Обзор. Коррекция постовариоэктомического синдрома должна включать эстроген-гестагенную терапию препаратами, наиболее приближенными к натуральным, такими, как, например, Фемостон®, так как они не ухудшают показатели жирового и углеводного обмена. Терапия тестостероном в физиологических дозах у женщин с хирургической менопаузой приводит к достоверному улучшению качества жизни.
A review. Correction of postovariectomy syndrome should be based on estrogen-progestin replacement with preparations that would maximally mimic natural hormones, such as Femoston® so that not to alter metabolism of lipids and carbohydrates. Physiological doses of testosterone provide significant improvement of the quality of life in women with surgical menopause.
1. Hickey M, Ambekar M, Hammond I. Should the ovaries be removed or retained at the time of hysterectomy for benign disease? Hum Reprod Update 2010, 16 (2): 131–41.
2. Henderson VW, Sherwin B.B. Surgical versus natural menopause: cognitive issues. Menopause 2007, 14: 572–9.
3. Shifren JL, Avis NE. Surgical menopause: effects on psychological well-being and sexuality. Menopause 2007; 14: 586–91.
4. Sievers C, Klotsche J, Pieper L et al. Low testosterone levels predict all-cause mortality and cardiovascular events in women: a prospective cohort study in German primary care patients. Eur Journ Endocr 2010; 163 (4): 699–708.
5. Buster JE, Kingsberg SA, Aguirre О et al. Testosterone patch for low sexual desirein surgically menopausal women: A randomized trial. Obstet Gynecol 2005; 105: 944–52.
6. Радзинский В.Е., Калинченко С.Ю., Апетов С.С. Синдром дефицита андрогенов у женщин. Вестник РУДН 2010; 6: 266–76.
7. Чеботникова Т.В., Андреева Е.Н. Дефицит андрогенов у женщин – новые возможности тканеселективных модуляторов. Трудный пациент, 2006; 9: 21–9.
8. Табеева Г.И., Марченко Л.А., Бутарева Л.Б., Габибуллаева З.Г. Возможности лечения эстроген- и андрогендефицитных состояний у женщин с преждевременной недостаточностью яичников. Гинекология, 2009; 1 (11): 55–9.
9. Калинченко С.Ю., Апетов С.С. Применение андрогенов у женщин в климактерическом периоде. Лечащий врач, 2009; 3: 36–8.
10. Bachmann GA, Bancroft J, Braunstein G et al. Female androgen insufficiency: the Princeton consensus statement on definition, classification and assessment. Fertil Steril 2002; 77: 660–5.
11. Panzer C, Guay A. Testosterone replacement therapy in naturally and surgically menopausal women. J Sex Med 2009; 6: 8–18.
12. Michelsen TM, Pripp AH, Tonstad S et al. Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk for hereditary breast ovarian cancer: a controlled observational study. Eur J Cancer 2009, 45: 82–9.
13. Salpeter SR, Walsh JME, Ormiston TM et al. Meta-analysis: effect of hormone–replacement therapy on components of the metabolic syndrome in postmenopausal women. Diab Obes Metab 2006; 8: 538–54.
14. Rosano G, Vitale C, Silvestri A, Fini M. Metabolic and vascular effects of progestins in post-menopausal women. Implications for cardioprotection. Maturitas 2003; 46S: S17–29.
15. Chlebowski RT, Hendrix SL, Langer RD et al. Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women's Health Initiative randomized trial. JAMA 2003; 289: 3243–53.
16. Hulley S, Furberg C, Barrett-Connor E et al. Noncardiovascular disease outcomes during 6.8 years of hormone therapy: heart and estrogen/progestin replacement study follow-up (HERS II). JAMA 2002; 288: 58–64.
17. Anderson GL, Chlebowski RT, Rossouw JE et al. Prior hormone therapy and breast cancer risk in the Women's Health Initiative randomized trial of estrogen plus progestin. Maturitas 2006; 55: 103–15.
18. Kenemans P. Postmenopausal hormone therapy and breast cancer: what is the problem? Maturitas 2005; 51: 75–82.
19. Schairer C, Lubin J, Troisi R et al. Menopausal estrogen and estrogen-progestin replacement therapy and breast cancer risk. JAMA 2000; 283: 485–91.
20. Campagnoli C, Clavel-Chapelon F, Kaaks R et al. Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. J Steroid Biochem Mol Biol 2005; 96: 95–108.
21. Campagnoli C, Abba C, Ambroggio S, Peris C. Pregnancy, progesterone and progestins in relation to breast cancer risk. J Steroid Biochem Mol Biol 2005; 97: 441–50.
