Symptoms of menopausal disorders during perimenopause (review article)

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The menopausal transition is an important period in a woman’s life, which is characterized not only by the irregularity of the menstrual cycle, but also by vasomotor manifestations, sleep disturbances, mood lability, depressive disorders, and initial manifestations of urogenital disorders. All of the above manifestations increase as the estrogen deficiency progresses. The use of menopausal hormone therapy (MHT) is the main pathogenetically substantiated method of treating manifestations of estrogen deficiency. However, when prescribing MHT, it is important to take into account all contraindications and the risks of developing complications against its background. Therefore, there is a need to select alternative methods for eliminating the symptoms of menopausal syndrome. In this case, metabolic therapy may be recommended as an additional method of treatment. In the presence of manifestations of an overactive bladder, the first-line drugs are M-cholinolytics. When choosing a drug from this group, it is important to take into account the features of its pharmacological action, the presence of concomitant pathology in the patient, the possibility of interaction with other drugs, the risks of side effects. In our opinion, trospium chloride meets all the requirements and can be recommended.

Full Text

Restricted Access

About the authors

Irina Yu. Ilyina

Pirogov Russian National Research Medical University

Author for correspondence.
Email: iliyina@mail.ru
ORCID iD: 0000-0001-8155-8775

Dr. Sci. (Med.), Professor at the Department of Obstetrics and Gynecology, Faculty of Medicine

