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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2021-3-106-111</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-6080</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПРЕ- И ПОСТМЕНОПАУЗА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PRE- AND POSTMENOPAUSE</subject></subj-group></article-categories><title-group><article-title>Нарушения сексуальной функции у пациенток в постменопаузе</article-title><trans-title-group xml:lang="en"><trans-title>Disorders of sexual function in postmenopausal patients</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7591-6281</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хашукоева</surname><given-names>А. З.</given-names></name><name name-style="western" xml:lang="en"><surname>Khashukoeva</surname><given-names>A. Z.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хашукоева Асият Зульчифовна - доктор медицинских наук, профессор кафедры акушерства и гинекологии.</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Asiyat Z. Khashukoeva - Dr. Sci. (Med.), Professor of Department of Obstetrics and Gynaecology.</p><p>1, Ostrovityanov St., Moscow, 117997</p></bio><email xlink:type="simple">azk05@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0304-4901</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бурденко</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Burdenko</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бурденко Марина Владимировна - кандидат медицинских наук, доцент кафедры акушерства и гинекологии, заместитель декана.</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Marina V. Burdenko - Cand. Sci. (Med.), Assistant Professor of Department of Obstetrics and Gynaecology.</p><p>1, Ostrovityanov St., Moscow, 117997</p></bio><email xlink:type="simple">bmv-0306@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4629-9074</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оверко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Overko</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Оверко Алексей Вячеславович - студент 4-го курса лечебного факультета.</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Alexey V. Overko - a fourth-year student, Faculty of General Medicine.</p><p>1, Ostrovityanov St., Moscow, 117997</p></bio><email xlink:type="simple">arabakor@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0523-846X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рыжова</surname><given-names>Т. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Ryzhova</surname><given-names>T. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рыжова Татьяна Евгеньевна - врач акушер-гинеколог клинико-диагностического отделения.</p><p>129226, Москва, ул. 1-ая Леонова, дом 16</p></bio><bio xml:lang="en"><p>Tatyana E. Ryzhova - Obstetrician-Gynecologist, Clinical Diagnostic Department.</p><p>16, 1st Leonov St, Moscow, 129226</p></bio><email xlink:type="simple">lesnoy_elf@list.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4252-4024</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сафонина</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Safonina</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сафонина Марина Сергеевна - студентка 4-го курса лечебного факультета.</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>Marina S. Safonina - a fourth-year student, Faculty of General Medicine.</p><p>1, Ostrovityanov St., Moscow, 117997</p></bio><email xlink:type="simple">marixie.s@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Российский национальный исследовательский медицинский университет им. Н.И. Пирогова<country>Россия</country></aff><aff xml:lang="en">Pirogov Russian National Research Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Российский геронтологический научно-клинический центр<country>Россия</country></aff><aff xml:lang="en">Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>15</day><month>04</month><year>2021</year></pub-date><volume>0</volume><issue>3</issue><fpage>106</fpage><lpage>111</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Хашукоева А.З., Бурденко М.В., Оверко А.В., Рыжова Т.Е., Сафонина М.С., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Хашукоева А.З., Бурденко М.В., Оверко А.В., Рыжова Т.Е., Сафонина М.С.</copyright-holder><copyright-holder xml:lang="en">Khashukoeva A.Z., Burdenko M.V., Overko A.V., Ryzhova T.E., Safonina M.S.