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Возможности профилактики и коррекции генитоуринарного менопаузального синдрома
Возможности профилактики и коррекции генитоуринарного менопаузального синдрома
Захаров И.С. Возможности профилактики и коррекции генитоуринарного менопаузального синдрома. Гинекология. 2018; 20 (2): 18–22.
DOI: 10.26442/2079-5696_2018.2.18-22
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Аннотация
В манифестации и развитии урогенитальных атрофических процессов, связанных с наступлением менопаузы, ведущую роль играет нарастающий дефицит эстрогенов. Важным обстоятельством является тот факт, что генитоуринарным менопаузальным расстройствам зачастую сопутствуют другие климактерические нарушения. В связи с этим ключевое место в профилактике и коррекции гипоэстрогенных состояний занимает системная менопаузальная гормональная терапия. Среди представителей системной менопаузальной гормональной терапии клиническую эффективность и низкий риск возможных осложнений продемонстрировали препараты, содержащие 17b-эстрадиол в комбинации с дроспиреноном. В литературе имеется значительное количество публикаций, отражающих положительное влияние указанных препаратов на состояние женщины при вазомоторных, психоэмоциональных климактерических расстройствах, снижении костной массы, а также в терапии и профилактике атрофических процессов урогенитального тракта, что позволяет применять указанную комбинацию гормонов в комплексной коррекции как системных, так и местных генитоуринарных менопаузальных нарушений.
Ключевые слова: генитоуринарный (урогенитальный) менопаузальный синдром, вульвовагинальная атрофия, менопаузальная гормональная терапия, 17b-эстрадиол, дроспиренон.
Key words: genitourinary menopausal syndrome, vulvovaginal atrophy, menopausal hormone therapy, 17b-estradiol, drospirenone.
Ключевые слова: генитоуринарный (урогенитальный) менопаузальный синдром, вульвовагинальная атрофия, менопаузальная гормональная терапия, 17b-эстрадиол, дроспиренон.
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Key words: genitourinary menopausal syndrome, vulvovaginal atrophy, menopausal hormone therapy, 17b-estradiol, drospirenone.
Полный текст
Список литературы
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17. Ильина Л.М., Юренева С.В., Дубровина А.В., Эбзиева З.Х. Влияние менопаузы на работающих женщин: фактор, которому не придается должного значения. Проблемы репродукции. 2016; 1: 87–94. / Il'ina L.M., Iureneva S.V., Dubrovina A.V., Ebzieva Z.Kh. Vliianie menopauzy na rabotaiushchikh zhenshchin: faktor, kotoromu ne pridaetsia dolzhnogo znacheniia. Problemy reproduktsii. 2016; 1: 87–94.
18. Oge T, Hassa H, Aydin Y et al. The relationship between urogenital symptoms and climacteric complaints. Climacteric 2013; 16 (6): 646–52.
19. Calleja-Agius J, Brincat MP. The urogenital system and the menopause. Climacteric 2015; 18 (1): 18–22.
20. Юренева С.В., Ильина Л.М., Якушевская О.В. Менопаузальная гормональная терапия в постменопаузе: качество жизни сегодня и в долгосрочной перспективе. Гинекология. 2016; 18 (1): 24–9. / Yureneva S.V., Ilyina L.M., Yakushevskaya O.V. Menopausal hormone therapy in postmenopausal women: the quality of life today and in the long term. Gynecology. 2016; 18 (1): 24–9. [in Russian]
21. Warming L, Ravn P, Nielsen T, Christiansen C. Safety and efficacy of drospirenone used in a continuous combination with 17b-estradiol for prevention of postmenopausal osteoporosis. Climacteric 2004; 7 (1): 103–11.
22. Gerlinger C, Gude K, Schmelter T et al. 0.5 vs. 1.0 mg estradiol in combination with drospirenone for the treatment of hot flushes. Climacteric 2015; 18 (4): 512–7.
23. Battaglia C, Cianciosi A, Mancini F et al. Angeliq versus Activelle in normotensive postmenopausal women: a prospective, randomized pilot study. Menopause 2009; 16 (4): 803–9.