Russian Federation, Moscow

References

  1. Menopause and menopausal condition in women. Clinical recommendations. 2021. (In Russ.).
  2. Miheev R.K., Grigoryan O.R., SHeremet’eva E.V., et al. Active longevity of a woman: the telomerase theory of aging at the heart of the management of the menopausal period. Voprosy ginekologii, akusherstva i perinatologii. 2022;21(3):116–21. (In Russ.).
  3. Smetnik V.P. Medicine menopause. M., 2006. 848 р. (In Russ.).
  4. Takahashi T.A., Johnson K.M. Menopause. Med Clin North Am. 2015;99(3):521–34. doi: 10.1016/j.mcna.2015.01.006.
  5. Santoro N., Epperson C.N., Mathews S.B. Menopausal Symptoms and Their Management. Endocrinol. Metab. Clin. North Am. 2015;44(3):497–515. doi: 10.1016/j.ecl.2015.05.001.
  6. Natcher W.H. NIH State-of-the-Science Conference on Management of Menopause-Related Symptoms Sponsored by: National Institutes of Health. Heal. 2005;3(118):1–172.
  7. Il’ina I.Yu., Dobrohotova Yu.E. The role of oxidative stress in the development of gynecological diseases. Akusherstvo i ginekologiya=Obstet Gynecol. 2021;2:150–54. (In Russ.).
  8. Park S.K., Harlow S.D., Zheng H., et al. Association between changes in oestradiol and follicle-stimulating hormone levels during the menopausal transition and risk of diabetes. Diab Med. 2017;34(4):531–38. doi: 10.1111/dme.13301.
  9. Celkovich L.S., SHulukyan Z.E., Balter R.B. et al. Features of endocrine regulation in women with menopausal metabolic syndrome. Rossiiskii vestnik akushera-ginekologa. 2022;22(2):25–31. (In Russ.).
  10. Ko S.H., Jung Y. Energy Metabolism Changes and Dysregulated Lipid Metabolism in Postmenopausal Women. Nutrients. 2021;13(12):4556. doi: 10.3390/nu13124556.
  11. Shalina M.A. Metabolic syndrome in older women. Zhurnal akusherstva i zhenskikh boleznei. 2019;68(3):81–8. (In Russ.). doi: 10.17816/JOWD68381-88.
  12. Kozlov P.V., Dobrohotova Yu.E., Il’ina I.Yu. Modern approaches to drug correction of genitourinary menopausal syndrome. Lechebnoe delo. 2021;2:58–64. (In Russ.).
  13. Palma F., Volpe A., Villa P., Cagnacci A. Writing group of AGATA study. Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: The AGATA study. Maturitas 2016;83:40–4. doi: 10.1016/j.maturitas.2015.09.001.
  14. NAMS position statement. The 2020 genitourinary syndrome of menopause position statement of The North American Menopause SocietyMenopause: The Journal of The North American Menopause Society Vol. 27; 9: 976-992. doi: 10.1097/GME.0000000000001609.
  15. Shifren J.L., Zincavage R., Cho E.L., et al. Women’s experience of vulvovaginal symptoms associated with menopause. Menopause. 2018;26:41–349. doi: 10.1097/GME.0000000000001275.
  16. Yureneva S.V. Risk optimization of MGT: monotherapy with transdermal estrogens or in combination with micronized progesterone. Benefits in relation to venous thromboembolism and breast cancer. Akusherstvo i ginekologiya=Obstet Gynecol. 2015;5:19–25. (In Russ.).
  17. Anagnostis P., Paschou S.A., Katsiki N., et al. Menopausal Hormone Therapy and Cardiovascular Risk: Where are we Now? Curr Vasc Pharmacol. 2019;17(6):564–72. doi: 10.2174/1570161116666180709095348.
  18. Berihanova R.R., Minenko I.A. The possibilities of complex non-drug programs in the correction of psychoemotional climacteric disorders in patients with metabolic syndrome. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul’tury. 2019;96(3):50–9. (In Russ.).
  19. Dabrowska-Galas M., Dabrowska J., Ptaszkowski K., Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Med. (Kaunas). 2019;55(8):466. doi: 10.3390/medicina55080466.
  20. Johnson A., Roberts L., Elkins G. Complementary and Alternative Medicine for Menopause. J Evid Based Integr Med. 2019;24: 2515690X19829380. doi: 10.1177/2515690X19829380.
  21. Ozcan H., Сolak P., Oturgan B., Gulsever E. Complementary and alternative treatment methods for menopausal hot flashes used in Turkey. Afr Health Sci. 2019;19(4): 3001–8. doi: 10.4314/ahs.v19i4.21.
  22. Maghalian M., Hasanzadeh R., Mirghafourvand M. The effect of oral vitamin E and omega-3 alone and in combination on menopausal hot flushes: A systematic review and meta-analysis. Post Reprod. Health. 2022;28(2):93–106. doi: 10.1177/20533691221083196.
  23. Farshbaf-Khalili A., Ostadrahimi A., Mirghafourvand M., et al. Clinical Efficacy of Curcumin and Vitamin E on Inflammatory-Oxidative Stress Biomarkers and Primary Symptoms of Menopause in Healthy Postmenopausal Women: A Triple-Blind Randomized Controlled Trial. J Nutr Metab. 2022;2022:6339715. doi: 10.1155/2022/6339715.
  24. Lloret A., Esteve D., Monllor P., et al. The Effectiveness of Vitamin E Treatment in Alzheimer’s Disease. Int J Mol Sci. 2019;20(4):879. doi: 10.3390/ijms20040879.
  25. Miyazawa T., Burdeos G.C., Itaya M., et al. Vitamin E: Regulatory Redox Interactions. IUBMB Life. 2019;71(4): 430–41. doi: 10.1002/iub.2008.
  26. Vallibhakara S.A., Nakpalat K., Sophonsritsuk A., et al. Effect of Vitamin E Supplement on Bone Turnover Markers in Postmenopausal Osteopenic Women: A Double-Blind, Randomized, Placebo-Controlled Trial. Nutrients. 2021;13(12):4226. doi: 10.3390/nu13124226.
  27. Wu C.C., Wang C.K., Yang A.M., et al. Selenium status is independently related to bone mineral density, FRAX score, and bone fracture history: NHANES, 2013 to 2014. Bone. 2021;143:115631. doi: 10.1016/j.bone.2020.115631.
  28. Perez Fernandez M.R., Martinez Lede I., Failde Garrido J.M., et al. Effects of the intake of dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids in a sample of postmenopausal women with metabolic syndrome: a randomized, triple-blind, placebo-controlled clinical trial. Nutr Hosp. 2021;38(5):983–92. doi: 10.20960/nh.03613.
  29. Bizerea T.O., Dezsi S.G., Marginean O., et al. The Link Between Selenium, Oxidative Stress and Pregnancy Induced Hypertensive Disorders. Clin Lab. 2018;64(10):1593–610. doi: 10.7754/Clin.Lab.2018.180307.
  30. Olechnowicz J., Tinkov A., Skalny A., Suliburska J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci. 2018;68(1):19–31. doi: 10.1007/s12576-017-0571-7.
  31. Pitsouni E., Grigoriadis T., Douskos A., et al. Efficacy of vaginal therapies alternative to vaginal estrogens on sexual function and orgasm of menopausal women: a systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2018;229:45–56. doi: 10.1016/j.ejogrb. 2018.08.008.
  32. Briggs P. Genitourinary syndrome of menopause. Post Reprod Health. 2019;23:41–4. doi: 10.1177/2053369119884144.
  33. Hill D.A., Crider M., Hill S.R. Hormone Therapy and Other Treatments for Symptoms of Menopause. Am Fam Physician. 2016;94(11):884–89.
  34. Maseroli E., Cellai I., Corno C., et al. Study of the anti-inflammatory effects of dihydrotestosterone in human vaginal smooth muscle cells. Endocr Abstr. 2019;63:1123.
  35. Rosa V.L., Ciebiera M., Lin LT., et al. Treatment of genitourinary syndrome of menopause: the potential effects of intravaginal ultralow-concentration oestriol and intravaginal dehydroepiandrosterone on quality of life and sexual function. Prz Menopauzalny. 2019;18(2):116–22. doi: 10.5114/pm.2019.86836.
  36. Urinary incontinence. Clinical recommendations. 2020. (In Russ.).
  37. Il’ina I.Yu., Dobrohotova Yu.E., Narimanova M.R., et al. Urinary incontinence: methods of treatment. Gynekologiya=Gynecol. 2018;20(1):92–5. (In Russ.). doi: 10.26442/ 2079-5696_20.1.92-95.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies