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Эстриол (локальные и системные формы) в лечении атрофического вульвовагинита
Эстриол (локальные и системные формы) в лечении атрофического вульвовагинита
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Аннотация
Атрофические процессы урогенитального тракта, атрофические вульвовагиниты – актуальная проблема гинекологии, обусловленная снижением уровня эстрогенов крови. Диагностика этого состояния не составляет затруднений, основывается на характерной клинической картине заболевания, но требует проведения обследования, цитологического контроля. Лечение основано на восполнении дефицита эстрогенов. В случае преобладания симптомов урогенитальной атрофии показано лечение эстриолом, как правило, его местными формами.
Ключевые слова: атрофический вульвовагинит, урогенитальный синдром, климактерический синдром, лечение, эстриол.
Key words: atrophic vulvovaginitis, urogenital syndrome, menopausal syndrome, treatment, estriol.
Ключевые слова: атрофический вульвовагинит, урогенитальный синдром, климактерический синдром, лечение, эстриол.
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Key words: atrophic vulvovaginitis, urogenital syndrome, menopausal syndrome, treatment, estriol.
Полный текст
Список литературы
1. Марченко Л.А., Тагиева Г.В., Ильина Л.М. Преждевременная недостаточность функции яичников: патогенез, диагностика и заместительная гормональная терапия. Гинекология. 2004; 6.
2. Sükür YE, Kıvançlı IB, Ozmen B. Ovarian aging and premature ovarian failure. J Turk Ger Gynecol Assoc 2014; 15 (3): 190–6.
3. Mehta A, Bachmann G. Vulvovaginal complaints. Clin Obstet Gynecol 2008; 51 (3): 549–55.
4. Brizzolara S, Killeen J, Severino R. Vaginal pH and parabasal cells in postmenopausal women. Obstet Gynecol 1999; 94 (5, Pt. 1): 700–3.
5. Nilsson K, Risberg B, Heimer G. The vaginal epithelium in the postmenopause – cytology, histology and pH as methods of assessment. Maturitas 1995; 21 (1): 51–6.
6. Сметник В.П. Руководство по климактерию. Под ред. В.П.Сметник, В.И.Кулакова. М.: МИА, 2001.
7. Kao A et al. Dyspareunia in postmenopausal women: a critical review. Pain Res Manag 2008; 13 (3): 43–54.
8. Lynch C. Vaginal estrogen therapy for the treatment of atrophic vaginitis. J Womens Health (Larchmt) 2009; 18 (10): 1595–606.
9. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician 2000; 61 (10): 3090.
10. Selvaggi SM. Atrophic vaginitis versus invasive squamous cell carcinoma on ThinPrep cytology: can the background be reliably distinguished? Diagn Cytopathol 2002; 27: 362.
11. Van der Laak JA, de Bie LM, de Leeuw H et al. The effect of Replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry. J Clin Pathol 2002; 55: 446.
12. Mehta A, Bachmann G. Vulvovaginal complaints. Clin Obstet Gynecol 2008; 51 (3): 549–55.
13. Mendoza N et al. Spanish consensus on premature menopause. Maturitas 2015; 80 (2): 220–5.
14. Slopień R, Warenik-Szymankiewicz A. Premature ovarian failure: diagnosis and treatment. Clin Exp Obstet Gynecol 2014; 41 (6): 659–61.
15. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2006; 18 (4). CD001500.
16. Балан В.Е. Принципы заместительной гормонотерапии урогенитальных расстройств. Cons. Med. 2003; 5 (7): 413–7.
17. Костава М.Н., Прилепская В.Н., Быковская О.В. Шеечно-влагалищная экосистема в постменопаузе и заместительная гормонотерапия. Гинекология. 2006 (экстравып.); с. 6–8.
18. Hustin J, van der Eynde JP. Cytological evaluation of the effect of various estrogens given in postmenopause. Acta Cytologica1977; 21: 225–8.
19. Schar G, Kochli OR, Fritz M, Haller U. Effect of vaginal estrogen therapy on urinary incontinence in postmenopause. Zentralbl Gynakol 1995; 117: 77–80.
20. Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N Engl J Med 1993; 329: 753–6.
21. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause/Society. North American Menopause Society. Menopause 2007; 14 (3, Pt. 1): 355–69.
22. Lee JS, Ettinger B, Stanczyk FZ et al. Comparison of methods to measure low serum estradiol levels in postmenopausal women. J Clin Endocrinol Metab 2006; 91: 3791.
23. Yang TS, Tsan SH, Chang SP, Ng HT. Efficacy and safety of estriol replacement therapy for climacteric women. Chin Med J (Taipei) 1995; 55: 386–91.
24. Nozaki M, Hashimoto K, Inoue Y et al. Usefulness of estriol for the treatment of bone loss in postmenopausal women. Nippon Sanka Fujinka Gakkai Zasshi 1996; 48: 83–8.
25. Овсянникова Т.В., Леваков С.А., Куликов И.А. Монотерапия эстрогенами у женщин с хирургической менопаузой. Гинекология. 2014; 16 (6): 22–4.
2. Sükür YE, Kıvançlı IB, Ozmen B. Ovarian aging and premature ovarian failure. J Turk Ger Gynecol Assoc 2014; 15 (3): 190–6.
3. Mehta A, Bachmann G. Vulvovaginal complaints. Clin Obstet Gynecol 2008; 51 (3): 549–55.
4. Brizzolara S, Killeen J, Severino R. Vaginal pH and parabasal cells in postmenopausal women. Obstet Gynecol 1999; 94 (5, Pt. 1): 700–3.
5. Nilsson K, Risberg B, Heimer G. The vaginal epithelium in the postmenopause – cytology, histology and pH as methods of assessment. Maturitas 1995; 21 (1): 51–6.
6. Сметник В.П. Руководство по климактерию. Под ред. В.П.Сметник, В.И.Кулакова. М.: МИА, 2001.
7. Kao A et al. Dyspareunia in postmenopausal women: a critical review. Pain Res Manag 2008; 13 (3): 43–54.
8. Lynch C. Vaginal estrogen therapy for the treatment of atrophic vaginitis. J Womens Health (Larchmt) 2009; 18 (10): 1595–606.
9. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician 2000; 61 (10): 3090.
10. Selvaggi SM. Atrophic vaginitis versus invasive squamous cell carcinoma on ThinPrep cytology: can the background be reliably distinguished? Diagn Cytopathol 2002; 27: 362.
11. Van der Laak JA, de Bie LM, de Leeuw H et al. The effect of Replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry. J Clin Pathol 2002; 55: 446.
12. Mehta A, Bachmann G. Vulvovaginal complaints. Clin Obstet Gynecol 2008; 51 (3): 549–55.
13. Mendoza N et al. Spanish consensus on premature menopause. Maturitas 2015; 80 (2): 220–5.
14. Slopień R, Warenik-Szymankiewicz A. Premature ovarian failure: diagnosis and treatment. Clin Exp Obstet Gynecol 2014; 41 (6): 659–61.
15. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2006; 18 (4). CD001500.
16. Балан В.Е. Принципы заместительной гормонотерапии урогенитальных расстройств. Cons. Med. 2003; 5 (7): 413–7.
17. Костава М.Н., Прилепская В.Н., Быковская О.В. Шеечно-влагалищная экосистема в постменопаузе и заместительная гормонотерапия. Гинекология. 2006 (экстравып.); с. 6–8.
18. Hustin J, van der Eynde JP. Cytological evaluation of the effect of various estrogens given in postmenopause. Acta Cytologica1977; 21: 225–8.
19. Schar G, Kochli OR, Fritz M, Haller U. Effect of vaginal estrogen therapy on urinary incontinence in postmenopause. Zentralbl Gynakol 1995; 117: 77–80.
20. Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N Engl J Med 1993; 329: 753–6.
21. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause/Society. North American Menopause Society. Menopause 2007; 14 (3, Pt. 1): 355–69.
22. Lee JS, Ettinger B, Stanczyk FZ et al. Comparison of methods to measure low serum estradiol levels in postmenopausal women. J Clin Endocrinol Metab 2006; 91: 3791.
