medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-352medsovet-7781Research ArticleПРЕ- И ПОСТМЕНОПАУЗАPRE- AND POSTMENOPAUSEСоединения природного происхождения в купировании симптомов и снижении рисков перименопаузального периодаNaturally occurring compounds in relieving symptoms and reducing perimenopausal riskshttps://orcid.org/0000-0001-6589-7654ШихЕ. В.ShikhE. V.

Ших Евгения Валерьевна – доктор медицинских наук, профессор, заведующая кафедрой клинической фармакологии и пропедевтики внутренних болезней.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Evgenia V. Shikh - Dr. Sci. (Med.), Professor, Head of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991

shikh_e_v@staff.sechenov.ruhttps://orcid.org/0000-0001-9817-9886МаховаА. А.MakhovaA. A.

Махова Анна Александровна - доктор медицинских наук, доцент кафедры клинической фармакологии и пропедевтики внутренних болезней.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Anna A. Makhova - Dr. Sci. (Med.), Associate Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991

makhova_a_a@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation20232010202301594103Copyright © Ших Е.В., Махова А.А., 20232023Ших Е.В., Махова А.А.Shikh E.V., Makhova A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7781

Наиболее существенно на здоровье женщины в постменопаузе влияют метаболические нарушения, которые носят прогрессирующий характер. Остеопороз и сердечно-сосудистые заболевания представляют собой наиболее важные долгосрочные последствия и серьезно влияют на качество жизни женщин в период менопаузы. Частой причиной обращения к врачу являются приливы – внезапное чувство жара или жжения, которое начинается в области лица, шеи, верхней части груди или спине. Иногда приливы сопровождаются покраснением кожи, появлением пятен или учащенным сердцебиением. В ряде случаев наблюдается локальное повышение температуры тела. Вышеперечисленные симптомы являются результатом нарушения функционирования термочувствительных нейронов, расположенных в гипоталамической области. Золотым стандартом фармакотерапии различных симптомов менопаузы является менопаузальная гормональная терапия. Однако наличие разнообразных абсолютных и относительных противопоказаний, а также отказ пациенток от лечения в основном в связи с гормонофобией привели к тому, что менее 30% женщин в менопаузе принимают заместительную гормональную терапию и только 15% продолжают ее в течение длительного периода. Пациентки часто настаивают на естественном подходе к купированию симптомов и хотят получить научно обоснованную информацию о различных вариантах гормонального и негормонального лечения. Обеспокоенность по поводу потенциальных побочных эффектов заместительной гормональной терапии привела к повышенному интересу к использованию фитоэстрогенов для купирования симптомов менопаузы. Рационально составленная комбинация фитоэстрогенов с микронутриентами представляет собой хорошо переносимую альтернативу, которую практически без ограничений можно применять для поддержания здоровья женщин в перименопаузе.

Metabolic disorders that are progressive in nature most significantly influence the health of postmenopausal women. Osteoporosis and cardiovascular diseases are the most important long-term consequences and seriously affect the menopausal women’s quality of life. Hot flashes, a sudden feeling of heat or burning that begins in the face, neck, upper chest or back regions, is a common reason to see a doctor. Sometimes, hot flashes are accompanied by redness of the skin, red blotches, or rapid heartbeat. In some cases, rises in local skin temperature are observed. The above symptoms are the result of impaired functioning of thermosensitive neurons in the hypothalamic region. Menopausal hormone therapy is the gold standard for pharmacotherapy of various menopausal symptoms. However, it has different absolute and relative contraindications, as well as patients’ refusal of treatment mainly due to hormone phobia, that have resulted in a situation where 30% of menopausal women take hormone replacement therapy and only 15% continue to take it for a long period. Patients often insist on a natural approach to symptom relief and need evidence-based information about different hormonal and non-hormonal treatment options. Concerns about potential side effects of the hormone replacement therapy resulted in increased interest rates for phytoestrogens to manage menopausal symptoms. A rational fixed dose combination of phytoestrogens and micronutrients is a well-tolerated alternative preparation to support the health of perimenopausal women, which can be used with virtually no restrictions.

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