24. Gambacciani M, Rosano G, Cappagli B et al. Clinical and metabolic effects of drospirenone-estradiol in menopausal women: a prospective study. Climacteric 2011; 14 (1): 18–24.
25. Dinger J, Bardenheuer K, Heinemann K. Drospirenone plus estradiol and the risk of serious cardiovascular events in postmenopausal women. Climacteric 2016; 19 (4): 349–56.
26. Anttila S, Hakkola J, Tuominen P. Methylation of cytochrome P4501A1 promoter in the lung is associated with tobacco smoking. Cancer Res 2003; 63: 8623–8.
27. Archer DF. Drospirenone and estradiol: a new option for the postmenopausal woman. Climacteric 2007; 10 (1): 3–10.
28. Genazzani AR, Schmelter T, Schaefers M et al. One-year randomized study of the endometrial safety and bleeding pattern of 0.25 mg drospirenone/0.5 mg 17b-estradiol in postmenopausal women. Climacteric 2013; 16 (4): 490–8.
29. Lin S-Q, Sun L-Z, Lin J-F et al. Estradiol 1 mg and drospirenone 2 mg as hormone replacement therapy in postmenopausal Chinese women. Climacteric 2011; 14 (4): 472–81.
30. Андреева Е.Н., Григорян О.Р., Абсатарова Ю.С. Эффективность использования низких доз дроспиренона и 17b-эстрадиола у женщин в постменопаузе (обзор литературы). Гинекология. 2015; 17 (1): 34–40. / Andreeva E.N., Grigoryan O.R., Absatarova Yu.S. The efficacy of 17b-estradiol and low dosed drospirenone use in postmenopausal women (literature review). Gynecology. 2015; 17 (1): 34–40. [in Russian]
31. Gass MLS, Maki P, Shifren JL. NAMS supports judicious use of systemic hormone therapy for women aged 65 years and older. Menopause 2015; 22 (7): 685–6.
32. Овсянникова Т.В., Куликов И.А. Индивидуальный выбор менопаузальной гормональной терапии. Гинекология. 2016; 18 (4): 59–62. / Ovsyannikova T.V., Kulikov I.A. Individual choice of menopausal hormone therapy. Gynecology. 2016; 18 (4): 59–62. [in Russian]
2. Briukhina E.V., Usol'tseva E.N. Srednevremennye menopauzal'nye rasstroistva v kontseptsii kachestva zhizni. Ural'skii med. zhurn. 2014; 4 (118): 57–62. [in Russian]
3. Totchiev G.F., Kotikova N.P. Opportunities to overcome the negative effects of menopause syndrome. Gynecology. 2015; 17 (6): 11–3. [in Russian]
4. Kolpinskiy G.I., Zakharov I.S. Diagnostika i prognozirovanie postmenopauzal'nogo osteoporoza. Kemerovo, 2015. [in Russian]
5. Zakharov I.S., Kolpinskiy G.I., Ponomareva M.V. Comprehensive approach to the prevention and correction of postmenopausal osteoporosis. Gynecology. 2017; 19 (6): 24–7. [in Russian]
6. Heinemann LAJ, Potthoff P, Schneider HPG. International versions of the Menopause Rating Scale (MRS). Health Quality Life Outcomes 2003; 1: 28.
7. Zakharov I.S. Evaluation of menopausal disorders in women with different levels of bone mineral density. Gynecology. 2015; 17 (6): 14–6. [in Russian]
8. Tao MF, Shao HF, Li CB, Teng YC. Correlation between the modified Kupperman Index and the Menopause Rating Scale in Chinese women. Patient Prefer Adherence 2013; 7: 223–9.
9. Gadzhieva Z.K. Funktsional'noe sostoianie nizhnikh mochevykh putei i medikamentoznaia profilaktika narushenii mocheispuskaniia u zhenshchin v klimakterii. Avtoref. dis. ... kand. med. nauk. M., 2001. [in Russian]
10. Ilovayskaya I. Similarity of female central (hypogonadotropic) hypogonadism and postmenopause. Climacteric 2017; 20 (4): 356–61.
11. Notelovitz M. Estrogen therapy in the management to problems associated with urogenital ageing-asimple diagnostic test and the effect of the route of hormone administration. Maturitas 1995; 115 (22): 31–3.