22. Sonnet E, Lacut K, Roudaut N et al. Effects of the route of oestrogen administration on IGF-1 and IGFBP-3 in healthy postmenopausal women: results froma randomized placebo-controlled study. Clin Endocrinol 2007; 66: 626–31.
23. Campagnoli C, Ambroggio S, Lotano MR, Peris C. Progestogen use in women approaching the menopause and breast cancer risk. Maturitas. 2009; 62 (4): 4230–338.
24. Davison SL, Bell R, Donath S et al. Androgen levels in adult females: Changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab 2005; 90: 3847–53.
25. Attar E. Aromatase and other steroidogenic genes in endometriosis: translational aspects// Hum. Reprod Update 2006; 12: 49–56.
26. Davis SR, Nijland EA. Pharmacological therapy for female sexual dysfunction: Has progress been made? Drugs 2008; 68: 259–64.
27. Drillich A, Davis SR. Androgen therapy in women: What we think we know. Exp Gerontol 2007; 42: 457–62.
28. Maia H, Casoy J, Valenle J. Testosterone replacement therapy in climacteric: benefits beyond sexuality. Gynecol Endocrin 2009; 25 (1): 12–20.
29. Sarrel P, Dobay В, Wiita В. Estrogen and estrogen-androgen replacement in postmenopausal women dissatisfied with estrogen-alone therapy.
J Reprod Med 1998; 43: 847–56.
30. Appeiioo MS, Midden M, van der Stege et al. Vaginal application of testosterone: a study on pharmacokinetics and the sexual response in healthy volunteers. J Sex Med 2006; 3: 541–9.
31. Berman JE, Almeida FG, Jolin J et al. Correlation of androgen receptors, aromatase and 5-a reductase in the human vagina with menopausal status. Fertil Steril 2003; 79: 925–31.
32. Kiaia Jr, Pimentel K, Casoy J, Athayde C. Should tibolone be used in the perimeno-pause to treat androgen deficiency. Abstract book of World Congress on Controversies in Obstetrics and Gynecology. Barcelona (Spain), 2007.
33. Odmark IS, Carlstrom K, Jonsson В, Jonasson AF. Conjugated estrogen/progestogen versus tibolone hormone replacement therapy in postmenopausal women. Effects on carbohydrate metabolism and scrum sex hormone binding globulin. Maturitas 2006; 53: 89–96.
34. Braunstein GD. Safety of testosterone treatment in postmenopausal women. Fertil Steril 2007; 88: 1–17.
35. Shifren JL, Davis SR, Moreau HI et al. Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women: Results from the INTIMATE NM1 Study. Menopause 2006; 13: 770–9.
36. Braunstein GD, Sundwall DA, Kate A et al. Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: randomized placebo-controlled trial. Arch Intern Med 2005: 165: 1582–9.
37. Buster JE, Kingsberg SA, Aguirre O et al. Testosterone patch for low sexual desirein surgically menopausal women: A randomized trial. Obstet Gynecol 2005; 105: 944–52.
38. Simon J, Braunstein G, Nachtigall L et al. Testosterone patch increases sexual activity and desire in surgically menopausal women with hypoactive sexual desire disorder. J Clin Endocrinol Metab 2005; 90: 5226–33.
39. Davis SR, Bouchard C, Kroll R et al. The effect of a testosterone transdermal system on hypoactive sexual desire disorder in postmenopausal women not receiving systemic estrogen therapy, the aphrodite study. 82 Annual Meeting of the Endocrine Society. Boston (USA), 2006.
40. Basaria S, Nguyen Т, Rosenson RS, Dobs AS. Effect of methyl testosterone administration on plasma viscosity in postmenopausal women. Clin Endocrinol (Oxf.) 2002; 57: 209–14.
41. Lukanova A, Lundin E, Micheli A et al. Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women. Int J Cancer 2004; 108: 425–32.
42. Somboonporn W, Davis SR. Postmenopausal testosterone therapy and breast cancer risk, Maturitas 2004; 49: 267–75.
43. Labrie F, Ittu TW, Labrie С et al. Endocrine and intracrine sources of androgens in women: Inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev 2003; 24: 152–82.
44. Tamimi RM, Hankinson SE, Chen WY et al. Combined estrogen and testosterone use and risk of breast cancer in postmenopausal women. Arch Intern Med 2006; 166: 1480–3.
45. Bitzer, Kenemans P, Mueck AQ. Breast cancer risk in postmenopausal women using testosterone in combination with hormone replacement therapy. Maturitas 2008; 59: 209–18.
