine levels with indicators of glucose metabolism and lipid metabolism in peri- and postmenopause women with type 2 diabetes mellitus and osteoarthritis

Type 2 diabetes mellitus (T2DM), among other modern diseases, certainly occupies a leading position today. Moreover, the comorbid combination of T2DM and osteoarthritis (OA) is a common example of the development of complications, disability and mortality these days. As you know, T2DM develops against the background of obesity and overweight. A significant group of patients prone to these pathologies are peri- and postmenopausal women. Estrogen deficiency during this period worsens the course of these interdependent conditions. Therefore, searching for ways of early diagnosis of OA in women with T2DM is an urgent task of internal medicine.&#x0D; Purpose. To determine the interdependencies of indicators of glucose metabolism and lipid metabolism with levels of visfatin (VF) and homocysteine (HC) in women with T2DM and OA in peri- and postmenopause.&#x0D; Methods. For the study, 120 thematic women in peri- and postmenopause were selected and were divided into three groups: 1st (n=20) - women with a mono-course of T2DM; 2nd (n=20) – with a mono-course of OA; 3rd (n=64) – with the comorbid course of T2DM and OA. The control group (CG) consisted of 16 relatively healthy women of the appropriate age. Diagnoses of T2DM and OA were established in accordance with the current Orders of the Ministry of Health of Ukraine. Laboratory diagnostic methods were performed according to standard methods.&#x0D; The results. According to the obtained results, the presence of interdependencies of all indicators of lipid metabolism and glucose-insulin metabolism was reliably determined, which indicated direct correlations (mostly of moderate strength) with the levels of HC and VF in the blood of the examinees, most pronounced in the comorbid combination of T2DM and OA in peri- and postmenopause.&#x0D; Conclusions. In work, an analysis of the correlations of indicators of glucose metabolism and lipid metabolism with disturbances in the metabolism of VF and HC in women with T2DM and OA in pre- and postmenopause was carried out, and their interdependent relationships were determined. The highest levels of VF and HC were recorded in the group of women with comorbid pathology of T2DM and OA.

The Relationship between Social Support and Mental Health Problems of Peri- and Postmenopausal Women during the SARS-CoV-2 Pandemic.

The COVID-19 pandemic affects women's mental health, because they are more predisposed to vulnerabilities and adverse impacts. Therefore, is important to find strategies for preventing and treating these mental health consequences in the female population. The main purposes of our study were to determine the level of social support received by peri- and postmenopausal women during the SARS-CoV-2 pandemic, as well as factors related to this level with reference to health status and sociodemographic variables. A total of 218 women in peri- and postmenopausal status participated in the study. The study assessed depression (Beck Depression Inventory), anxiety (the Spielberg State-Trait Anxiety Scale), climacteric symptoms (the Blatt-Kupperman Index), social support (the Inventory of Social Supportive Behaviors). The majority of the respondents had a moderate level of anxiety as a state (40.8%), a low level of anxiety as a trait (51.4%), no depressive symptoms (75.2%) and no climacteric symptoms (52.3%). Age was found to significantly correlate with anxiety as a state (p = 0.036). The anxiety as state was significantly stronger in people with higher education than in people with secondary education (p = 0.019). Professionally inactive women had more emotional (p = 0.05) and appraisal (p = 0.014) support than women who work. The analysis demonstrated no statistically significant correlation between social support and depression, anxiety or climacteric symptoms (p > 0.05). The majority of peri- and postmenopausal women had no depressive symptoms and/or anxiety symptoms. Professionally inactive women had more emotional and appraisal support than women who work. The analysis demonstrated no statistically significant correlation between social support and depression, anxiety or climacteric symptoms.

Clinical and genetic aspects of menopausal hormone therapy - a modern paradigm. What changed COVID-19 pandemic?

In the modern paradigm of public health protection, much attention is paid to the health of women in peri- and postmenopause, and a personalized approach prevails. It is generally recognized that the pathogenetic therapy of menopausal disorders is hormone therapy. But the COVID-19 pandemic has made its own adjustments to the routine strategy of choosing menopausal hormone therapy (MHT). The purpose of this review was to analyze studies on the dependence of the effectiveness of MHT on clinical and genetic aspects in the context of the ongoing COVID-19 pandemic. The review highlights the main risks of MHT for thromboembolic diseases and coagulation complications characteristic of COVID-19, discusses genetic predispositions that aggravate the course of the post-COVID period, as well as the effectiveness of estrogens in protecting the vascular endothelium and increasing the number of CD4+ T cells, providing an adequate immune response when infected with SARS-CoV-2. Numerous studies show that the complications characteristic of the severe course of COVID-19 are multifactorial in nature and cannot be unambiguously explained only by genetic predisposition. However, with the development of personalized medicine, special attention should be paid to the study of genetic aspects that can equally contribute to the occurrence of menopausal disorders in healthy women and aggravate the course of the post-pregnancy period. The data presented allow us to conclude that in the context of the ongoing COVID-19 pandemic at the population level, MHT can bring significant benefits to women during menopause due to the beneficial effect of estrogens on vascular walls. Additional study of the relationship between the course of the postcovid period in MHT users and polymorphisms of candidate genes that determine the risks of thrombotic complications and metabolic consequences is required.