12. Panay N. Genitourinary syndrome of the menopause – dawn of a new era? Climacteric 2015; 18 (1): 13–7.
13. Baber RJ, Panay N, Fenton A. 2016 IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric 2016; 19 (2): 109–50.
14. The 2017 hormone therapy position statement of the North American Menopause Society. Menopause 2017; 24 (7): 728–53.
15. Prilepskaya V.N. Genitourinary menopausal syndrome: the potential of estriol. Gynecology. 2018; 20 (1): 5–8. [in Russian]
16. Tikhomirova E.V. Osobennosti kliniki i lecheniia urogenital'nykh rasstroistv v perimenopauze. Avtoref. dis. ... kand. med. nauk. M., 2005. [in Russian]
17. Il'ina L.M., Iureneva S.V., Dubrovina A.V., Ebzieva Z.Kh. Vliianie menopauzy na rabotaiushchikh zhenshchin: faktor, kotoromu ne pridaetsia dolzhnogo znacheniia. Problemy reproduktsii. 2016; 1: 87–94.
18. Oge T, Hassa H, Aydin Y et al. The relationship between urogenital symptoms and climacteric complaints. Climacteric 2013; 16 (6): 646–52.
19. Calleja-Agius J, Brincat MP. The urogenital system and the menopause. Climacteric 2015; 18 (1): 18–22.
20. Yureneva S.V., Ilyina L.M., Yakushevskaya O.V. Menopausal hormone therapy in postmenopausal women: the quality of life today and in the long term. Gynecology. 2016; 18 (1): 24–9. [in Russian]
21. Warming L, Ravn P, Nielsen T, Christiansen C. Safety and efficacy of drospirenone used in a continuous combination with 17b-estradiol for prevention of postmenopausal osteoporosis. Climacteric 2004; 7 (1): 103–11.
22. Gerlinger C, Gude K, Schmelter T et al. 0.5 vs. 1.0 mg estradiol in combination with drospirenone for the treatment of hot flushes. Climacteric 2015; 18 (4): 512–7.
23. Battaglia C, Cianciosi A, Mancini F et al. Angeliq versus Activelle in normotensive postmenopausal women: a prospective, randomized pilot study. Menopause 2009; 16 (4): 803–9.
24. Gambacciani M, Rosano G, Cappagli B et al. Clinical and metabolic effects of drospirenone-estradiol in menopausal women: a prospective study. Climacteric 2011; 14 (1): 18–24.
25. Dinger J, Bardenheuer K, Heinemann K. Drospirenone plus estradiol and the risk of serious cardiovascular events in postmenopausal women. Climacteric 2016; 19 (4): 349–56.
26. Anttila S, Hakkola J, Tuominen P. Methylation of cytochrome P4501A1 promoter in the lung is associated with tobacco smoking. Cancer Res 2003; 63: 8623–8.
27. Archer DF. Drospirenone and estradiol: a new option for the postmenopausal woman. Climacteric 2007; 10 (1): 3–10.
28. Genazzani AR, Schmelter T, Schaefers M et al. One-year randomized study of the endometrial safety and bleeding pattern of 0.25 mg drospirenone/0.5 mg 17b-estradiol in postmenopausal women. Climacteric 2013; 16 (4): 490–8.
29. Lin S-Q, Sun L-Z, Lin J-F et al. Estradiol 1 mg and drospirenone 2 mg as hormone replacement therapy in postmenopausal Chinese women. Climacteric 2011; 14 (4): 472–81.
30. Andreeva E.N., Grigoryan O.R., Absatarova Yu.S. The efficacy of 17b-estradiol and low dosed drospirenone use in postmenopausal women (literature review). Gynecology. 2015; 17 (1): 34–40. [in Russian]
31. Gass MLS, Maki P, Shifren JL. NAMS supports judicious use of systemic hormone therapy for women aged 65 years and older. Menopause 2015; 22 (7): 685–6.