46. Dimitrakakis, Jones RA Liu A, Bandy CA. Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy. Menopause 2004; 11: 531–5.
47. Shufelt CL, Braunstein GD. Testosterone and the breast. Menopause Int 2008; 14: 117–22.
________________________________________________
1. Hickey M, Ambekar M, Hammond I. Should the ovaries be removed or retained at the time of hysterectomy for benign disease? Hum Reprod Update 2010, 16 (2): 131–41.
2. Henderson VW, Sherwin B.B. Surgical versus natural menopause: cognitive issues. Menopause 2007, 14: 572–9.
3. Shifren JL, Avis NE. Surgical menopause: effects on psychological well-being and sexuality. Menopause 2007; 14: 586–91.
4. Sievers C, Klotsche J, Pieper L et al. Low testosterone levels predict all-cause mortality and cardiovascular events in women: a prospective cohort study in German primary care patients. Eur Journ Endocr 2010; 163 (4): 699–708.
5. Buster JE, Kingsberg SA, Aguirre О et al. Testosterone patch for low sexual desirein surgically menopausal women: A randomized trial. Obstet Gynecol 2005; 105: 944–52.
6. Радзинский В.Е., Калинченко С.Ю., Апетов С.С. Синдром дефицита андрогенов у женщин. Вестник РУДН 2010; 6: 266–76.
7. Чеботникова Т.В., Андреева Е.Н. Дефицит андрогенов у женщин – новые возможности тканеселективных модуляторов. Трудный пациент, 2006; 9: 21–9.
8. Табеева Г.И., Марченко Л.А., Бутарева Л.Б., Габибуллаева З.Г. Возможности лечения эстроген- и андрогендефицитных состояний у женщин с преждевременной недостаточностью яичников. Гинекология, 2009; 1 (11): 55–9.
9. Калинченко С.Ю., Апетов С.С. Применение андрогенов у женщин в климактерическом периоде. Лечащий врач, 2009; 3: 36–8.
10. Bachmann GA, Bancroft J, Braunstein G et al. Female androgen insufficiency: the Princeton consensus statement on definition, classification and assessment. Fertil Steril 2002; 77: 660–5.
11. Panzer C, Guay A. Testosterone replacement therapy in naturally and surgically menopausal women. J Sex Med 2009; 6: 8–18.
12. Michelsen TM, Pripp AH, Tonstad S et al. Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk for hereditary breast ovarian cancer: a controlled observational study. Eur J Cancer 2009, 45: 82–9.
13. Salpeter SR, Walsh JME, Ormiston TM et al. Meta-analysis: effect of hormone–replacement therapy on components of the metabolic syndrome in postmenopausal women. Diab Obes Metab 2006; 8: 538–54.
14. Rosano G, Vitale C, Silvestri A, Fini M. Metabolic and vascular effects of progestins in post-menopausal women. Implications for cardioprotection. Maturitas 2003; 46S: S17–29.
15. Chlebowski RT, Hendrix SL, Langer RD et al. Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women's Health Initiative randomized trial. JAMA 2003; 289: 3243–53.
16. Hulley S, Furberg C, Barrett-Connor E et al. Noncardiovascular disease outcomes during 6.8 years of hormone therapy: heart and estrogen/progestin replacement study follow-up (HERS II). JAMA 2002; 288: 58–64.
17. Anderson GL, Chlebowski RT, Rossouw JE et al. Prior hormone therapy and breast cancer risk in the Women's Health Initiative randomized trial of estrogen plus progestin. Maturitas 2006; 55: 103–15.
18. Kenemans P. Postmenopausal hormone therapy and breast cancer: what is the problem? Maturitas 2005; 51: 75–82.
19. Schairer C, Lubin J, Troisi R et al. Menopausal estrogen and estrogen-progestin replacement therapy and breast cancer risk. JAMA 2000; 283: 485–91.
20. Campagnoli C, Clavel-Chapelon F, Kaaks R et al. Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. J Steroid Biochem Mol Biol 2005; 96: 95–108.
21. Campagnoli C, Abba C, Ambroggio S, Peris C. Pregnancy, progesterone and progestins in relation to breast cancer risk. J Steroid Biochem Mol Biol 2005; 97: 441–50.
22. Sonnet E, Lacut K, Roudaut N et al. Effects of the route of oestrogen administration on IGF-1 and IGFBP-3 in healthy postmenopausal women: results froma randomized placebo-controlled study. Clin Endocrinol 2007; 66: 626–31.