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/6080">https://www.med-sovet.pro/jour/article/view/6080</self-uri><abstract><sec><title>Введение</title><p>Введение. Согласно данным исследований за последние годы, в настоящее время расстройства сексуальной сферы широко распространены среди пациенток в постменопаузе и оказывают существенное влияние на качество их жизни.</p></sec><sec><title>Цель</title><p>Цель. Проанализировав различные источники литературы, определить основные причины нарушения сексуальной функции у пациенток в постменопаузе и способы их лечения.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В ходе исследования проблемы было проанализировано 25 источников литературы - как российских, так и зарубежных, датируемых 2007-2020 гг.</p></sec><sec><title>Результаты и обсуждение</title><p>Результаты и обсуждение. В данной статье рассмотрены основные этиологические аспекты расстройств сексуальной сферы у женщин в постменопаузе, таких как расстройства сексуального влечения, болевые сексуальные расстройства, оргазмические расстройства. Представлена роль физиологических процессов, происходящих в организме женщины в данный возрастной период в формировании сексуальной дисфункции, а именно влияние недостаточности половых гормонов (в частности эстрогенов) и генитоуринарного синдрома на нарушения сексуальной сферы. Описаны основные методы лечения, включающие заместительную гормональную терапию, использование неинвазивных лазерных технологий, хирургическую коррекцию дисфункции и атрофии мышц тазового дна. Особое внимание уделено применению синтетического стероида тиболона и препарата для лечения гиполибидемии флибансерина, представлены данные об их высокой эффективности.</p></sec><sec><title>Выводы</title><p>Выводы. Основное место среди проявлений сексуальной дисфункции занимают расстройства сексуального влечения и болевые сексуальные расстройства. Потому так важно уделять внимание этой проблеме, а лечение сексуальной дисфункции должно быть направлено на устранение ее причин.</p></sec><sec><title>Заключение</title><p>Заключение. Во многих случаях сексуальной дисфункции необходима психотерапия. Менопаузальная гормональная терапия положительно влияет на сексуальную функцию пациенток. Терапия тестостероном в данном случае обоснована, но используется редко, так как имеет ряд побочных эффектов и противопоказаний. Синтетические стероиды (тиболон) показали хороший результат в лечении сексуальных нарушений.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Research in recent years has shown that sexual dysfunction is now common in post-menopausal women and that it has a significant impact on their quality of life.</p></sec><sec><title>Aim</title><p>Aim: to identify the major causes of sexual dysfunction in postmenopausal women and their treatment options, by analysing different literature sources.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. During the study of this problem, 25 sources of literature, both Russian and foreign, dating from 2007 to 2020 were analysed.</p></sec><sec><title>Results and discussion</title><p>Results and discussion. The main etiological aspects of sexual dysfunction in postmenopausal women, such as disorders of sexual desire, sexual pain disorders, orgasmic disorders are considered in this article. The role of physiological processes occurring in a woman’s organism during this age period in the formation of sexual dysfunction is presented, namely, the influence of insufficiency of sex hormones (In particular, estrogens) and genitourinary syndrome on disorders of the sexual sphere.</p><p>The main methods of treatment are described, including hormone replacement therapy, the use of non-invasive laser technology, and surgical correction of the dysfunction and atrophy of the pelvic floor muscles. Particular attention is paid to the use of the synthetic steroid tibolone and flibanserin, a drug used to treat hypoactive sexual desire disorder, and the data concerning their high efficacy are presented.</p></sec><sec><title>Conclusions</title><p>Conclusions. The predominant manifestation of sexual dysfunction are disorders of sexual desire and sexual pain disorders. Thus it is important to pay attention to this problem and to treat sexual dysfunction by treating its causes.</p></sec><sec><title>Conclusion</title><p>Conclusion. The treatment of sexual dysfunction must address the causes. In many cases, psychotherapy is necessary. MHT has a positive effect on the sexual function of patients. Testosterone therapy is justified in this case, but is rarely used, as it has a number of side effects and contraindications. Synthetic steroids (Tibolone) have shown good results in the treatment of sexual dysfunction.