Personalized use of minor food components in the menopause period

In the Russian Federation, the number of women in peri- and postmenopause is more than 21 million [1]. In addition to changes in sex hormone levels associated with menopause, its timing is an important predictor of future health outcomes, such as the duration of vasomotor symptoms and the risk of developing hormone-dependent tumors. The influence of reproductive factors (e.g., age at menarche, pregnancy) and sociodemographic factors on intermediate and long-term health outcomes of menopause has been extensively studied in the past. However, the influence of a woman’s diet on the course of menopause has not been studied sufficiently. There is also little evidence in the literature on the impact of diet at a young age, the so-called established eating patterns, on the menopause course. The authors aim to study the actual nutrition of menopausal women with manifestations of climacteric syndrome and make an attempt to influence the quality of life and the manifestation of menopausal syndrome with the help of lifestyle correction, diet modification and the use of minor biologically active substances. The aim was also to determine the features of the diet of women of reproductive age (to determine the excess and lack of nutrients) in order to create an algorithm for correcting the diet and preventing delayed risk factors.

Health-Related Quality of Life in perimenopausal women with PCOS

Background: Several studies have shown that younger women with polycystic ovary syndrome (PCOS) have decreased Health-Related Quality of Life (HRQoL) compared with women in general. Method: In this study peri- and postmenopausal women previously diagnosed with PCOS (n = 27) were compared with randomly selected, age-matched controls (n = 94). Mean age of the study participants was 52 years. Structured interviews and Short Form (SF)-36 questionnaires were used. Results: No differences in SF-36 scores were found, median for the physical summary score was 54 vs. 57, for women with PCOS and controls, respectively; and 53 vs. 53 for the mental summary score, with no differences in any of the eight dimensions of HRQoL. There were no significant difference in prevalence of depression and/or anxiety. The use of drugs for mood disorders was 22% in both groups. Conclusion: PCOS women of peri- and postmenopausal ages had similar HRQoL compared with age-matched controls.

Особенности течения COVID-19 у женщин в пери- и постменопаузе. Роль менопаузальной гормональной терапии

A literature review on the effect of peri- and postmenopausal period on the course of novel coronavirus infection and post-COVID-19 syndrome was performed. The aspects of hormone replacement therapy against the background of therapy for COVID-19 and post-COVID-19 syndrome were studied. The postmenopausal period in women was found to be a risk factor for a more severe course of COVID-19. Estradiol may act as a protective factor for women with COVID-19 by regulating cellular and humoral immunity factors such as interleukin-2, -6, -8, tumor necrosis factor-α and C3. Prolonged course of COVID-19, persistence of its symptoms and development of severe post-COVID-19 syndrome are associated with female sex, with women in peri- and postmenopausal period being most vulnerable. Symptoms of estrogen deficiency and menopause may be similar to the manifestations of post-COVID-19 syndrome, and these conditions can coexist and aggravate each other. According to international experts, the use of hormone replacement therapy will help to improve the well-being of women, their quality of life, and relieve the symptoms typical of menopause and post-COVID-19 syndrome. Key words: coronavirus infection, COVID-19, menopause, post-COVID-19 syndrome, hormone replacement therapy, estrogen

Complex diagnosis and treatment of hyperplastic processes and endometrial cancer

The urgency of the problem of endometrial hyperplastic processes is due to the high risk of their malignancy, especially in women in peri- and postmenopause. The frequency of malignancy of endometrial hyperplastic processes varies within a fairly wide range (0.25–50%) and is determined by the morphological features of the disease, the duration of its recurrence, and the age of the patients. The aim of our work is to optimize the tactics of managing women with hyperplastic processes and endometrial cancer based on the development of an algorithm for diagnosing, treating and predicting the outcomes of therapy for this pathology using modern medical technologies. The complex use of clinical, laboratory, instrumental methods allows you to choose the best methods for diagnosing and treating endometrial hyperplastic processes.

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.

