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Современные подходы к управлению менопаузой
Современные подходы к управлению менопаузой
Артымук Н.В., Тачкова О.А., Марочко Т.Ю. Современные подходы к управлению менопаузой. Гинекология. 2021; 23 (2): 137–143. DOI: 10.26442/20795696.2021.2.200691
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Аннотация
Цель. Провести аналитический обзор современных источников научной литературы, освещающих современные подходы к улучшению качества и увеличению продолжительности жизни в постменопаузе.
Материалы и методы. Проведен анализ 58 зарубежных и отечественных источников литературы по данной теме.
Результаты. Менопауза – это время значительных перемен для женщин и подходящее время для оценки и укрепления здоровья. Консультирование пациентки должно включать информирование по вопросам образа жизни, контрацепции, индивидуальных и семейных рисков онкологических заболеваний и остеопороза. Для коррекции симптомов менопаузы могут применяться гормональные, негормональные и дополнительные методы. Менопаузальная гормональная терапия – наиболее эффективное лечение менопаузальных вазомоторных симптомов и может быть предложено большинству женщин. Местное лечение эстрогенами эффективно для лечения генитоуринарного синдрома. Женщина должна иметь возможность сделать осознанный выбор в отношении применения менопаузальной гормональной терапии, основанный на сбалансированной и точной информации о ее преимуществах и рисках.
Заключение. В основе управления менопаузой лежит модификация образа жизни. Решение о лечении менопаузальных симптомов с применением гормональных, негормональных и дополнительных методов должно приниматься индивидуально в зависимости от наличия факторов риска и предпочтений пациентки.
Ключевые слова: менопауза, период менопаузального перехода, перименопауза, менопаузальная гормональная терапия, контрацепция
Materials and methods. The analysis of 47 foreign and domestic literature sources on this topic is carried out.
Results. Menopause is a time of significant change for women and a good time to assess and promote health. Patient counseling should include information on lifestyle, contraception, individual and family risks of cancer and osteoporosis. Hormonal, non-hormonal and complementary methods can be used to correct the symptoms of menopause. MHT is the most effective treatment for symptom relief and can be offered to most women. Topical vaginal oestrogen treatment is effective in relieving urogenital symptoms. Women should be able to make informed choices regarding the use of MHT, based on balanced and accurate information about its benefits and risks.
Conclusion. Menopause is a time of change for women and provides an opportunity for health assessment and promotion. The decision to treat menopausal symptoms using hormonal, non-hormonal and complementary methods should be made on an individual basis depending on the presence of risk factors and the patient’s preferences.
Keywords: menopause, menopausal transition period, perimenopause, menopausal hormone therapy, contraception
Материалы и методы. Проведен анализ 58 зарубежных и отечественных источников литературы по данной теме.
Результаты. Менопауза – это время значительных перемен для женщин и подходящее время для оценки и укрепления здоровья. Консультирование пациентки должно включать информирование по вопросам образа жизни, контрацепции, индивидуальных и семейных рисков онкологических заболеваний и остеопороза. Для коррекции симптомов менопаузы могут применяться гормональные, негормональные и дополнительные методы. Менопаузальная гормональная терапия – наиболее эффективное лечение менопаузальных вазомоторных симптомов и может быть предложено большинству женщин. Местное лечение эстрогенами эффективно для лечения генитоуринарного синдрома. Женщина должна иметь возможность сделать осознанный выбор в отношении применения менопаузальной гормональной терапии, основанный на сбалансированной и точной информации о ее преимуществах и рисках.
Заключение. В основе управления менопаузой лежит модификация образа жизни. Решение о лечении менопаузальных симптомов с применением гормональных, негормональных и дополнительных методов должно приниматься индивидуально в зависимости от наличия факторов риска и предпочтений пациентки.
Ключевые слова: менопауза, период менопаузального перехода, перименопауза, менопаузальная гормональная терапия, контрацепция
________________________________________________
Materials and methods. The analysis of 47 foreign and domestic literature sources on this topic is carried out.
Results. Menopause is a time of significant change for women and a good time to assess and promote health. Patient counseling should include information on lifestyle, contraception, individual and family risks of cancer and osteoporosis. Hormonal, non-hormonal and complementary methods can be used to correct the symptoms of menopause. MHT is the most effective treatment for symptom relief and can be offered to most women. Topical vaginal oestrogen treatment is effective in relieving urogenital symptoms. Women should be able to make informed choices regarding the use of MHT, based on balanced and accurate information about its benefits and risks.
