The experience of using micronized estradiol in the preoperative period in patients with postmenopausal genital prolapse

Introduction. The aim is to evaluate the efficacy and safety of the use of micronized estriol produced in the form of a vaginal cream in the preoperative period in patients with pelvic floor muscle failure in postmenopause.

Aim. To evaluate the efficacy and safety of the use of micronized estriol in the preoperative period in patients with pelvic organ prolapse (POP) in postmenopause.

Results. The effectiveness of therapy with the studied drug made it possible to obtain a rapid clinical effect with a significant improvement in the condition of the mucous membranes and a decrease in the manifestation of IVA in patients already at the end of the first week of use. No side effects or adverse events were detected against the background of Ovestin use.

Conclusion. The experience of preoperative preparation using Ovestin (Aspen Bad Oldesloe GmbH, Germany), in the form of a vaginal cream (1 mg/g, 15 g, with a calibrated applicator) in patients with genital prolapse in postmenopausal provides restoration of the structure and elasticity of the vaginal mucosa, which contributes to the uncomplicated course of the postoperative period.

1. Balan VE, Kovaleva LA, Tikhomirova EV. Genitourinary or urogentical syndrome: possibilities of long-term therapy. Meditsinskiy Sovet. 2016;(12):98–101. (In Russ.) https://doi.org/10.21518/2079-701X2016-12-98-101.

2. Apolikhina IA, Yureneva SV, Malyshkina DA. Genitourinary syndrome of menopause: contemporary approaches to diagnosis and management. Akusherstvo i Ginekologiya (Russian Federation). 2020;12(Suppl.):4–8. (In Russ.) Available at: https://aig-journal.ru/articles/GENITOURINARNYIMENOPAUZALNYI-SINDROM-OVREMENNYE-PODHODY-K-DIAGNOSTIKEI-LEChENIU.html.

3. Khullar V, Anding R, Robinson D, Castro-Diaz D, Dmochowski R, Cardozo L. Under what circumstances should stress incontinence surgery be performed at the same time as prolapse surgery? ICI-RS 20. Neurourol Urodyn. 2017;36(4):909–914. https://doi.org/10.1002/nau.23245.

4. Chushkov YuV, Kuznetsova IV, Ishchenko AI. A role for topical administration of estriol in optimizing outcome of surgical treatment in periand postmenopausal patients with female genital prolapse. Effective Pharmacotherapy. 2015;19(1-2):24–28. (In Russ.) Available at: https://umedp.ru/articles/rol_mestnogo_ispolzovaniya_estriola_v_optimizatsii_iskhodov_operativnogo_lecheniya_opushcheniya_polo.html.

5. Palacios S, Nappi RE, Bruyniks N, Particco M, Panay N. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause. Climacteric. 2018;21(3):286–291. https://doi.org/10.1080/13697137.2018.1446930.

6. Mension E, Alonso I, Tortajada M, Matas I, Gomes S, Ribera L et al. Genitourinary syndrome of menopause assessment tools. J Midlife Health. 2021;12(2):99–102. https://doi.org/10.4103/jmh.jmh_93_21.

7. Адамян ЛВ, Андреева ЕН, Артымук НВ, Белокринницкая ТЕ, Беженарь ВФ, Гвоздев МЮ. Клинические рекомендации. Выпадение женских половых органов. M.: Министерство здравоохранения Российской Федерации; 2021. C. 49. Режим доступа: https://minzdrav.samregion.ru/wp-content/uploads/sites/28/2021/07/kr647.pdf.

8. Мудраковская ЭВ, Горелик СГ, Колпакова НА, Журавлева ЯВ. Актуальная проблема женщин в постменопаузе – урогенитальные расстройства. Научные ведомости Белгородского государственного университета. Серия: Медицина. Фармация. 2012;(10-1):111–116. Режим доступа: https://elibrary.ru/rbwlbr.

9. Mudrakovskaya EV, Gorelik SG, Kolpakova NA, Zhuravleva IaV. Actual problem of women in a postmenopause – urogenital disorders. Nauchnye Vedomosti Belgorodskogo Gosudarstvennogo Universiteta. Seriya: Meditsina. Farmatsiya. 2012;(10-1):111–116. (In Russ.) Available at: https://elibrary.ru/rbwlbr.

10. Gliniewicz K, Schneider GM, Ridenhour BJ, Williams CJ, Song Y, Farage MA et al. Comparison of the vaginal microbiomes of premenopausal and postmenopausal women. Front Microbiol. 2019;10:193. https://doi.org/10.3389/fmicb.2019.00193.

11. Перпанова ТС, Синякова ЛА, Локшин КЛ, Ашрафян ЛА, Балан ВЕ, Ермакова ЕИ. Цистит у женщин: клинические рекомендации. M.: Министерство здравоохранения Российской Федерации; 2021. 28 с. Режим доступа: http://disuria.ru/_ld/10/1014_kr21N30mz.pdf.

12. Адамян ЛВ, Андреева ЕН, Аполихина ИА, Артымук НВ. Менопауза и климактерическое состояние у женщины: клинические рекомендации. M.: Министерство здравоохранения Российской Федерации; 2021. 85 с. Режим доступа: http://disuria.ru/_ld/11/1199_kr21N95MZ.pdf.

13. Ali ES, Mangold C, Peiris АN. Estriol: emerging clinical benefits. Menopause. 2017;24(9):1081–1085. https://doi.org/10.1097/gme.0000000000000855.

14. Palacios S, Nappi RE, Bruyniks N, Particco M, Panay N. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause. Climacteric. 2018;21(3):286–291. https://doi.org/10.1080/13697137.2018.1446930