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>сексуальная дисфункция</kwd><kwd>постменопауза</kwd><kwd>сексуальные расстройства</kwd><kwd>причины</kwd><kwd>гормональная терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>sexual dysfunction</kwd><kwd>postmenopausal women</kwd><kwd>sexual disorders</kwd><kwd>causes</kwd><kwd>hormonal therapy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Tsai T.F., Yeh C.H., Hwang T.I.S. Female Sexual Dysfunction: Physiology, Epidemiology, Classification, Evaluation and Treatment. Urol Sci. 2011;22(1):7-13. doi: 10.1016/S1879-5226(11)60002-X.</mixed-citation><mixed-citation xml:lang="en">Tsai T.F., Yeh C.H., Hwang T.I.S. Female Sexual Dysfunction: Physiology, Epidemiology, Classification, Evaluation and Treatment. Urol Sci. 2011;22(1):7-13. doi: 10.1016/S1879-5226(11)60002-X.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Гурко ГИ., Щербакова С.А. Сексуальная функция у пожилых людей и качество их жизни. Геронтология. 2013;(3):274-281. Режим доступа: http//:Www.gerontology.su/files/pdf/123-pdf.pdf.</mixed-citation><mixed-citation xml:lang="en">Gyrko G.I., Scsherbakova S.A. Sexual Function in the Elderly and Their Quality of Life. Gerontologiya = Gerontology. 2013;(3):274-281. (In Russ.) Available at: http://www.gerontology.su/files/pdf/123-pdf.pdf.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Granville L., Pregler J. Women's Sexual Health and Aging. JAm Geriatr Soc. 2018;66(3):595-601. doi: 10.im/jgs.15198.</mixed-citation><mixed-citation xml:lang="en">Granville L., Pregler J. Women's Sexual Health and Aging. JAm Geriatr Soc. 2018;66(3):595-601. doi: 10.1111/jgs.15198.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Allen M.S. Sexual Activity and Cognitive Decline in Older Adults. Arch Sex Behav. 2018;47(6):1711-1719. doi: 10.1007/s10508-018-1193-8.</mixed-citation><mixed-citation xml:lang="en">Allen M.S. Sexual Activity and Cognitive Decline in Older Adults. Arch Sex Behav. 2018;47(6):1711-1719. doi: 10.1007/s10508-018-1193-8.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Jackson S.E., Firth J., Veronese N., Stubbs B., Koyanagi A., Yang L., Smith L. Decline in Sexuality and Wellbeing in Older Adults: A Population-Based Study. J Affect Disord. 2019;245:912-917. doi: 10.1016/j.jad.2018.11.091.</mixed-citation><mixed-citation xml:lang="en">Jackson S.E., Firth J., Veronese N., Stubbs B., Koyanagi A., Yang L., Smith L. Decline in Sexuality and Wellbeing in Older Adults: A Population-Based Study. J Affect Disord. 2019;245:912-917. doi: 10.1016/j.jad.2018.11.091.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Дё Н.В., Хрипунова ГИ. Современные подходы к диагностике, прогнозированию течения и лечению климактерического синдрома у женщин. Саратовский научно-медицинский журнал. 2008;3(21):125-130. Режим доступа: http://www.ssmj.ru/system/files/2008_03_125_130.pdf.</mixed-citation><mixed-citation xml:lang="en">Dyo N.V., Khripunova G.I. Modern Approaches to Diagnostics, Forecasting of Currentand Treatment of Climacteric Syndrome at Women. Saratovskiy nauchno-meditsinskiy zhurnal = Saratov Journal of Medical Scientific Research. 2008;3(21):125-130. (In Russ.) Available at: http://www.ssmj.ru/system/files/2008_03_125_130.pdf.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Freak-Poli R., Kirkman M., De Castro Lima G., Direk N., Franco O.H., Tiemeier H. Sexual Activity and Physical Tenderness in Older Adults: Cross-Sectional Prevalence and Associated Characteristics. J Sex Med. 2017;14(7):918-927. doi: 10.1016/j.jsxm.2017.05.010.</mixed-citation><mixed-citation xml:lang="en">Freak-Poli R., Kirkman M., De Castro Lima G., Direk N., Franco O.H., Tiemeier H. Sexual Activity and Physical Tenderness in Older Adults: Cross-Sectional Prevalence and Associated Characteristics. J Sex Med. 2017;14(7):918-927. doi: 10.1016/j.jsxm.2017.05.010.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Zeleke B.M., Bell RJ., Billah B., Davis S.R. Hypoactive Sexual Desire Dysfunction in Community-Dwelling Older Women. Menopause. 2017;24(4):391-399. doi: 10.1097/GME.0000000000000767.</mixed-citation><mixed-citation xml:lang="en">Zeleke B.M., Bell RJ., Billah B., Davis S.R. Hypoactive Sexual Desire Dysfunction in Community-Dwelling Older Women. Menopause. 2017;24(4):391-399. doi: 10.1097/GME.0000000000000767.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Smith L., Grabovac I., Veronese N., Soysal P., Isik A.T., Stubbs B. et al. Sleep Quality, Duration, and Associated Sexual Function at Older Age: Findings from the English Longitudinal Study of Ageing. J Sex Med. 2019;16(3): 427-433. doi: 10.1016/j.jsxm.2019.01.005.