The role of tibolone in the elimination of climacteric syndrome symptoms

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Background: Menopause is characterized by a gradual decline and eventual "turn-off" of ovarian function. Physiological changes in a woman's body are accompanied by the development of neuropsychiatric, vegetovascular, and neuroendocrine symptoms. Menopause is an important period associated with intense hormonal changes that can cause cognitive decline, anxiety and depression, sexual dysfunction, and sleep disturbances.

Objective: To conduct a comparative analysis of the use of various pharmacological drugs for the correction of menopausal symptoms.

Materials and methods: The study was conducted at the Pirogov City Hospital No. 1 during the period of September 2024–June 2025. The study included 62 postmenopausal women that were divided into 3 groups: Group 1 (n=21) – patients who received tibolone (Leatrisa) for 6 months; Group 2 (n=17) – patients who received a drug containing estradiol 1 mg and dydrogesterone 5 mg (E2/DYD); Group 3 (n=24) – postmenopausal women who did not receive menopausal hormontherapy (MHT). In addition to standard research methods, a questionnaire was administered (Greene Menopause Index, Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Female Sexual Distress Scale (FSDS), sleep quality questionnaire).

Results: Tibolone's effect was found to be comparable to that of E2/DYD, a drug recommended for use 12 months after menopause, in terms of relieving menopausal symptoms and alleviating their severity. Tibolone is effective in treating sexual dysfunction in postmenopausal women due to its androgenic metabolite. The results of the study showcase that tibolone has no proliferative effect on the endometrium.

Conclusion: Tibolone significantly improves sexual function, reduces anxiety and depression, alleviates menopausal symptoms, and promotes weight stabilization, without causing endometrial proliferative effects. We believe tibolone can be considered an effective therapy for many postmenopausal women.

全文:

受限制的访问

作者简介

Irina Ilyina

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

编辑信件的主要联系方式.
Email: iliyina@mail.ru
ORCID iD: 0000-0001-8155-8775

Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology, Faculty of Medicine

俄罗斯联邦, 117513, Moscow, Ostrovitianov str., 1-9

Yulia Dobrokhotova

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

Email: pr.dobrohotova@mail.ru
ORCID iD: 0000-0002-7830-2290

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Medicine

俄罗斯联邦, 117513, Moscow, Ostrovitianov str., 1-9

Metanat Narimanova

Pirogov Russian National Research Medical University of the Ministry of Health of Russia

Email: iliyina@mail.ru
ORCID iD: 0000-0003-0677-2952

PhD, Associate Professor at the Department of Obstetrics and Gynecology, Faculty of Medicine