23. Yang TS, Tsan SH, Chang SP, Ng HT. Efficacy and safety of estriol replacement therapy for climacteric women. Chin Med J (Taipei) 1995; 55: 386–91.
24. Nozaki M, Hashimoto K, Inoue Y et al. Usefulness of estriol for the treatment of bone loss in postmenopausal women. Nippon Sanka Fujinka Gakkai Zasshi 1996; 48: 83–8.
25. Овсянникова Т.В., Леваков С.А., Куликов И.А. Монотерапия эстрогенами у женщин с хирургической менопаузой. Гинекология. 2014; 16 (6): 22–4.
2. Sükür YE, Kıvançlı IB, Ozmen B. Ovarian aging and premature ovarian failure. J Turk Ger Gynecol Assoc 2014; 15 (3): 190–6.
3. Mehta A, Bachmann G. Vulvovaginal complaints. Clin Obstet Gynecol 2008; 51 (3): 549–55.
4. Brizzolara S, Killeen J, Severino R. Vaginal pH and parabasal cells in postmenopausal women. Obstet Gynecol 1999; 94 (5, Pt. 1): 700–3.
5. Nilsson K, Risberg B, Heimer G. The vaginal epithelium in the postmenopause – cytology, histology and pH as methods of assessment. Maturitas 1995; 21 (1): 51–6.
6. Сметник В.П. Руководство по климактерию. Под ред. В.П.Сметник, В.И.Кулакова. М.: МИА, 2001.
7. Kao A et al. Dyspareunia in postmenopausal women: a critical review. Pain Res Manag 2008; 13 (3): 43–54.
8. Lynch C. Vaginal estrogen therapy for the treatment of atrophic vaginitis. J Womens Health (Larchmt) 2009; 18 (10): 1595–606.
9. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician 2000; 61 (10): 3090.
10. Selvaggi SM. Atrophic vaginitis versus invasive squamous cell carcinoma on ThinPrep cytology: can the background be reliably distinguished? Diagn Cytopathol 2002; 27: 362.
11. Van der Laak JA, de Bie LM, de Leeuw H et al. The effect of Replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry. J Clin Pathol 2002; 55: 446.
12. Mehta A, Bachmann G. Vulvovaginal complaints. Clin Obstet Gynecol 2008; 51 (3): 549–55.
13. Mendoza N et al. Spanish consensus on premature menopause. Maturitas 2015; 80 (2): 220–5.
14. Slopień R, Warenik-Szymankiewicz A. Premature ovarian failure: diagnosis and treatment. Clin Exp Obstet Gynecol 2014; 41 (6): 659–61.
15. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2006; 18 (4). CD001500.
16. Балан В.Е. Принципы заместительной гормонотерапии урогенитальных расстройств. Cons. Med. 2003; 5 (7): 413–7.
17. Костава М.Н., Прилепская В.Н., Быковская О.В. Шеечно-влагалищная экосистема в постменопаузе и заместительная гормонотерапия. Гинекология. 2006 (экстравып.); с. 6–8.
18. Hustin J, van der Eynde JP. Cytological evaluation of the effect of various estrogens given in postmenopause. Acta Cytologica1977; 21: 225–8.
19. Schar G, Kochli OR, Fritz M, Haller U. Effect of vaginal estrogen therapy on urinary incontinence in postmenopause. Zentralbl Gynakol 1995; 117: 77–80.
20. Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N Engl J Med 1993; 329: 753–6.
21. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause/Society. North American Menopause Society. Menopause 2007; 14 (3, Pt. 1): 355–69.
22. Lee JS, Ettinger B, Stanczyk FZ et al. Comparison of methods to measure low serum estradiol levels in postmenopausal women. J Clin Endocrinol Metab 2006; 91: 3791.
23. Yang TS, Tsan SH, Chang SP, Ng HT. Efficacy and safety of estriol replacement therapy for climacteric women. Chin Med J (Taipei) 1995; 55: 386–91.
24. Nozaki M, Hashimoto K, Inoue Y et al. Usefulness of estriol for the treatment of bone loss in postmenopausal women. Nippon Sanka Fujinka Gakkai Zasshi 1996; 48: 83–8.