</mixed-citation><mixed-citation xml:lang="en">Smith L., Grabovac I., Veronese N., Soysal P., Isik A.T., Stubbs B. et al. Sleep Quality, Duration, and Associated Sexual Function at Older Age: Findings from the English Longitudinal Study of Ageing. J Sex Med. 2019;16(3):427-433. doi: 10.1016/j.jsxm.2019.01.005.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Legocki LJ., Aikens J.E., Sen A., Haefner H.K., Reed B.D. Interpretation of the Sexual Functioning Questionnaire in the Presence of Vulvar Pain. J Low Genit Tract Dis. 2013;17(3):273-279. doi: 10.1097/LGT.0b013e31826ca384.</mixed-citation><mixed-citation xml:lang="en">Legocki LJ., Aikens J.E., Sen A., Haefner H.K., Reed B.D. Interpretation of the Sexual Functioning Questionnaire in the Presence of Vulvar Pain. J Low Genit Tract Dis. 2013;17(3):273-279. doi: 10.1097/LGT.0b013e31826ca384.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Lindau S.T., Schumm L.P, Laumann E.O., Levinson W., O'Muircheartaigh CA., Waite LJ. A Study of Sexuality and Health among Older Adults in the United States. N Engl J Med. 2007;357(8):762-774. doi: 10.1056/NEJMoa067423.</mixed-citation><mixed-citation xml:lang="en">Lindau S.T., Schumm L.P., Laumann E.O., Levinson W., O'Muircheartaigh CA., Waite LJ. A Study of Sexuality and Health among Older Adults in the United States. N Engl J Med. 2007;357(8):762-774. doi: 10.1056/NEJMoa067423.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Доброхотова Ю.Э., Хашукоева А.З., Агаева М.И., Агаева З.А. Особенности сексуальной функции у женщин в пожилом возрасте. Лечащий врач. 2020;(1):43-46. doi: 10.26295/OS.2019.82.97.009.</mixed-citation><mixed-citation xml:lang="en">Dobrokhotova Yu.E., Khashukoeva A.Z., Agaeva M.I., Agaeva Z.A. Features of Changes in Sexual Function in Women in Old Age. Lechaschi Vrach Journal. 2020;(1):43-46. (In Russ.) doi: 10.26295/OS.2019.82.97.009.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Столярова У.В., Хворостухина Н.Ф. Психоэмоциональные нарушения при климактерическом синдроме. Фундаментальные исследования. 2013; (9-1):202-206. Режим доступа: https://www.elibrary.ru/item.asp?id=20174845.</mixed-citation><mixed-citation xml:lang="en">Stolyarova U.V., Khvorostukhina N.F. Psychoemotional Violations in Menopausal Syndrome. Fundamentalnye issledovaniya = Fundamental Research. 2013;(9-1):202-206. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=20174845.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Carranza-Lira S., Nunez F.D.C. Sexual Dysfunction Prevalence in a Group of Pre- and Postmenopausal Mexican Women. Prz Menopauzalny. 2018;17(1):39-42. doi: 10.5114/pm.2018.74901.</mixed-citation><mixed-citation xml:lang="en">Carranza-Lira S., Nunez F.D.C. Sexual Dysfunction Prevalence in a Group of Pre- and Postmenopausal Mexican Women. Prz Menopauzalny. 2018;17(1):39-42. doi: 10.5114/pm.2018.74901.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Huang AJ., Gregorich S.E., Kuppermann M., Nakagawa S., Van Den Eeden S.K., Brown J.S. et al. Day-to-Day Impact of Vaginal Aging Questionnaire: A Multidimensional Measure of the Impact of Vaginal Symptoms on Functioning and Well-Being in Postmenopausal Women. Menopause. 2015;22(2):144-154. doi: 10.1097/GME.0000000000000281.</mixed-citation><mixed-citation xml:lang="en">Huang AJ., Gregorich S.E., Kuppermann M., Nakagawa S., Van Den Eeden S.K., Brown J.S. et al. Day-to-Day Impact of Vaginal Aging Questionnaire: A Multidimensional Measure of the Impact of Vaginal Symptoms on Functioning and Well-Being in Postmenopausal Women. Menopause. 2015;22(2):144-154. doi: 10.1097/GME.0000000000000281.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Nappi R.E., Cucinella L., Martini E., Rossi M., Tiranini L., Martella S. et al. Sexuality in Premature Ovarian Insufficiency. Climacteric. 2019;22(3): 289-295. doi: 10.1080/13697137.2019.1575356.</mixed-citation><mixed-citation xml:lang="en">Nappi R.E., Cucinella L., Martini E., Rossi M., Tiranini L., Martella S. et al. Sexuality in Premature Ovarian Insufficiency. Climacteric. 2019;22(3): 289-295. doi: 10.1080/13697137.2019.1575356.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Harlow S.D., Gass M., Hall J.E., Lobo R., Maki P, Rebar R.W. et al. Executive Summary of the Stages of Reproductive Aging Workshop. Menopause. 2012;19(4):387-395. doi: 10.1097/gme.0b013e31824d8f40.</mixed-citation><mixed-citation xml:lang="en">Harlow S.D., Gass M., Hall J.E., Lobo R., Maki P., Rebar R.W. et al. Executive Summary of the Stages of Reproductive Aging Workshop. Menopause. 