Therapeutic effects of lignans in women in perimenopausal and postmenopausal periods (review of literature)

Today, there is a tendency towards an increase of the number of the female population that has crossed the line of menopause, which makes it more urgent to improve the quality of life of women and to develop safe methods for the prevention and treatment of climacteric syndrome (CS), which is an integral medical, social and economic problems. In view of the presence of contraindications for use and defined risks of complications with the use of hormone menopausal therapy (HRT), it is necessary to develop alternative methods for the prevention and treatment of perimenopausal symptoms. This literary review of domestic and foreign sources demonstrates information about the role of the plant lignan 7-hydroxymatairezinol (7-HMR) in maintaining the physical and psychoemotional health of women in the period of peri- and postmenopause. As a result of the analysis of the therapeutic effects of the 7-HMR molecule, the ability to relieve the main symptoms of CS (neurovegetative presentations and emotional disorders), to improve the general state of health and metabolic profile of perimenopausal women was revealed. High safety and low incidence of side effects were noted, as well as a positive effect on the dynamics of body weight. The presence of a stable anti-inflammatory and antioxidant activity 7-HMR makes it possible to recommend this lignan to women in the climacteric period as an effective drug for the prevention of the formation of immune deficiency, which contributes to the development of oncological and autoimmune diseases. The proven antitumor activity confirms the promise of using the 7-HMR for the implementation of oncopreventive measures in women of peri- and postmenopausal age.

Cliniopathological profile in women with abnormal uterine bleeding

Introduction: Abnormal uterine bleeding is a challenging gynecological problem caused by various endometrial pathologies and is a major clinical problem among women in peri and postmenopausal age groups. The problem is common worldwide but causes may vary from one region to another. Aims and Objectives: The main objective was to evaluate pathological spectrum of different endometrial lesions in abnormal uterine bleeding and to correlate with clinical history and diagnosis. Materials and Methods: The study was a prospective study done from August 2017 to July 2019. The specimens received from endometrial biopsy were included in the study. All the specimens were fixed in formalin and processed through paraffin wax embedding method. Sections were cut at 3-5 micrometer thickness and stained by Hematoxylin and Eosin (H&E) stain and were examined under light microscope. Result: A total no. of 247 cases were studied. Out of these, 57 cases were of Proliferative endometrium, 33 cases of Secretory endometrium, 34 cases of simple hyperplasia without atypia, 11 cases of cystic glandular hyperplasia, 17 cases of complex hyperplasia with atypia, 09 cases of menstrual phase endometrium, 07 cases of irregular shedding, 06 cases of endometrial polyp and anovulatory cycle, 04 cases of endometritis, 03 cases each of simple hyperplasia with atypia, progesterone exposed endometrium and inadequate secretory phase, 02 cases each of complex hyperplasia without atypia, atrophic endometrium, products of conception and inadequate proliferative phase and 01 case each of stromal hyperplasia. 45 samples were inadequate. Maximum cases of abnormal uterine bleeding were seen between 31-40 years of age. Interpretation and Conclusion: Abnormal uterine bleeding is one of the commonest condition for which patients seek advice in the gynecological outpatient department. Analysis of histopathology of endometrium in abnormal uterine bleeding helps in management of patients and to know th

Depressive symptoms and type II diabetes mellitus among midlife women.

A decision tree analysis helps determine the complex characteristics of the groups that are closely connected with specific outcomes. Using a decision tree analysis, the purpose of this secondary analysis was to examine the associations of type II diabetes mellitus (DM) to depressive symptoms among midlife women from four major racial/ethnic groups in the US. while identifying the complex characteristics of the women that were closely linked to depressive symptoms. The data from two larger Internet survey studies were used for this analysis. The data from a total of 164 women (62 with type II diabetes and 102 without diabetes) were included. The data were collected using several instruments to measure background characteristics, health and menopausal status, and depressive symptoms (the Depression Index for Midlife Women). The data analysis was conducted using independent t tests, Mann-Whitney U tests, and decision tree analyses. The total numbers and total severity scores of depressive symptoms were significantly higher in those with DM compared with those without DM (P < 0.05). There were significant differences in the total numbers and total severity scores of depressive symptoms by menopausal status and race/ethnicity (P < 0.05). DM was a significant factor that influenced the total severity scores of depressive symptoms among midlife women in peri- or postmenopausal stages who were born outside the US and among midlife women in their premenopausal stage (P < 0.05). This study indicated several combined characteristics of midlife women at high risk for depressive symptoms that could provide directions for future interventions.