25. Овсянникова Т.В., Леваков С.А., Куликов И.А. Монотерапия эстрогенами у женщин с хирургической менопаузой. Гинекология. 2014; 16 (6): 22–4.
________________________________________________
2. Sükür YE, Kıvançlı IB, Ozmen B. Ovarian aging and premature ovarian failure. J Turk Ger Gynecol Assoc 2014; 15 (3): 190–6.
3. Mehta A, Bachmann G. Vulvovaginal complaints. Clin Obstet Gynecol 2008; 51 (3): 549–55.
4. Brizzolara S, Killeen J, Severino R. Vaginal pH and parabasal cells in postmenopausal women. Obstet Gynecol 1999; 94 (5, Pt. 1): 700–3.
5. Nilsson K, Risberg B, Heimer G. The vaginal epithelium in the postmenopause – cytology, histology and pH as methods of assessment. Maturitas 1995; 21 (1): 51–6.
6. Сметник В.П. Руководство по климактерию. Под ред. В.П.Сметник, В.И.Кулакова. М.: МИА, 2001.
7. Kao A et al. Dyspareunia in postmenopausal women: a critical review. Pain Res Manag 2008; 13 (3): 43–54.
8. Lynch C. Vaginal estrogen therapy for the treatment of atrophic vaginitis. J Womens Health (Larchmt) 2009; 18 (10): 1595–606.
9. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician 2000; 61 (10): 3090.
10. Selvaggi SM. Atrophic vaginitis versus invasive squamous cell carcinoma on ThinPrep cytology: can the background be reliably distinguished? Diagn Cytopathol 2002; 27: 362.
11. Van der Laak JA, de Bie LM, de Leeuw H et al. The effect of Replens on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry. J Clin Pathol 2002; 55: 446.
12. Mehta A, Bachmann G. Vulvovaginal complaints. Clin Obstet Gynecol 2008; 51 (3): 549–55.
13. Mendoza N et al. Spanish consensus on premature menopause. Maturitas 2015; 80 (2): 220–5.
14. Slopień R, Warenik-Szymankiewicz A. Premature ovarian failure: diagnosis and treatment. Clin Exp Obstet Gynecol 2014; 41 (6): 659–61.
15. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2006; 18 (4). CD001500.
16. Балан В.Е. Принципы заместительной гормонотерапии урогенитальных расстройств. Cons. Med. 2003; 5 (7): 413–7.
17. Костава М.Н., Прилепская В.Н., Быковская О.В. Шеечно-влагалищная экосистема в постменопаузе и заместительная гормонотерапия. Гинекология. 2006 (экстравып.); с. 6–8.
18. Hustin J, van der Eynde JP. Cytological evaluation of the effect of various estrogens given in postmenopause. Acta Cytologica1977; 21: 225–8.
19. Schar G, Kochli OR, Fritz M, Haller U. Effect of vaginal estrogen therapy on urinary incontinence in postmenopause. Zentralbl Gynakol 1995; 117: 77–80.
20. Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N Engl J Med 1993; 329: 753–6.
21. The role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women: 2007 position statement of The North American Menopause/Society. North American Menopause Society. Menopause 2007; 14 (3, Pt. 1): 355–69.
22. Lee JS, Ettinger B, Stanczyk FZ et al. Comparison of methods to measure low serum estradiol levels in postmenopausal women. J Clin Endocrinol Metab 2006; 91: 3791.
23. Yang TS, Tsan SH, Chang SP, Ng HT. Efficacy and safety of estriol replacement therapy for climacteric women. Chin Med J (Taipei) 1995; 55: 386–91.
24. Nozaki M, Hashimoto K, Inoue Y et al. Usefulness of estriol for the treatment of bone loss in postmenopausal women. Nippon Sanka Fujinka Gakkai Zasshi 1996; 48: 83–8.
25. Овсянникова Т.В., Леваков С.А., Куликов И.А. Монотерапия эстрогенами у женщин с хирургической менопаузой. Гинекология. 2014; 16 (6): 22–4.
Авторы
В.Н.Прилепская, А.В.Ледина
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздрава России, Москва
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздрава России, Москва
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