2012;19(4):387-395. doi: 10.1097/gme.0b013e31824d8f40.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Lee D.M., Tetley J., Pendleton N. Urinary Incontinence and Sexual Health in a Population Sample of Older People. BJU Int. 2018;122(2):300-308. doi: 10.1111/bju.14177.</mixed-citation><mixed-citation xml:lang="en">Lee D.M., Tetley J., Pendleton N. Urinary Incontinence and Sexual Health in a Population Sample of Older People. BJU Int. 2018;122(2):300-308. doi: 10.1111/bju.14177.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Pakgohar M., Sabetghadam S., Rahimparvar S.F., Kazemnejad A. Sexual Function and Help Seeking for Urinary Incontinence in Postmenopausal Women. J Women Aging. 2016;28(1):2-8. doi: 10.1080/08952841.2014.950546.</mixed-citation><mixed-citation xml:lang="en">Pakgohar M., Sabetghadam S., Rahimparvar S.F., Kazemnejad A. Sexual Function and Help Seeking for Urinary Incontinence in Postmenopausal Women. J Women Aging. 2016;28(1):2-8. doi: 10.1080/08952841.2014.950546.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Miller V.M., Kling J.M., Files J.A., Joyner MJ., Kapoor E., Moyer A.M. et al. What's in a Name: Are Menopausal “Hot Flashes” a Symptom of Menopause or a Manifestation of Neurovascular Dysregulation? Menopause. 2018;25(6):700-703. doi: 10.1097/GME.0000000000001065.</mixed-citation><mixed-citation xml:lang="en">Miller V.M., Kling J.M., Files J.A., Joyner MJ., Kapoor E., Moyer A.M. et al. What's in a Name: Are Menopausal “Hot Flashes” a Symptom of Menopause or a Manifestation of Neurovascular Dysregulation? Menopause. 2018;25(6):700-703. doi: 10.1097/GME.0000000000001065</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Шмигель Н.Е. Психология сексуальных расстройств. РиТМ - Психология для всех. 2013;(3):50-53. Режим доступа: https://www.b17.ru/article/sex_rasstroystva.</mixed-citation><mixed-citation xml:lang="en">Shmigel N.E. Psychology of Sexual Disorders. RiTM - Psikhologiya dlya vsek h = RiTM - Psychology for All. 2013;(3):50-53. (In Russ.) Available at: https://www.b17.ru/article/sex_rasstroystva/.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Chang C.H., Fried N.M. Laser Probe with Integrated Contact Cooling for Subsurface Tissue Thermal Remodeling. J Miss Acad Sci. 2018;63(2 Suppl 1):202-205. Available at: https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC6388701.</mixed-citation><mixed-citation xml:lang="en">Chang C.H., Fried N.M. Laser Probe with Integrated Contact Cooling for Subsurface Tissue Thermal Remodeling. J Miss Acad Sci. 2018;63(2 Suppl 1):202-205. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388701/.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Сухих Г.Т., Сметник В.П., Андреева Е.Н., Балан В.Е., Гависова А.А., Григорян О.Р и др. Менопаузальная гормонотерапия и сохранение здоровья женщин в зрелом возрасте: клинические рекомендации. М.: Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова; 2015. 49 с. Режим доступа: https://www.elibrary.ru/item.asp?id=36373039.</mixed-citation><mixed-citation xml:lang="en">Sukhikh G.T., Smetnik V.P., Andreeva E.N., Balan V.E., Gavisova A.A., Grigoryan O.R. et al. Menopausal Hormone Therapy and Health Maintenance of Women in Adulthood: Clinical Guidelines. Moscow: Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; 2015. 49 p. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=36373039.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Kautzky-Willer A., Harreiter J., Abrahamian H., Weitgasser R., Fasching P, Hoppichler F., Lechleitner M. Sex and Gender-Specific Aspects in Prediabetes and Diabetes Mellitus-Clinical Recommendations. Wiener klinische Wochenschrift. 2019;131:221-228. doi: 10.1007/s00508-018-1421-1.</mixed-citation><mixed-citation xml:lang="en">Kautzky-Willer A., Harreiter J., Abrahamian H., Weitgasser R., Fasching P., Hoppichler F., Lechleitner M. Sex and Gender-Specific Aspects in Prediabetes and Diabetes Mellitus-Clinical Recommendations. Wiener kli-nische Wochenschrifi. 2019;131:221-228. doi: 10.1007/s00508-018-1421-1.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Davis S.R., Wahlin-Jacobsen S. Testosterone in Women - the Clinical Significance. Lancet Diabetes Endocrinol. 2015;3(12):980-992. doi: 10.1016/S2213-8587(15)00284-3.</mixed-citation><mixed-citation xml:lang="en">Davis S.R., Wahlin-Jacobsen S. Testosterone in Women - the Clinical Significance. Lancet Diabetes Endocrinol. 2015;3(12):980-992. doi: 10.1016/S2213-8587(15)00284-3.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
