medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-13-76-83medsovet-5789Research ArticleПРЕ- И ПОСТМЕНОПАУЗАPRE- AND POSTMENOPAUSEМенопауза: вверх по лестнице, ведущей внизMenopause: up the stairs leading downhttps://orcid.org/0000-0001-8284-8117ГаспарянС. А.GasparyanS. A.

Гаспарян Сусанна Арташесовна - доктор медицинских наук, профессор кафедры урологии, детской урологии-андрологии, акушерства и гинекологии Института дополнительного последипломного образования.

355017, Ставрополь, ул. Мира, д. 310

Susanna A. Gasparyan - Dr. of Sci. (Med.), Professor of the Department of Urology, Pediatric Urology-Andrology, Obstetrics and Gynecology of the Institute of Continuing Postgraduate Education.

310, Mir St., Stavropol, 355017

prof-gasp55@yandex.ruhttps://orcid.org/0000-0002-6374-9786ВасиленкоИ. А.VasilenkoI. A.

Василенко Ирина Анатольевна - доктор медицинских наук, профессор Института мехатроники и информационных технологий, РГУ им. А.Н. Косыгина (Технологии. Дизайн. Искусство); заведующая научно-исследовательской лабораторией, МОНИКИ им. М.Ф. Владимирского.

117997, Москва, ул. Садовническая, д. 33, стр. 1; 129110, Москва, ул. Щепкина, д. 61/2, корп. 1

Irina A. Vasilenko - Dr. of Sci. (Med.), Professor of the Institute of Mechatronics and Information Technology, RSU named after A.N. Kosygin (Technology. Design. Art)”; Head of Research Laboratory, MRRCInamed after M.F. Vladimirsky.

33, Bldg. 1, Sadovnicheskaya St., Moscow, 117997; 61/2, Bldg. 1, Schepkin St., Moscow, 129110

vasilenko0604@gmail.comhttps://orcid.org/0000-0002-7943-9432ПапиковаК. А.PapikovaK. A.

Папикова Карина Александровна - кандидат медицинских наук, доцент кафедры урологии, детской урологии-андрологии, акушерства и гинекологии Института дополнительного последипломного образования.

355017, Ставрополь, ул. Мира, д. 310

Karine A. Papikova - Cand. of Sci. (Med.), Associate Professor of the Department of Urology, Pediatric Urology-Andrology, Obstetrics and Gynecology of the Institute of Continuing Postgraduate Education.

310, Mir St., Stavropol, 355017

https://orcid.org/0000-0003-3163-7074ДросоваЛ. Д.DrosovaL. D.

Дросова Лариса Дживаншировна - аспирант кафедры урологии, детской урологии-андрологии, акушерства и гинекологии Института дополнительного последипломного образования.

355017, Ставрополь, ул. Мира, д. 310

Larisa D. Drosova - Postgraduate student of the Department of Urology, Pediatric Urology-Andrology, Obstetrics and Gynecology of the Institute of Continuing Postgraduate Education.

310, Mir St., Stavropol, 355017

azrunc@bk.ruСтавропольский государственный медицинский университетРоссияStavropol State Medical UniversityRussian FederationРоссийский государственный университет им. А.Н. Косыгина (Технологии. Дизайн. Искусство); Московский областной научно-исследовательский клинический институт им. М.Ф. ВладимирскогоРоссияRussian State University named after A.N. Kosygin (Technology. Design. Art); Moscow Regional Research Clinical Institute named after M.F. VladimirskyRussian Federation2020121020200137683Copyright © Гаспарян С.А., Василенко И.А., Папикова К.А., Дросова Л.Д., 20202020Гаспарян С.А., Василенко И.А., Папикова К.А., Дросова Л.Д.Gasparyan S.A., Vasilenko I.A., Papikova K.A., Drosova L.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/5789

Постменопауза - важный этап физиологического старения женщины, связанный с появлением целого комплекса вегетативно-сосудистых, психических и обменно-эндокринных нарушений, возникающих на фоне угасания гормональной функции яичников и общей возрастной инволюции организма. При общих механизмах развития клинические проявления постменопаузы достаточно индивидуальны и степень их выраженности зависит не только от гормональных изменений, но и внешних факторов (условий жизни, состояния здоровья, социального функционирования и субъективного восприятия старения).

В обзоре описаны наиболее характерные симптомы менопаузального перехода: вазомоторные (приливы и повышенная потливость), урогенитальные (сухость во влагалище, диспареуния, дизурия), психоэмоциональные (раздражительность, необоснованная агрессивность, нарушения сна), когнитивные расстройства (снижение памяти, концентрации). Показана важность и необходимость коррекции симптомов постменопаузы с применением заместительной гормональной терапии. Препараты, содержащие комбинацию 17в-эстрадиол/дроспиренон, продемонстрировали эффективность в уменьшении климактерических симптомов и благоприятный профиль безопасности, а, значит, могут быть препаратами выбора для лечения симптомов менопаузы. Длительное применение низких доз Е2 и ДРСП в постменопаузе, по результатам многоцентрового постмаркетингового исследования, продемонстрировало значительное улучшение симптомов менопаузы у 86% респондентов.

Кроме назначения патогенетической терапии, важным аспектом оказания специализированной медицинской помощи женщинам, находящимся в пери- и постменопаузальном периоде, является необходимость повышения их осведомленности о проблемах климактерия с целью изменения отношения к собственному здоровью, управления менопаузальными симптомами и улучшения качества жизни.

Postmenopause is an important stage in physiological aging of women, which is associated with a whole complex of vegetative-vascular, mental, and metabolic-endocrine disorders that develop against the background of the ovarian failure and general age-related involution of the body. While there are general mechanisms of development, the clinical symptoms of postmenopause are quite individual and their severity depends not only on endocrine changes, but also on the external factors (living conditions, health status, social functioning and subjective perception of aging).

The review describes the most typical symptoms of the menopausal transition: vasomotor (hot flashes and excessive sweating), urogenital (vaginal dryness, dyspareunia, dysuria), psychoemotional (irritation, unfounded aggression, sleep disturbances), cognitive disorders (memory loss, concentration problems).

The management of postmenopausal symptoms is important and should be carried out using hormone replacement therapy. The combined drugs containing 17p-estradiol and drospirenone have proved to be effective in reducing menopausal symptoms and safe in use, therefore they can be the drugs of choice to treat menopausal symptoms. The multicentre post-marketing study showed that the long-term use of low-dose E2 and DRSP in postmenopausal women significantly improved menopausal symptoms in 86% of respondents. In addition to prescribing pathogenetic therapy, an important aspect of specialized medical care provided to women in the peri- and postmenopausal period is the need to raise their awareness of the menopause problems, change their attitude to their own health, manage menopausal symptoms and improve the quality of life.

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The authors declare that there are no conflicts of interest present.