medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-16-124-129medsovet-7099Research ArticleПРЕ- И ПОСТМЕНОПАУЗАPRE- AND POSTMENOPAUSEАльтернативная и комплементарная коррекция климактерических расстройствAlternative and complementary correction of menopausal disordershttps://orcid.org/0000-0002-8584-5517АверковаВ. Г.AverkovaV. G.

Виктория Геннадьевна Аверкова, аспирант

отделение гинекологической эндокринологии

117997

ул. Академика Опарина, д. 4

Москва

Victoriya G. Averkova, Postgraduate Student

Department of Gynecological Endocrinology

117997

4, Academician Oparin St.

Moscow

buch1202@mail.ruhttps://orcid.org/0000-0002-7430-1207ЯкушевскаяО. В.YakushevskayaO. V.

Оксана Владимировна Якушевская, к. м. н., врач акушер-гинеколог, онколог, научный сотрудник

отделение гинекологической эндокринологии

117997

ул. Академика Опарина, д. 4

Москва

Oksana V. Yakushevskaya, Cand. Sci. (Med.), Obstetrician- Gynecologist, Oncologist, Research Associate

Department of Gynecological Endocrinology

117997

4, Academician Oparin St.

Moscow

aluckyone777@gmail.comНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В. И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian Federation202209102022016124129Copyright © Аверкова В.Г., Якушевская О.В., 20222022Аверкова В.Г., Якушевская О.В.Averkova V.G., Yakushevskaya O.V.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/7099

   Менопауза, определяемая как отсутствие менструаций в течение 12 мес. и более, представляет собой многомерный эволюционный процесс, оказывающий существенное влияние на качество жизни женщин и риск развития возраст-ассоциированной патологии. Каждый год в период менопаузы вступает 47 млн женщин во всем мире. Возраст началаменопаузы является наиболее важным фактором, определяющим статус здоровья женщин и в значительной степени риск как заболеваемости, так и смертности. Менопауза может быть индуцирована хирургическим вмешательством, химио- или лучевой терапией. Около трети жизни женщин приходится на период постменопаузы, который достаточно часто (60–70 %) сопровождается развитием различных симптомов, связанных с дефицитом эстрогенов. К инициальным проявлениям климактерического синдрома, прежде всего, относят вазомоторные симптомы (ВМС). Частота ВМС превалирует в двухлетний период непосредственно до и после последней менструации. У ряда пациенток приливы могут начинаться задолго (за 10 лет) до менопаузы и продолжаться в течение длительного времени. На фоне дефицита эстрогенов часто отмечается ночная потливость, дисфорические расстройства, урогенитальная атрофия / нарушения мочеиспускания, сексуальные (снижение либидо) и когнитивные изменения, нарушения сна. МГТ следует рассматривать как терапевтическое вмешательство первой линии коррекции климактерических расстройств и профилактики возраст-ассоциированной патологии у женщин с преждевременной недостаточностью яичников и у женщин в менопаузе в возрасте до 60 лет. Для пациенток, настороженно относящихся к гормональной терапии или имеющих абсолютные / относительные противопоказания к использованию МГТ, следует рассмотреть альтернативные методы коррекции менопаузальных расстройств, которые включают нефармакологические и фармакологические негормональные средства с различной степенью эффективности и безопасности. Фитоэстрогены уверенно заняли нишу альтернативной терапии климактерических расстройств.

   Menopause, defined as the cessation of menses for 12 months and more, is a multidimensional evolutionary process, which has a considerable impact on the women’s quality of life and the risk of development of age-associated pathology. 47 million of women around the world enter the menopausal period each year. The menopause onset age is the most important factor which determines the woman health status and, to a large extent, both the risk of morbidity and mortality. Menopause may be induced by a surgical intervention, chemotherapy, and radiation therapy. Post-menopause period accounts for about onethird of a woman’s life and is quite often accompanied by the development of different symptoms associated with estrogen deficiency. Vasomotor symptoms (VMS) are primarily referred to the initial manifestations of the climacteric syndrome. VMS frequency prevails within the two-year period immediately before and after the last menstruation. In some patients, hot flashes can begin long before (10 years prior to) the menopause and persist for a long time. Night sweats, dysphoric disorders, urogenital atrophy / urination disorders, sexual (decreased libido) and cognitive changes, and sleep disturbances are often observed due to the estrogen deficiency. MHT should be considered as a first line therapeutic intervention for the correction of climacteric disorders and prevention of age-associated pathology in women with premature ovarian failure and in menopausal women under the age of 60. For patients who are wary of hormonal therapy or have absolute / relative contradictions to the use of MHT, alternative methods of menopausal disorders correction, which include nonpharmacological and pharmacological non-hormonal drugs with different degrees of efficiency and safety should be considered. Phytoestrogens have confidently filled a niche of alternative therapy for the treatment of menopausal disorders.

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