32. Ovsyannikova T.V., Kulikov I.A. Individual choice of menopausal hormone therapy. Gynecology. 2016; 18 (4): 59–62. [in Russian]
2. Брюхина Е.В., Усольцева Е.Н. Средневременные менопаузальные расстройства в концепции качества жизни. Уральский мед. журн. 2014; 4 (118): 57–62. / Briukhina E.V., Usol'tseva E.N. Srednevremennye menopauzal'nye rasstroistva v kontseptsii kachestva zhizni. Ural'skii med. zhurn. 2014; 4 (118): 57–62. [in Russian]
3. Тотчиев Г.Ф., Котикова Н.П. Возможности преодоления негативных последствий климактерического синдрома. Гинекология. 2015; 17 (6): 11–3. / Totchiev G.F., Kotikova N.P. Opportunities to overcome the negative effects of menopause syndrome. Gynecology. 2015; 17 (6): 11–3. [in Russian]
4. Колпинский Г.И., Захаров И.С. Диагностика и прогнозирование постменопаузального остеопороза. Кемерово, 2015. / Kolpinskiy G.I., Zakharov I.S. Diagnostika i prognozirovanie postmenopauzal'nogo osteoporoza. Kemerovo, 2015. [in Russian]
5. Захаров И.С., Колпинский Г.И., Пономарева М.В. Комплексный подход к профилактике и коррекции постменопаузального остеопороза. Гинекология. 2017; 19 (6): 24–7. / Zakharov I.S., Kolpinskiy G.I., Ponomareva M.V. Comprehensive approach to the prevention and correction of postmenopausal osteoporosis. Gynecology. 2017; 19 (6): 24–7. [in Russian]
6. Heinemann LAJ, Potthoff P, Schneider HPG. International versions of the Menopause Rating Scale (MRS). Health Quality Life Outcomes 2003; 1: 28.
7. Захаров И.С. Оценка менопаузальных нарушений у женщин с различным уровнем минеральной плотности кости. Гинекология. 2015; 17 (6): 14–6. / Zakharov I.S. Evaluation of menopausal disorders in women with different levels of bone mineral density. Gynecology. 2015; 17 (6): 14–6. [in Russian]
8. Tao MF, Shao HF, Li CB, Teng YC. Correlation between the modified Kupperman Index and the Menopause Rating Scale in Chinese women. Patient Prefer Adherence 2013; 7: 223–9.
9. Гаджиева З.К. Функциональное состояние нижних мочевых путей и медикаментозная профилактика нарушений мочеиспускания у женщин в климактерии. Автореф. дис. ... канд. мед. наук. М., 2001. / Gadzhieva Z.K. Funktsional'noe sostoianie nizhnikh mochevykh putei i medikamentoznaia profilaktika narushenii mocheispuskaniia u zhenshchin v klimakterii. Avtoref. dis. ... kand. med. nauk. M., 2001. [in Russian]
10. Ilovayskaya I. Similarity of female central (hypogonadotropic) hypogonadism and postmenopause. Climacteric 2017; 20 (4): 356–61.
11. Notelovitz M. Estrogen therapy in the management to problems associated with urogenital ageing-asimple diagnostic test and the effect of the route of hormone administration. Maturitas 1995; 115 (22): 31–3.
12. Panay N. Genitourinary syndrome of the menopause – dawn of a new era? Climacteric 2015; 18 (1): 13–7.
13. Baber RJ, Panay N, Fenton A. 2016 IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric 2016; 19 (2): 109–50.
14. The 2017 hormone therapy position statement of the North American Menopause Society. Menopause 2017; 24 (7): 728–53.
15. Прилепская В.Н. Генитоуринарный менопаузальный синдром: возможности эстриола. Гинекология. 2018; 20 (1): 5–8. / Prilepskaya V.N. Genitourinary menopausal syndrome: the potential of estriol. Gynecology. 2018; 20 (1): 5–8. [in Russian]
16. Тихомирова Е.В. Особенности клиники и лечения урогенитальных расстройств в перименопаузе. Автореф. дис. ... канд. мед. наук. М., 2005. / Tikhomirova E.V. Osobennosti kliniki i lecheniia urogenital'nykh rasstroistv v perimenopauze. Avtoref. dis. ... kand. med. nauk. M., 2005. [in Russian]
17. Ильина Л.М., Юренева С.В., Дубровина А.В., Эбзиева З.Х. Влияние менопаузы на работающих женщин: фактор, которому не придается должного значения. Проблемы репродукции. 2016; 1: 87–94. / Il'ina L.M., Iureneva S.V., Dubrovina A.V., Ebzieva Z.Kh. Vliianie menopauzy na rabotaiushchikh zhenshchin: faktor, kotoromu ne pridaetsia dolzhnogo znacheniia. Problemy reproduktsii. 2016; 1: 87–94.
