Modern view on the management of patients with genitourinary menopausal syndrome

Cover Page

Cite item

Full Text

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

Abstract

Today, the problem of menopausal syndrome (MS) remains relevant for many reasons: increased life expectancy, active social life in a given period of time, decreased quality of life, including physical health, emotional well-being and social aspects. Modern medicine offers new methods of treating and supporting women during menopause, which increases interest in studying and improving the management of menopausal syndrome (MS). MS and genitourinary menopausal syndrome (GUMS) are closely related, because both are a consequence of a decrease in estrogen levels in a woman’s body during menopause. GUMS refers to symptoms that affect the genital area, urinary tract, and bladder. Problems such as vaginal dryness, discomfort during sexual intercourse, frequent urination and recurring urinary infections develop. The most significant urological problem is urinary incontinence, which has not only medical but also social significance and negatively affects the quality of life. The most effective drug therapy for GUMS in women is local estrogen therapy in combination with combined oral menopausal hormone therapy (MHT). Replenishing the deficiency of vitamins and elements involved in metabolic processes is of great importance. Metabolic therapy can be considered not only as an alternative treatment, but also as an additional therapy while taking MHT drugs, which significantly improves the results of treatment. In order to eliminate the symptoms of an overactive bladder, it is possible to prescribe trospium chloride (Spazmex®), taking into account contraindications.

Full Text

Restricted Access

About the authors

Irina Y. Ilyina

Pirogov Russian National Research Medical University

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

Dr. Sci. (Med.)