Conclusion. Menopause is a time of change for women and provides an opportunity for health assessment and promotion. The decision to treat menopausal symptoms using hormonal, non-hormonal and complementary methods should be made on an individual basis depending on the presence of risk factors and the patient’s preferences.
Keywords: menopause, menopausal transition period, perimenopause, menopausal hormone therapy, contraception
Полный текст
Список литературы
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2. Minkin MJ. Menopause: Hormones, Lifestyle, and Optimizing Aging. Obstet Gynecol Clin North Am. 2019; 46 (3): 501–14. DOI: 10.1016/j.ogc.2019.04.008
3. Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop+10: addressing the unfinished agenda of staging reproductive aging. Climacteric 2012; 15: 105–14. Available at:
http://gynendo.ru/wpcontent/uploads/2012/08/etapi_starenija_reproduct_sist_zhenschin_straw+10.pdf. Accessed: 16.02.2021.
4. Gracia CR, Freeman EW. Onset of the Menopause Transition: The Earliest Signs and Symptoms. Obstet Gynecol Clin North Am. 2018; 45 (4): 585–97. DOI: 10.1016/j.ogc.2018.07.002
5. Magraith K, Stuckey B. Making choices at menopause. The Royal Australian College of General Practitioners 2019; 48 (7).
Available at: https://www1.racgp.org.au/getattachment/471e4285-62b8-4591-8678-014c9bf09453/Making-choices-at-menop.... Accessed: 16.02.2021.
6. Pis’mo Minzdrava Rossii ot 02.10.2015 №15-4/10/2-5804 “O napravlenii klinicheskikh rekomendatsii “Menopauzal’naia gormonoterapiia i sokhranenie zdorov’ia zhenshchin v zrelom vozraste” (vmeste s “Klinicheskimi rekomendatsiiami (Protokolom lecheniia)...” utverzhdennymi Rossiiskim obshchestvom akusherov-ginekologov 21.09.2015)” (in Russian)
7. Avis NE, Zhao X, Johannes CB, et al. Correlates of sexual function among multi-ethnic middle-aged women: results from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2018; 25 (11): 1244–55. DOI: 10.1097/GME.0000000000001226
8. El Khoudary SR, Greendale G, Crawford SL, et al. The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2019; 26 (10): 1213–27. DOI: 10.1097/GME.0000000000001424
9. Roberts H, Hickey M. Managing the menopause: An update. Maturitas. 2016; 86: 53–8. DOI: 10.1016/j.maturitas.2016.01.007
10. Montazeri SA, Ramezani Tehrani F, Bidhendi Yarandi R, et al. Effect of aging, menopause, and age at natural menopause on the trend in body mass index: a 15-year population-based cohort. Fertil Steril. 2019; 111 (4): 780–6. DOI: 10.1016/j.fertnstert.2018.12.017
11. Artymuk NV, Belokrinitskaya TE. Clinical norms. Obstetrics and gynecology. 2nd ed., rev. and add. Moscow: GEOTAR-Media, 2019 (in Russian)
12. Artymuk NV, Belokrinitskaya TE. Clinical norms. Obstetrics and gynecology. Moscow: GEOTAR-Media, 2018. Available at:
https://www.rosmedlib.ru/book/ISBN9785970446546.html. Accessed: 16.02.2021 (in Russian)
13. Sarri G, Pedder H, Dias S, et al. Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause. BJOG. 2017; 124 (10): 1514–23. DOI: 10.1111/1471-0528.14619
14. Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015; 175 (4): 531–9. DOI: 10.1001/jamainternmed.2014.8063
15. Faubion SS, Larkin LC, Stuenkel CA, et al. CONSENSUS RECOMMENDATIONS. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health Menopause 2018; 25 (6): 1–13. DOI: 10.1097/GME.0000000000001121. Available at:
https://www.menopause.org/docs/default-source/professional/management_of_genitourinary_syndrome_of_m.... Accessed: 16.02.2021.
16. Artymuk NV. Post-release of the 14th International Menopause Congress. Cancun, Mexico, May 1-4, 2014. Gynecology. 2014; 16 (4): 53–7 (in Russian)
17. Scavello I, Maseroli E, Di Stasi V, Vignozzi L. Sexual Health in Menopause. Medicina (Kaunas). 2019; 55 (9): 559. DOI: 10.3390/medicina55090559
18. Am EF. Genitourinary syndrome of menopause. Aust Fam Physician. 2017; 46 (7).
19. National Institute for Health and Clinical Excellence. Menopause: Diagnosis and Management (NG23) 2015. Last updated 5 December 2019. Available at: https://www.nice.org.uk/guidance/ng23/resources/menopause-diagnosis-and-management-pdf-1837330217413. Accessed: 16.02.2021.
20. Depmann M, Eijkemans MJC, Broer SL, et al. Does AMH relate to timing of menopause? Results of an Individual Patient Data meta-analysis. J Clin Endocrinol Metab. 2018. DOI: 10.1210/jc.2018-00724
21. De Kat AC, van der Schouw YT, Eijkemans MJC, et al. Can Menopause Prediction Be Improved With Multiple AMH Measurements? Results From the Prospective Doetinchem Cohort Study. J Clin Endocrinol Metab. 2019; 104 (11): 5024–31. DOI: 10.1210/jc.2018-02607
22. Neves-e-Castro M, Birkhäuser M, Samsioe G, et al. EMAS position statement: The ten point guide to the integral management of menopausal health. Maturitas. 2015; 81: 88–92. DOI: 10.1016/j.maturitas.2015.02.003
23. De Villiers TJ, Pines A, Panay N, et al. International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health. Available at:
https://www.imsociety.org/manage/images/pdf/802eee22ead864635d9fa16e52fc7b2d.pdf. Accessed: 16.02.2021.
24. Bondarev D, Laakkonen EK, Finni T, et al. Physical performance in relation to menopause status and physical activity. Menopause. 2018; 25 (12): 1432–41. DOI: 10.1097/GME.0000000000001137
25. Neilson HK, Farris MS, Stone CR, et al. Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis. Menopause. 2017; 24 (3): 322–44. DOI: 10.1097/GME.0000000000000745
26. Dugan SA, Gabriel KP, Lange-Maia BS, Karvonen-Gutierrez C. Physical Activity and Physical Function: Moving and Aging. Obstet Gynecol Clin North Am. 2018; 45 (4): 723–36. DOI: 10.1016/j.ogc.2018.07.009
27. Dąbrowska-Galas M, Dąbrowska J, Ptaszkowski K, Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Medicina (Kaunas). 2019; 55 (8): 466. DOI: 10.3390/medicina55080466
28. Vaska MM, Brenner DR, Friedenreich CM. Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis. Menopause. 2017; 24 (3): 322–44. DOI: 10.1097/GME.0000000000000745
29. Baldwin MK, Jensen JT. Contraception during the perimenopause. Maturitas. 2013; 76: 235–42.
30. Avis NE, Brockwell S, Colvin A. A universal menopausal syndrome? Am J Med. 2005; 118 (Suppl. 12B): 37–46. DOI: 10.1016/j.amjmed.2005.09.057
31. Klein J, Sauer MV. Assessing fertility in women of advanced reproductive age. Am J Obstet Gynecol. 2001; 185: 758–70.
32. Nelson SM, Telfer EE, Anderson RA. The ageing ovary and uterus: new biological insights. Hum Reprod Update. 2013; 19: 67–83.
33. Reproductive Endocrinology and Infertility Committee, Family Physicians Advisory Committee, Maternal–Fetal Medicine Committee, et al. Advanced reproductive age and fertility. J Obstet Gynaecol Can. 2011; 33: 1165–7115.
34. Faculty of Sexual & Reproductive Healthcare. FSRH Guideline: Contraception for Women Aged Over 40 Years. August 2017 (Amended September 2019). Available at: https://www.fsrh.org/standards-and-guidance/documents/fsrh-guidance-contraception-for-women-aged-ove.... Accessed: 16.02.2021.
35. Kanmaz AG, İnan AH, Beyan E, et al. Effect of advanced maternal age on pregnancy outcomes: a single-centre data from a tertiary healthcare hospital. J Obstet Gynaecol. 2019; 39 (8): 1104–11. DOI: 10.1080/01443615.2019.1606172
36. Pinheiro RL, Areia AL, Mota Pinto A, Donato H. Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-Analysis. Acta Med Port. 2019; 32 (3): 219–26. DOI: 10.20344/amp.11057
37. Kahveci B, Melekoglu R, Evruke IC, Cetin C. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth. 2018; 18 (1): 343. DOI: 10.1186/s12884-018-1984-x
38. Fitzpatrick KE, Tuffnell D, Kurinczuk JJ, Knight M. Pregnancy at very advanced maternal age: a UK population-based cohort study. BJOG. 2017; 124 (7): 1097–106. DOI: 10.1111/1471-0528.14269
39. Lean SC, Derricott H, Jones RL, Heazell AEP. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One. 2017; 12 (10): e0186287. DOI: 10.1371/journal.pone.0186287
40. Lobo RA, Pickar JH, Stevenson JC, et al. Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause. Atherosclerosis. 2016; 254: 282–90. DOI: 10.1016/j.atherosclerosis.2016.10.005
41. U.S. Preventive Services Task Force. Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: U.S. Preventive Services Task Force Recommendation Statement (Draft). Available at:
http://www.uspreventiveservicestaskforce.org/draftrec.htm. Accessed: 16.02.2021.
42. Baber RJ, Panay N, Fenton A, et al. IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric. 2016; 19 (2). DOI: 10.3109/13697137.2015.1129166
43. Cobin RH, Goodman NF; AACE Reproductive Endocrinology Scientific Committee. American Association of Clinical Endocrinologists and American College of Endocrinology Position Statement on Menopause–2017 update. Available at: https://journals.aace.com/doi/pdf/10.4158/EP171828.PS. Accessed: 16.02.2021.
44. Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Lancet. 2019; 394: 1159–68. DOI: 10.1016/ S0140-6736(19)31709-X. Available at:
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)31709-X.pdf. Accessed: 16.02.2021.
45. Al-Ajmi K, Lophatananon A, Ollier W, Muir KR. Risk of breast cancer in the UK biobank female cohort and its relationship to anthropometric and reproductive factors. PLOS ONE. 2018; 13 (7): e0201097.
DOI: 10.1371/journal.pone.0201097. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201097. Accessed: 16.02.2021.
46. Wang C, Huang Q, Liang CL, et al. Effect of cimicifuga racemosa on menopausal syndrome caused by LHRH-a in breast cancer.
J Ethnopharmacol. 2019; 238: 111840. DOI: 10.1016/j.jep.2019.111840
47. Zhou Q, Tao J, Song H, et al. Chinese herbal medicine Kuntai capsule for treatment of menopausal syndrome: a systematic review of randomized clinical trials. Complement Ther Med. 2016; 29: 63–71. DOI: 10.1016/j.ctim.2016.09.011
48. Wang Y, Lou XT, Shi YH, et al. Erxian decoction, a Chinese herbal formula, for menopausal syndrome: An updated systematic review.
J Ethnopharmacol. 2019; 234: 8–20. DOI: 10.1016/j.jep.2019.01.010
49. Kaunitz AM, Manson JE. Management of Menopausal Symptoms. Obstet Gynecol. 2015; 126 (4): 859–76. DOI: 10.1097/AOG.0000000000001058
50. Adamyan LV, Artymuk NV, Ermakova OA. Formulary of medicines in obstetrics and gynecology. Ed. V.E. Radzinsky. Moscow: GEOTAR-Media, 2011 (in Russian)
51. Adamyan LV, Absatarova YuS, Andreeva EN, et al. Gynecology. Pharmacotherapy without mistakes. A guide for doctors. Ed. G.T. Sukhikh, V.N. Serov, V.N. Prilepskaya, I.I. Baranova. Moscow: E-noto, 2020 (in Russian)].
52. Jannini EA, Nappi RE. Couplepause: A New Paradigm in Treating Sexual Dysfunction During Menopause and Andropause. Sex Med Rev. 2018; 6 (3): 384–95. DOI: 10.1016/j.sxmr.2017.11.002
53. Faubion SS, Larkin LC, Stuenkel CA, et al. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health. Menopause. 2018; 25 (6): 596–608. DOI: 10.1097/GME.0000000000001121
54. Samuels JB, Garcia MA. Treatment to External Labia and Vaginal Canal With CO2 Laser for Symptoms of Vulvovaginal Atrophy in Postmenopausal Women. Aesthet Surg J. 2019; 39 (1): 83–93. DOI: 10.1093/asj/sjy087
55. Gambacciani M, Palacios S. Laser therapy for the restoration of vaginal function. Maturitas. 2017; 99: 10–5. DOI: 10.1016/j.maturitas.2017.01.012
56. Pearson A, Booker A, Tio M, Marx G. Vaginal CO2 laser for the treatment of vulvovaginal atrophy in women with breast cancer: LAAVA pilot study. Breast Cancer Res Treat. 2019; 178 (1): 135–40. DOI: 10.1007/s10549-019-05384-9
57. Cruz VL, Steiner ML, Pompei LM, et al. Randomized, double-blind, placebo-controlled clinical trial for evaluating the efficacy of fractional CO2 laser compared with topical estriol in the treatment of vaginal atrophy in postmenopausal women. Menopause. 2018; 25 (1): 21–8. DOI: 10.1097/GME.0000000000000955
58. Rabley A, O’Shea T, Terry R, et al. Laser Therapy for Genitourinary Syndrome of Menopause. Curr Urol Rep. 2018; 19 (10): 83. DOI: 10.1007/s11934-018-0831-y
59. Archer DF, Simon JA, Portman DJ, et al. Ospemifene for the treatment of menopausal vaginal dryness, a symptom of the genitourinary syndrome of menopause. Expert Rev Endocrinol Metab. 2019; 14 (5): 301–14. DOI: 10.1080/17446651.2019.1657008
2. Minkin MJ. Menopause: Hormones, Lifestyle, and Optimizing Aging. Obstet Gynecol Clin North Am. 2019; 46 (3): 501–14. DOI: 10.1016/j.ogc.2019.04.008
3. Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop+10: addressing the unfinished agenda of staging reproductive aging. Climacteric 2012; 15: 105–14. Available at: http://gynendo.ru/wpcontent/uploads/2012/08/etapi_starenija_reproduct_sist_zhenschin_straw+10.pdf. Accessed: 16.02.2021.
4. Gracia CR, Freeman EW. Onset of the Menopause Transition: The Earliest Signs and Symptoms. Obstet Gynecol Clin North Am. 2018; 45 (4): 585–97. DOI: 10.1016/j.ogc.2018.07.002
5. Magraith K, Stuckey B. Making choices at menopause. The Royal Australian College of General Practitioners 2019; 48 (7).
Available at: https://www1.racgp.org.au/getattachment/471e4285-62b8-4591-8678-014c9bf09453/Making-choices-at-menop.... Accessed: 16.02.2021.
6. Письмо Минздрава России от 02.10.2015 №15-4/10/2-5804 «О направлении клинических рекомендаций “Менопаузальная гормонотерапия и сохранение здоровья женщин в зрелом возрасте” (вместе с “Клиническими рекомендациями (Протоколом лечения)...” утвержденными Российским обществом акушеров-гинекологов 21.09.2015)» [Pis’mo Minzdrava Rossii ot 02.10.2015 №15-4/10/2-5804 “O napravlenii klinicheskikh rekomendatsii “Menopauzal’naia gormonoterapiia i sokhranenie zdorov’ia zhenshchin v zrelom vozraste” (vmeste s “Klinicheskimi rekomendatsiiami (Protokolom lecheniia)...” utverzhdennymi Rossiiskim obshchestvom akusherov-ginekologov 21.09.2015)” (in Russian)].
7. Avis NE, Zhao X, Johannes CB, et al. Correlates of sexual function among multi-ethnic middle-aged women: results from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2018; 25 (11): 1244–55. DOI: 10.1097/GME.0000000000001226
8. El Khoudary SR, Greendale G, Crawford SL, et al. The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2019; 26 (10): 1213–27. DOI: 10.1097/GME.0000000000001424
9. Roberts H, Hickey M. Managing the menopause: An update. Maturitas. 2016; 86: 53–8. DOI: 10.1016/j.maturitas.2016.01.007
10. Montazeri SA, Ramezani Tehrani F, Bidhendi Yarandi R, et al. Effect of aging, menopause, and age at natural menopause on the trend in body mass index: a 15-year population-based cohort. Fertil Steril. 2019; 111 (4): 780–6. DOI: 10.1016/j.fertnstert.2018.12.017
11. Артымук Н.В., Белокриницкая Т.Е. Клинические нормы. Акушерство и гинекология. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2019 [Artymuk NV, Belokrinitskaya TE. Clinical norms. Obstetrics and gynecology. 2nd ed., rev. and add. Moscow: GEOTAR-Media, 2019 (in Russian)].
12. Артымук Н.В., Белокриницкая Т.Е. Клинические нормы. Акушерство и гинекология. М.: ГЭОТАР-Медиа, 2018. Режим доступа:
https://www.rosmedlib.ru/book/ISBN9785970446546.html. Ссылка активна на 16.02.2021 [Artymuk NV, Belokrinitskaya TE. Clinical norms. Obstetrics and gynecology. Moscow: GEOTAR-Media, 2018. Available at:
https://www.rosmedlib.ru/book/ISBN9785970446546.html. Accessed: 16.02.2021 (in Russian)].
13. Sarri G, Pedder H, Dias S, et al. Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause. BJOG. 2017; 124 (10): 1514–23. DOI: 10.1111/1471-0528.14619
14. Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015; 175 (4): 531–9. DOI: 10.1001/jamainternmed.2014.8063
15. Faubion SS, Larkin LC, Stuenkel CA, et al. CONSENSUS RECOMMENDATIONS. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health Menopause 2018; 25 (6): 1–13. DOI: 10.1097/GME.0000000000001121. Available at:
https://www.menopause.org/docs/default-source/professional/management_of_genitourinary_syndrome_of_m.... Accessed: 16.02.2021.
16. Артымук Н.В. Пострелиз 14-го Международного конгресса по менопаузе. Канкун, Мексика, 1–4 мая 2014 г. Гинекология. 2014; 16 (4): 53–7 [Artymuk NV. Post-release of the 14th International Menopause Congress. Cancun, Mexico, May 1-4, 2014. Gynecology. 2014; 16 (4): 53–7 (in Russian)].
17. Scavello I, Maseroli E, Di Stasi V, Vignozzi L. Sexual Health in Menopause. Medicina (Kaunas). 2019; 55 (9): 559. DOI: 10.3390/medicina55090559
18. Am EF. Genitourinary syndrome of menopause. Aust Fam Physician. 2017; 46 (7).
19. National Institute for Health and Clinical Excellence. Menopause: Diagnosis and Management (NG23) 2015. Last updated 5 December 2019. Available at: https://www.nice.org.uk/guidance/ng23/resources/menopause-diagnosis-and-management-pdf-1837330217413. Accessed: 16.02.2021.
20. Depmann M, Eijkemans MJC, Broer SL, et al. Does AMH relate to timing of menopause? Results of an Individual Patient Data meta-analysis. J Clin Endocrinol Metab. 2018. DOI: 10.1210/jc.2018-00724
21. De Kat AC, van der Schouw YT, Eijkemans MJC, et al. Can Menopause Prediction Be Improved With Multiple AMH Measurements? Results From the Prospective Doetinchem Cohort Study. J Clin Endocrinol Metab. 2019; 104 (11): 5024–31. DOI: 10.1210/jc.2018-02607
22. Neves-e-Castro M, Birkhäuser M, Samsioe G, et al. EMAS position statement: The ten point guide to the integral management of menopausal health. Maturitas. 2015; 81: 88–92. DOI: 10.1016/j.maturitas.2015.02.003
23. De Villiers TJ, Pines A, Panay N, et al. International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health. Available at:
https://www.imsociety.org/manage/images/pdf/802eee22ead864635d9fa16e52fc7b2d.pdf. Accessed: 16.02.2021.
24. Bondarev D, Laakkonen EK, Finni T, et al. Physical performance in relation to menopause status and physical activity. Menopause. 2018; 25 (12): 1432–41. DOI: 10.1097/GME.0000000000001137
25. Neilson HK, Farris MS, Stone CR, et al. Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis. Menopause. 2017; 24 (3): 322–44. DOI: 10.1097/GME.0000000000000745
26. Dugan SA, Gabriel KP, Lange-Maia BS, Karvonen-Gutierrez C. Physical Activity and Physical Function: Moving and Aging. Obstet Gynecol Clin North Am. 2018; 45 (4): 723–36. DOI: 10.1016/j.ogc.2018.07.009
27. Dąbrowska-Galas M, Dąbrowska J, Ptaszkowski K, Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Medicina (Kaunas). 2019; 55 (8): 466. DOI: 10.3390/medicina55080466
28. Vaska MM, Brenner DR, Friedenreich CM. Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis. Menopause. 2017; 24 (3): 322–44. DOI: 10.1097/GME.0000000000000745
29. Baldwin MK, Jensen JT. Contraception during the perimenopause. Maturitas. 2013; 76: 235–42.
30. Avis NE, Brockwell S, Colvin A. A universal menopausal syndrome? Am J Med. 2005; 118 (Suppl. 12B): 37–46. DOI: 10.1016/j.amjmed.2005.09.057
31. Klein J, Sauer MV. Assessing fertility in women of advanced reproductive age. Am J Obstet Gynecol. 2001; 185: 758–70.
32. Nelson SM, Telfer EE, Anderson RA. The ageing ovary and uterus: new biological insights. Hum Reprod Update. 2013; 19: 67–83.
33. Reproductive Endocrinology and Infertility Committee, Family Physicians Advisory Committee, Maternal–Fetal Medicine Committee, et al. Advanced reproductive age and fertility. J Obstet Gynaecol Can. 2011; 33: 1165–7115.
34. Faculty of Sexual & Reproductive Healthcare. FSRH Guideline: Contraception for Women Aged Over 40 Years. August 2017 (Amended September 2019). Available at: https://www.fsrh.org/standards-and-guidance/documents/fsrh-guidance-contraception-for-women-aged-ove.... Accessed: 16.02.2021.
35. Kanmaz AG, İnan AH, Beyan E, et al. Effect of advanced maternal age on pregnancy outcomes: a single-centre data from a tertiary healthcare hospital. J Obstet Gynaecol. 2019; 39 (8): 1104–11. DOI: 10.1080/01443615.2019.1606172
36. Pinheiro RL, Areia AL, Mota Pinto A, Donato H. Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-Analysis. Acta Med Port. 2019; 32 (3): 219–26. DOI: 10.20344/amp.11057
37. Kahveci B, Melekoglu R, Evruke IC, Cetin C. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy Childbirth. 2018; 18 (1): 343. DOI: 10.1186/s12884-018-1984-x
38. Fitzpatrick KE, Tuffnell D, Kurinczuk JJ, Knight M. Pregnancy at very advanced maternal age: a UK population-based cohort study. BJOG. 2017; 124 (7): 1097–106. DOI: 10.1111/1471-0528.14269
39. Lean SC, Derricott H, Jones RL, Heazell AEP. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One. 2017; 12 (10): e0186287. DOI: 10.1371/journal.pone.0186287
40. Lobo RA, Pickar JH, Stevenson JC, et al. Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause. Atherosclerosis. 2016; 254: 282–90. DOI: 10.1016/j.atherosclerosis.2016.10.005
41. U.S. Preventive Services Task Force. Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: U.S. Preventive Services Task Force Recommendation Statement (Draft). Available at:
http://www.uspreventiveservicestaskforce.org/draftrec.htm. Accessed: 16.02.2021.
42. Baber RJ, Panay N, Fenton A, et al. IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric. 2016; 19 (2). DOI: 10.3109/13697137.2015.1129166
43. Cobin RH, Goodman NF; AACE Reproductive Endocrinology Scientific Committee. American Association of Clinical Endocrinologists and American College of Endocrinology Position Statement on Menopause–2017 update. Available at: https://journals.aace.com/doi/pdf/10.4158/EP171828.PS. Accessed: 16.02.2021.
44. Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Lancet. 2019; 394: 1159–68. DOI: 10.1016/ S0140-6736(19)31709-X. Available at:
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)31709-X.pdf. Accessed: 16.02.2021.
45. Al-Ajmi K, Lophatananon A, Ollier W, Muir KR. Risk of breast cancer in the UK biobank female cohort and its relationship to anthropometric and reproductive factors. PLOS ONE. 2018; 13 (7): e0201097.
DOI: 10.1371/journal.pone.0201097. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201097. Accessed: 16.02.2021.
46. Wang C, Huang Q, Liang CL, et al. Effect of cimicifuga racemosa on menopausal syndrome caused by LHRH-a in breast cancer.
J Ethnopharmacol. 2019; 238: 111840. DOI: 10.1016/j.jep.2019.111840
47. Zhou Q, Tao J, Song H, et al. Chinese herbal medicine Kuntai capsule for treatment of menopausal syndrome: a systematic review of randomized clinical trials. Complement Ther Med. 2016; 29: 63–71. DOI: 10.1016/j.ctim.2016.09.011
48. Wang Y, Lou XT, Shi YH, et al. Erxian decoction, a Chinese herbal formula, for menopausal syndrome: An updated systematic review.
J Ethnopharmacol. 2019; 234: 8–20. DOI: 10.1016/j.jep.2019.01.010
49. Kaunitz AM, Manson JE. Management of Menopausal Symptoms. Obstet Gynecol. 2015; 126 (4): 859–76. DOI: 10.1097/AOG.0000000000001058
50. Адамян Л.В., Артымук Н.В., Ермакова О.А. Формуляр лекарственных средств в акушерстве и гинекологии. Под ред. В.Е. Радзинского. М.: ГЭОТАР-Медиа, 2011 [Adamyan LV, Artymuk NV, Ermakova OA. Formulary of medicines in obstetrics and gynecology. Ed. V.E. Radzinsky. Moscow: GEOTAR-Media, 2011 (in Russian)].
51. Адамян Л.В., Абсатарова Ю.С., Андреева Е.Н. и др. Гинекология. Фармакотерапия без ошибок. Руководство для врачей. Под ред.
Г.Т. Сухих, В.Н. Серова, В.Н. Прилепской, И.И. Баранова. М.: Е-ното, 2020 [Adamyan LV, Absatarova YuS, Andreeva EN, et al. Gynecology. Pharmacotherapy without mistakes. A guide for doctors. Ed. G.T. Sukhikh, V.N. Serov, V.N. Prilepskaya, I.I. Baranova. Moscow: E-noto, 2020 (in Russian)].
52. Jannini EA, Nappi RE. Couplepause: A New Paradigm in Treating Sexual Dysfunction During Menopause and Andropause. Sex Med Rev. 2018; 6 (3): 384–95. DOI: 10.1016/j.sxmr.2017.11.002
53. Faubion SS, Larkin LC, Stuenkel CA, et al. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health. Menopause. 2018; 25 (6): 596–608. DOI: 10.1097/GME.0000000000001121
54. Samuels JB, Garcia MA. Treatment to External Labia and Vaginal Canal With CO2 Laser for Symptoms of Vulvovaginal Atrophy in Postmenopausal Women. Aesthet Surg J. 2019; 39 (1): 83–93. DOI: 10.1093/asj/sjy087
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56. Pearson A, Booker A, Tio M, Marx G. Vaginal CO2 laser for the treatment of vulvovaginal atrophy in women with breast cancer: LAAVA pilot study. Breast Cancer Res Treat. 2019; 178 (1): 135–40. DOI: 10.1007/s10549-019-05384-9
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59. Archer DF, Simon JA, Portman DJ, et al. Ospemifene for the treatment of menopausal vaginal dryness, a symptom of the genitourinary syndrome of menopause. Expert Rev Endocrinol Metab. 2019; 14 (5): 301–14. DOI: 10.1080/17446651.2019.1657008
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59. Archer DF, Simon JA, Portman DJ, et al. Ospemifene for the treatment of menopausal vaginal dryness, a symptom of the genitourinary syndrome of menopause. Expert Rev Endocrinol Metab. 2019; 14 (5): 301–14. DOI: 10.1080/17446651.2019.1657008
Авторы
Н.В. Артымук*, О.А. Тачкова, Т.Ю. Марочко
ФБГОУ ВО «Кемеровский государственный медицинский университет» Минздрава России, Кемерово, Россия
*artymuk@gmail.com
Kemerovo State Medical University, Kemerovo, Russia
*artymuk@gmail.com
ФБГОУ ВО «Кемеровский государственный медицинский университет» Минздрава России, Кемерово, Россия
*artymuk@gmail.com
________________________________________________
Kemerovo State Medical University, Kemerovo, Russia
*artymuk@gmail.com
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