俄罗斯联邦, 117513, Moscow, Ostrovitianov str., 1-9

参考

  1. Кузнецова И.В. Выбор между гормональной и альтернативной терапией в периоде менопаузального перехода и постменопаузе. РМЖ. 2018; 2(1): 43-7. [Kuznetsova I.V. The choice of hormonal and alternative therapy in menopausal and post-menopausal period. RMJ. 2018; 2(1): 43-7 (in Russian)].
  2. Министерство здравоохранения Российской Федерации. Российское общество акушеров-гинекологов. Клинические рекомендации. Менопауза и климактерическое состояние у женщины. М.; 2021. 55 с. [Ministry of Health of the Russian Federation. Clinical guidelines. Menopause and menopausal syndrome in women. Moscow; 2021. 55 p. (in Russian)].
  3. Thurston R.C., El Khoudary S.R., Tepper P.G., Jackson E.A., Joffe H., Chen H.Y. et al. Trajectories of vasomotor symptoms and carotid intima media thickness in the study of women’s health across the nation. Stroke. 2016; 47(1): 12-7. https://dx.doi.org/10.1161/STROKEAHA.115.010600
  4. Ярмолинская М.И., Колошкина А.В. Возможности тканеселективной эстрогенной регуляции у пациенток в постменопаузе. Акушерство и гинекология. 2024; 5: 32-43. [Yarmolinskaya M.I., Koloshkina A.V. Possibilities of tissue-selective estrogen regulation in postmenopausal patients. Obstetrics and Gynecology. 2024; (5): 32-43 (in Russian)]. https://dx.doi.org/10.18565/aig.2024.117
  5. Ткач В.В., Нуруддинова Э.С., Ткач А.В. Когнитивные расстройства у женщин в период менопаузы. Научное обозрение. Медицинские науки. 2022; 3: 91-6. [Tkach V.V., Nuriddinova E.S., Tkach A.V. Cognitive disorders in menopausal women. Scientific review. Medical sciences. 2022; 3: 91-6 (in Russian)].
  6. Багинская Н.Н., Козловский В.И. Методы оценки когнитивных нарушений у пациентов с сердечно-сосудистыми заболеваниями в общей врачебной практике. Здравоохранение (Минск). 2022; 2(899): 49-58. [Baginskaya N.N., Kozlovsky V.I. Methods for assessing cognitive impairments in patients with cardiovascular diseases in general medical practice. Health Care (Minsk). 2022; 2(899): 49-58 (in Russian)].
  7. Zhang C., Zhao M., Li Z., Song Y. Follicle-stimulating hormone positively as sociates with metabolic factors in perimenopausal women. Int. J. Endocrinol. 2020; 2020: 7024321. https://dx.doi.org/10.1155/2020/7024321
  8. Maki P.M., Kornstein S.G., Joffe H., Bromberger J.T., Freeman E.W., Athappilly G. et al. Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. J. Womens Health (Larchmt). 2019; 28(2): 117-34. https://dx.doi.org/10.1089/jwh.2018.27099.mensocrec
  9. Ахмедова А.А., Горобец Л.Н. Особенности клинической картины аффективных расстройств у женщин в период менопаузального перехода и ранней постменопаузы. Журнал неврологии и психиатрии им. С.С. Корсакова. 2024; 124(4): 75-9. [Akhmedova A.A., Gorobets L.N. Features of the clinical picture of affective disorders in women during the menopausal transition and early postmenopause. S.S. Korsakov Journal of neurology and psychiatry. 2024; 124(4): 75-9 (in Russian)]. https://dx.doi.org/10.17116/jnevro202412404175
  10. Мазо Г.Э., Ганзенко М.А. Депрессии у женщин в период менопаузального перехода. Психиатрия и психофармакотерапия (Журнал им. П.Б. Ганнушкина. 2016; 18(6): 30-6. [Mazo G.E., Ganzenko M.A. Depression in women during the menopausal transition. Psychiatry and Psychopharmacotherapy (P.B. Gannushkin Journal). 2016; 18(6): 30-6 (in Russian)].
  11. Петрова А.В. Психоэмоциональные расстройства у женщин с ожирением в постменопаузальном периоде. Уральский медицинский журнал. 2015; 125(2): 92-5. [Petrova А.V. Psycho-emotional disorders in woman with obesity in postmenopause. Ural Medical Journal. 2015; 125(2): 92-5 (in Russian)].
  12. Nazarpour S., Simbar M., Tehrani F.R. Factors affecting sexual function in menopause: a review article. Taiwan. J. Obstet. Gynecol. 2016; 55(4): 480-7. https://dx.doi.org/10.1016/j.tjog.2016.06.001
  13. Сандакова Е.А., Жуковская И.Г. Гинекологические аспекты сексуальной дисфункции в постменопаузальном периоде. РМЖ. Мать и дитя. 2023; 6(1): 26-30. [Sandakova E.A., Zhukovskaya I.G. Gynecological aspects of sexual dysfunction in the postmenopausal period. RMJ. Mother and child. 2023; 6(1): 26-30 (in Russian)]. https://dx.doi.org/10.32364/2618-8430-2023-6-1-26-30