Russian Federation, Moscow

References

  1. Шулукян З.Е., Целкович Л.С., Балтер Р.Б. и др. Характер клинических проявлений климактерического синдрома и композиционного состава тела у женщин с менопаузальным метаболическим синдромом. Медицинский совет. 2021;13:170–75. [Shulukyan Z.E., Celkovich L.S., Balter R.B., et al. The nature of clinical manifestations of menopausal syndrome and body composition in women with menopausal metabolic syndrome. Meditsinskii sovet. 2021;13:170–5. (In Russ.)].
  2. Козлов П.В., Доброхотова Ю.Э., Ильина И.Ю. Современные подходы к медикаментозной коррекции генитоуринарного менопаузального синдрома. Лечебное дело. 2021;2:585–64. [Kozlov P.V., Dobrohotova Yu.E., Il’ina I.Yu. Modern approaches to the drug correction of genitourinary menopausal syndrome. Lechebnoe delo. 2021;2:585–64. (In Russ.)].
  3. Менопауза и климактерическое состояние у женщины. Клинические рекомендации. 2021. [Menopause and menopausal condition in women. Clin. Recommend. 2021. (In Russ.)].
  4. Михельсон А.А., Лазукина М.В., Мелкозеро- ва О.А., Полянин Д.В. Трехкомпонентная локальная терапия генитоуринарного менопаузального синдрома у женщин с хирургической коррекцией пролапса гениталий. Российский вестник акушера-гинеколога. 2019:19(2):76–82. [Mihel’son A.A., Lazukina M.V., Melkozerova O.A., Polyanin D.V. Three-component local therapy of genitourinary menopausal syndrome in women with surgical correction of genital prolapse. Rossiiskii vestnik akushera-ginekologa=Rus Bull Obstet-Gynecol. 2019:19(2):76–82. (In Russ.)].
  5. Ripperda C.M., Maldonado P.A., Acevedo J.F., et al. Vaginal estrogen: a dual-edged sword in postoperative healing of the vaginal wall. Menopause. 2017;24:7:838–49. doi: 10.1097/GME.0000000000000840.
  6. Лукьянова Д.М., Смольнова Т.Ю., Адамян Л.В. Современные молекулярно-генетические и биохимические предикторы генитального пролапса (обзор литературы). Проблемы репродукции. 2016;4:8–12. [Lukyanova D.M., Smol´nova T.Yu., Adamyan L.V. Modern molecular-genetic and biochemical predicators of genital prolapse (review of literature). Problemy reproduktsii. 2016;4:8–12. (In Russ.)]. Doi: 10.17116/ repro20162248-12.
  7. Cruz V.L., Steiner M.L., Pompei L.M., et al. Randomized, doubleblind, 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. 2017;25:1:21–8. doi: 10.1097/GME.0000000000000955.
  8. Setty P., Redekal L., Warren M.P. Vaginal estrogen use and effects on quality of life and urogenital morbidity in postmenopausal women after publication of the Womens Health initiative in NewYork City. Menopause. 2016;23:1:7–10. doi: 10.1097/GME. 0000000000000493.
  9. Менопаузальная гормональная терапия и здоровье женщины: мнение специалистов. По материалам конференции «Гормоны и женщина. Возрастные аспекты МГТ». Гинекология. 2018;20(6):9–15. [Menopausal hormone therapy and women’s health: the opinion of experts. Based on the materials of the conference «Hormones and a woman. Age-related aspects of MGT». Gynecology. 2018;20(6):9–15. (In Russ.)].
  10. Ильина И.Ю. Климактерический синдром: возможности метаболической терапии. Акушерство и гинекология. 2022;6:163–8. [Il’ina I.Yu. Menopausal syndrome: possibilities of metabolic therapy. Akusherstvo i ginekologiya=Obstet Gynecol. 2022;6:163–68. (In Russ.)].
  11. The 2017 hormone therapy position statement of The North American Menopause Society NAMS. Menopause: J North Am Menopause Soc. 2017;24(7):728–53. Doi: 10.1097 /GME.0000000000000921. Available at: https://www.menopause.org/docs/ default-source/2017/nams-2017-hormonetherapy-position-statement.pdf.
  12. Ильина И.Ю., Доброхотова Ю.Э., Наримано- ва М.Р. и др. Недержание мочи: методы лечения. Гинекология. 2018;20(1):92–5. [Il’ina I.Yu., Dobrohotova Yu.E., Narimanova M.R., et al. Urinary incontinence: treatment methods. Gynecology. 2018;20(1):92–5. (In Russ.)].
  13. Недержание мочи. Клинические рекомендации. М., 2020. [Urinary incontinence. Clinical guidelines. M., 2020. (In Russ.)].
  14. Мазо Е.Б., Школьников М.Е., Кривобородов Г.Г. Гиперактивный мочевой пузырь у больных пожилого возраста. Consilium Medicum. 2006;8(12):97–101. [Mazo E.B., Shkol’ni- kov M.E., Krivoborodov G.G. Overactive bladder in elderly patients. Consilium Medicum. 2006;8(12):97–101. (In Russ.)].
  15. Борисов В.В. Гиперактивный мочевой пузырь: эффективное лечение. Consilium Medicum. 2014;16(7):22–8. [Borisov V.V. Overactive Bladder: Effective Treatment. Consilium Medicum. 2014;16(7):22–8. (In Russ.)].