18. Oge T, Hassa H, Aydin Y et al. The relationship between urogenital symptoms and climacteric complaints. Climacteric 2013; 16 (6): 646–52.
19. Calleja-Agius J, Brincat MP. The urogenital system and the menopause. Climacteric 2015; 18 (1): 18–22.
20. Юренева С.В., Ильина Л.М., Якушевская О.В. Менопаузальная гормональная терапия в постменопаузе: качество жизни сегодня и в долгосрочной перспективе. Гинекология. 2016; 18 (1): 24–9. / Yureneva S.V., Ilyina L.M., Yakushevskaya O.V. Menopausal hormone therapy in postmenopausal women: the quality of life today and in the long term. Gynecology. 2016; 18 (1): 24–9. [in Russian]
21. Warming L, Ravn P, Nielsen T, Christiansen C. Safety and efficacy of drospirenone used in a continuous combination with 17b-estradiol for prevention of postmenopausal osteoporosis. Climacteric 2004; 7 (1): 103–11.
22. Gerlinger C, Gude K, Schmelter T et al. 0.5 vs. 1.0 mg estradiol in combination with drospirenone for the treatment of hot flushes. Climacteric 2015; 18 (4): 512–7.
23. Battaglia C, Cianciosi A, Mancini F et al. Angeliq versus Activelle in normotensive postmenopausal women: a prospective, randomized pilot study. Menopause 2009; 16 (4): 803–9.
24. Gambacciani M, Rosano G, Cappagli B et al. Clinical and metabolic effects of drospirenone-estradiol in menopausal women: a prospective study. Climacteric 2011; 14 (1): 18–24.
25. Dinger J, Bardenheuer K, Heinemann K. Drospirenone plus estradiol and the risk of serious cardiovascular events in postmenopausal women. Climacteric 2016; 19 (4): 349–56.
26. Anttila S, Hakkola J, Tuominen P. Methylation of cytochrome P4501A1 promoter in the lung is associated with tobacco smoking. Cancer Res 2003; 63: 8623–8.
27. Archer DF. Drospirenone and estradiol: a new option for the postmenopausal woman. Climacteric 2007; 10 (1): 3–10.
28. Genazzani AR, Schmelter T, Schaefers M et al. One-year randomized study of the endometrial safety and bleeding pattern of 0.25 mg drospirenone/0.5 mg 17b-estradiol in postmenopausal women. Climacteric 2013; 16 (4): 490–8.
29. Lin S-Q, Sun L-Z, Lin J-F et al. Estradiol 1 mg and drospirenone 2 mg as hormone replacement therapy in postmenopausal Chinese women. Climacteric 2011; 14 (4): 472–81.
30. Андреева Е.Н., Григорян О.Р., Абсатарова Ю.С. Эффективность использования низких доз дроспиренона и 17b-эстрадиола у женщин в постменопаузе (обзор литературы). Гинекология. 2015; 17 (1): 34–40. / Andreeva E.N., Grigoryan O.R., Absatarova Yu.S. The efficacy of 17b-estradiol and low dosed drospirenone use in postmenopausal women (literature review). Gynecology. 2015; 17 (1): 34–40. [in Russian]
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Авторы
И.С.Захаров*
ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России. 650056, Россия, Кемерово, ул. Ворошилова, д. 22а
*isza@mail.ru
Kemerovo State Medical University of the Ministry of Health of the Russian Federation. 650056, Russian Federation, Kemerovo, ul. Voroshilova, d. 22a
*isza@mail.ru
ФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава России. 650056, Россия, Кемерово, ул. Ворошилова, д. 22а
*isza@mail.ru
________________________________________________
Kemerovo State Medical University of the Ministry of Health of the Russian Federation. 650056, Russian Federation, Kemerovo, ul. Voroshilova, d. 22a
*isza@mail.ru
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