  14. Nazarpour S., Simbar M., Khorrami M., Jafari Torkamani Z., Saghafi R., Alavi-Majd H. The association between sexual function and body image among postmenopausal women: a crosssectional study. BMC Womens Health. 2021; 21(1): 403. https://dx.doi.org/10.1186/s12905-021-01549-1
  15. Мадаева И.М., Семенова Н.В., Астафьев В.А., Дружинина Е.Б., Лабыгина А.В. Особенности сна у женщин в климактерическом периоде (обзор литературы). Acta biomedica scientifica. 2018; 3(3): 75-81. [Madaeva I.M., Semenova N.V., Astafyev V.A., Druzhinina E.B., Labygina A.B. Sleep features in menopausal women (literature review). Acta biomedica scientifica. 2018; 3(3): 75-81 (in Russian)]. https://dx.doi.org/10.29413/ABS.2018-3.3.11
  16. Gao C.C., Kapoor E., Lipford M.C., Miller V.M., Schroeder D.R., Mara K.C. et al. Association of vasomotor symptoms and sleep apnea risk in midlife women. Menopause. 2017; 25(4): 391-8. https://dx.doi.org/10.1097/GME.0000000000001020
  17. Baber R.J., Panay N., Fenton A. Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016; 19(2): 109-50. https://dx.doi.org/10.3109/13697137.2015.1129166
  18. Доброхотова Ю.Э., Ильина И.Ю., Сафарли С.Э. Аномальные маточные кровотечения и кровотечения в постменопаузе на фоне приема менопаузальной гормональной терапии: современные данные. РМЖ. Мать и дитя. 2024; 7(3): 241-7. [Dobrokhotova Yu.E., Ilyina I.Yu., Safarli S.E. Abnormal uterine bleeding and postmenopausal bleeding in women taking menopausal hormone therapy: current data. RMJ. Mother and child. 2024; 7(3): 241-7 (in Russian)]. https://dx.doi.org/10.32364/2618-8430-2024-7-3-9
  19. Tsiligiannis S., Wick-Urban B.C., van der Stam J., Stevenson J.C. Efficacy and safety of a low-dose continuous combined hormone replacement therapy with 0.5 mg 17β-estradiol and 2.5 mg dydrogesterone in subgroups of postmenopausal women with vasomotor symptoms. Maturitas. 2020; 139: 20-6. https://dx.doi.org/10.1016/j.maturitas.2020.05.002
  20. Ампилогова Д.М., Солопова А.Г., Блинов Д.В., Быковщенко Г.К., Хлопкова С.В., Иванов А.Е. Влияние реабилитации на качество жизни пациенток с вульвовагинальной атрофией. Акушерство, гинекология и репродукция. 2024; 18(3): 338-51. [Ampilogova D.M., Solopova A.G., Blinov D.V., Bykovshchenko G.K., Khlopkova S.V., Ivanov A.E. The impact of rehabilitation on the quality of life in patients with vulvovaginal atrophy. Obstetrics, Gynecology and Reproduction. 2024; 18(3): 338-51 (in Russian)]. https://dx.doi.org/10.17749/2313-7347/ob.gyn.rep.2024.537
  21. Lampio L., Polo-Kantola P., Polo O., Kauko T., Aittokallio J., Saaresranta T. Sleep in midlife women: effects of menopause, vasomotor symptoms, and depressive symptoms. Menopause. 2014; 21(11): 1217-24. https://dx.doi.org/10.1097/GME.0000000000000239
  22. Phillips B.A., Mannino D. Correlates of sleep complaints in adults: the ARIC Study. J. Clin. Sleep Med. 2005; 1(3): 277-83.
  23. Тихомиров А.Л., Манухин И.Б., Манухина Е.И., Казенашев В.В. Для кого тиболон? Лечащий врач. 2016; 9: 78-80. [Tikhomirov A.L., Manukhin I.B., Manukhina E.I., Kazenashev V.V. For whom is tibolon? Lvrach.ru. 2016; 9: 78-80 (in Russian)].
  24. Gupta B., Mittal P., Khuteta R., Bhargava A. A comparative study of CEE, tibolone, and DHEA as hormone replacement. J. Obstet. Gynecol. India. 2013; 63(3): 194-8. https://dx.doi.org/10.1007/s13224-012-0297-7
  25. Raj R., Sharma N., Garg R., Goyal E. Comparative safety and efficacy of tibolone and escitalopram in postmenopausal women. Ind. Psychiatry J. 2021; 30(1): 140-8. https://dx.doi.org/10.4103/0972-6748.328805
  26. Hsiao S.M., Liao S.C. Effect of tibolone vs hormone replacement therapy on climacteric symptoms and psychological distress. J. Chin. Med. Assoc. 2024; 87(2): 189-95. https://dx.doi.org/10.1097/JCMA.0000000000001012

补充文件

附件文件
动作
1. JATS XML
下载
2. Figure. Assessment of sleep quality in patients from different groups during the study

下载 (68KB)
索引源数据

版权所有 © Bionika Media, 2025