23. Campagnoli C, Ambroggio S, Lotano MR, Peris C. Progestogen use in women approaching the menopause and breast cancer risk. Maturitas. 2009; 62 (4): 4230–338.
24. Davison SL, Bell R, Donath S et al. Androgen levels in adult females: Changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab 2005; 90: 3847–53.
25. Attar E. Aromatase and other steroidogenic genes in endometriosis: translational aspects// Hum. Reprod Update 2006; 12: 49–56.
26. Davis SR, Nijland EA. Pharmacological therapy for female sexual dysfunction: Has progress been made? Drugs 2008; 68: 259–64.
27. Drillich A, Davis SR. Androgen therapy in women: What we think we know. Exp Gerontol 2007; 42: 457–62.
28. Maia H, Casoy J, Valenle J. Testosterone replacement therapy in climacteric: benefits beyond sexuality. Gynecol Endocrin 2009; 25 (1): 12–20.
29. Sarrel P, Dobay В, Wiita В. Estrogen and estrogen-androgen replacement in postmenopausal women dissatisfied with estrogen-alone therapy.
J Reprod Med 1998; 43: 847–56.
30. Appeiioo MS, Midden M, van der Stege et al. Vaginal application of testosterone: a study on pharmacokinetics and the sexual response in healthy volunteers. J Sex Med 2006; 3: 541–9.
31. Berman JE, Almeida FG, Jolin J et al. Correlation of androgen receptors, aromatase and 5-a reductase in the human vagina with menopausal status. Fertil Steril 2003; 79: 925–31.
32. Kiaia Jr, Pimentel K, Casoy J, Athayde C. Should tibolone be used in the perimeno-pause to treat androgen deficiency. Abstract book of World Congress on Controversies in Obstetrics and Gynecology. Barcelona (Spain), 2007.
33. Odmark IS, Carlstrom K, Jonsson В, Jonasson AF. Conjugated estrogen/progestogen versus tibolone hormone replacement therapy in postmenopausal women. Effects on carbohydrate metabolism and scrum sex hormone binding globulin. Maturitas 2006; 53: 89–96.
34. Braunstein GD. Safety of testosterone treatment in postmenopausal women. Fertil Steril 2007; 88: 1–17.
35. Shifren JL, Davis SR, Moreau HI et al. Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women: Results from the INTIMATE NM1 Study. Menopause 2006; 13: 770–9.
36. Braunstein GD, Sundwall DA, Kate A et al. Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: randomized placebo-controlled trial. Arch Intern Med 2005: 165: 1582–9.
37. Buster JE, Kingsberg SA, Aguirre O et al. Testosterone patch for low sexual desirein surgically menopausal women: A randomized trial. Obstet Gynecol 2005; 105: 944–52.
38. Simon J, Braunstein G, Nachtigall L et al. Testosterone patch increases sexual activity and desire in surgically menopausal women with hypoactive sexual desire disorder. J Clin Endocrinol Metab 2005; 90: 5226–33.
39. Davis SR, Bouchard C, Kroll R et al. The effect of a testosterone transdermal system on hypoactive sexual desire disorder in postmenopausal women not receiving systemic estrogen therapy, the aphrodite study. 82 Annual Meeting of the Endocrine Society. Boston (USA), 2006.
40. Basaria S, Nguyen Т, Rosenson RS, Dobs AS. Effect of methyl testosterone administration on plasma viscosity in postmenopausal women. Clin Endocrinol (Oxf.) 2002; 57: 209–14.
41. Lukanova A, Lundin E, Micheli A et al. Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women. Int J Cancer 2004; 108: 425–32.
42. Somboonporn W, Davis SR. Postmenopausal testosterone therapy and breast cancer risk, Maturitas 2004; 49: 267–75.
43. Labrie F, Ittu TW, Labrie С et al. Endocrine and intracrine sources of androgens in women: Inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev 2003; 24: 152–82.
44. Tamimi RM, Hankinson SE, Chen WY et al. Combined estrogen and testosterone use and risk of breast cancer in postmenopausal women. Arch Intern Med 2006; 166: 1480–3.
45. Bitzer, Kenemans P, Mueck AQ. Breast cancer risk in postmenopausal women using testosterone in combination with hormone replacement therapy. Maturitas 2008; 59: 209–18.
46. Dimitrakakis, Jones RA Liu A, Bandy CA. Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy. Menopause 2004; 11: 531–5.
47. Shufelt CL, Braunstein GD. Testosterone and the breast. Menopause Int 2008; 14: 117–22.