Uterine adenosarcoma. Report of 5 cases and review of literature

Uterine adenosarcoma is an uncommon biphasic tumor with benign epithelial and malignant mesenchymal components, often presenting difficulties for morphological diagnosis. We describe 5 cases of adenosarcoma of the uterine corpus and cervix, and vaginal stump in patients aged 46-76 years. Clinical data, ultrasound results, morphological data, including immunohistochemical studies with antibodies to CD10, estrogen and progesterone receptors, desmin, smooth muscle actin, and Ki-67 are presented. Large polypoid mass of the epithelial-mesenchymal structure within the uterine cavity in women of peri - and postmenopausal age require the exclusion of malignancy of the mesenchymal component with searchig for diagnostic criteria - periglandular cuffing of the stromal cells and mitoses.

RELATION OF ENDOMETRIAL PATHOLOGICAL CHANGES WITH ENDOCRINE DISORDERS AND METABOLIC SYNDROME

Endometrial hyperplasia (EH) is an abnormal proliferation of endometrial glands and stroma and is associated with an increased risk of endometrial cancer (EC). Risk factors such as obesity, chronic anovulation, late menopause, hypertension, and diabetes lead to an increased risk of EH and EC. Aim: to determine the association of pathological changes in the endometrium with endocrine disorders and metabolic syndrome in women in peri and postmenopause. This study including a total of 139 patients in peri and postmenopause. &nbsp;The examined group consisted of 104 women with fractional explorative curettage due to a medical indication and was divided into two subgroups: peri and postmenopausal. The control group included 35 healthy women. Anamnestic data, body weight, height, blood pressure measurement, were taken from all patients, and the following laboratory parameters were determined: glucose, TSH, thyroxine, glycosylated hemoglobin (HbA1c), and Vitamin D . The presence of metabolic syndrome (MetS) according to its diagnostic criteria was also determined. In our study, significance was found in the comparison of the examined and the control group (p = 0.0001) in addition to the significantly higher BMI in the examined group. The comparison also &nbsp;indicated the existence of a significant difference in the level of glycemia in addition to a significantly higher level in the examined group (p = 0.0001). The statistical analysis did not indicate a significant difference between the two subgroups of the examined group, nor between the examined and the control group in terms of TSH, thyroxine and HbA1c levels. The value of vit. D was significantly higher in the control than &nbsp;in the study group (p = 0.0001). The analysis showed that patients with fractional explorative curettage had 4.982 times [OR = 4.982 (2.06–12.02) 99% CI] significantly more often MetS compared to women in the control group. Patients in the examined group had a significantly higher BMI, glycemia, and more frequent presence of MetS than those in the control group. Keywords: endometrium, risk factors, fractional explorative curettage, metabolic syndrome

Vasocorrigating effect of general magnetotherapy and electromyostimulation with biofeedback in combination with fractional microablative co2 laser therapy in patients with posterior vaginal wall prolapse after surgery

Background. The high recurrence rate after surgical treatment of pelvic organ prolapse makes it necessary to improve therapeutic methods.&#x0D; Objective: to develop and scientifically substantiate the use of a rehabilitation complex, including general magnetotherapy, electromyostimulation with biofeedback in combination with fractional microablative therapy with a CO2 laser, in patients of different age groups with rectocele after surgery.&#x0D; Methods. The article presents the treatment data for 100 women of childbearing, peri- and menopausal age with rectocele IIIII degree, which were divided into 2 groups comparable in terms of clinical and functional characteristics (main and control), within each group they were divided by 2 subgroups: subgroup A included women of childbearing age, subgroup B included women of peri- and menopausal age. The patients of the main group in the early postoperative period after plastic surgery for rectocella (from 1 day) underwent a course of general magnetotherapy and in the late postoperative period (one month after the operation) they performed a set of measures consisting of a course of electromyostimulation with biological connection of the pelvic floor muscles and a special complex physiotherapy exercises and 2 intravaginal procedures of fractional microablative CO2 laser therapy with an interval of 45 weeks. Patients in the control group after surgical treatment of rectocele in the late postoperative period received symptomatic therapy, including painkillers and antispasmodics, which served as a backdrop for patients of the main group.&#x0D; Results. As a result of the studies, it was found that regardless of the age and severity of uterine blood flow disorders in the uterine arteries in patients with rectocele, the most pronounced dynamics was observed in patients of the main group, which, in our opinion, is associated primarily with the vasoactive effects of general magnetotherapy, manifested in the removal of spasm from arteries and arterioles, improving the contractility of the veins and increasing venous outflow, which in combination with electrical stimulation, exercises to strengthen the muscles of the pelvis bottom and fractional microablative therapy allowed to obtain such a pronounced vasocorrigating effect.&#x0D; Conclusions. Due to the pathogenetic effect of the developed complex (electrical stimulation, exercises to strengthen the pelvic floor muscles and fractional microablative therapy) on one of the main mechanisms of the development of the disease, a pronounced vasocorrecting effect was obtained.