  16. Протасова А.Э., Юренева С.В., Байрамов Н.Н., Компедина В.И. Менопауза, ожирение и коморбидность: возможности менопаузальной гормональной терапии. Акушерство и гинекология. 2019;5:43–8. [Protasova A.E., Yureneva S.V., Bajramov N.N., Kompedina V.I. Menopause, obesity and comorbidity: the possibilities of menopausal hormone therapy. Akusherstvo i ginekologiya=Obstet Gynecol. 2019;5:43–8. (In Russ.)]. doi: 10.18565/aig.2019.5.43-487.
  17. Андреева Е.Н., Шереметьева Е.В. Психические аспекты и нарушение жирового обмена в климактерии. Акушерство и гинекология. 2019;9:165–72. [Andreeva E.N., Sheremet’eva E.V. Mental aspects and violation of fat metabolism in menopause. Akusherstvo i ginekologiya=Obstet Gynecol. 2019;9:165–72. (In Russ.)].
  18. Nudy M., Chichilli V.M., Foy A.J. A systematic review and meta-regression analysis to examine the ‘timing hypothesis’ of hormone replacement therapy on mortality, coronary heart disease, and stroke. IJC. Heart & Vasculature. 2019;22:123–31.
  19. Бериханова Р.Р., Миненко И.А. Возможности комплексных нелекарственных программ в коррекции психоэмоциональных климактерических расстройств у пациенток с метаболическим синдромом. Вопросы курортологии, физиотерапии и лечебной физической культуры. 2019;96(3):50–9. [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=Quest Balneol Physiother Ther Phys Cult. 2019;96(3):50–9. (In Russ.)].
  20. Ильина И.Ю., Доброхотова Ю.Э. Роль окислительного стресса в развитии гинекологических заболеваний. Акушерство и гинекология. 2021;2:150–57. [Il’ina I.Yu., Dobrohotova Yu.E. The role of oxidative stress in the development of gynecological diseases. Akusherstvo i ginekologiya=Obstet Gynecol. 2021;2:150–57. (In Russ.)].
  21. Балан В.Е., Ковалева Л.А., Рафаэлян И.В. Роль негормональной терапии в лечении симптомов климактерического синдрома. Вопросы гинекологии, акушерства и перинатологии. 2012;12(5):67–71. [Balan V.E., Kovaleva L.A., Rafaelyan I.V. The role of non-hormonal therapy in the treatment of symptoms of menopausal syndrome. Voprosy ginekologii, akusherstva i perinatologii. 2012;12(5):67–71. (In Russ.)].
  22. Якушевская О.В. Возможности применения фитоэстрогенов в терапии климактерического синдрома. Медицинский совет. 2020;13:99–104. [Yakushevskaya O.V. The possibilities of using phytoestrogens in the treatment of menopausal syndrome. Meditsinskii sovet. 2020;13:99–104. (In Russ.)].
  23. Леваков С.А., Кедрова А.Г., Ванке Н.С. и др. Применение витаминов и минералов для уменьшения симптомов менопаузы после овариэктомии у женщин позднего репродуктивного возраста. Клиническая практика. 2011;3(7):34–40. [Levakov S.A., Kedrova A.G., Vanke N.S., et al. The use of vitamins and minerals to reduce the symptoms of menopause after ovariectomy in women of late reproductive age. Klinicheskaya praktika=Clin Pract. 2011;3(7):34–40. (In Russ.)].
  24. Бериханова Р.Р., Миненко И.А. Негормональная коррекция климактерических расстройств у пациенток с метаболическим синдромом. Вестник новых медицинских технологий. 2015;2:25. [Berihanova R.R., Minenko I.A. Non-hormonal correction of menopausal disorders in patients with metabolic syndrome. Vestnik novykh meditsinskikh tekhnologii=Bull New Med Technol. 2015;2:25. ё(In Russ.)].
  25. Ventura M., Melo M., Carrilho F. Selenium and thyroid disease: from pathophysiology to treatment. Int. J. Endocrinol. 2017; 3:1–9.
  26. Садыкова Г.К., Олина А.А. Роль дефицита селена в развитии дисфункции щитовидной железы во время беременности (обзор литературы). Медицинская наука и образование Урала. 2020;21–4(104):159–63. [Sadykova G.K., Olina A.A. The role of selenium deficiency in the development of thyroid dysfunction during pregnancy (literature review). Meditsinskaya nauka i obrazovanie Urala=Med Sci Educat Urals. 2020;21–4(104):159–63. (In Russ.)].
  27. Razavi M., Jamilian M., Fakhrieh Kashan Z., et al. Selenium supplementation and the effects on reproductive outcomes, biomarkers of inflammation, and oxidative stress in women with polycystic ovary syndrome. Horm Metab Res. 2016;48(3):185–90. doi: 10.1055/s-0035-1559604.
  28. Кузнецова И.В. Возможности негормональной коррекции нарушений менструального цикла. Медицинский совет. 2019;13:16–27. [Kuznecova I.V. The possibilities of non-hormonal correction of menstrual disorders. Meditsinskii sovet. 2019;13:16–27 (In Russ.)].
  29. Kingsberg S.A., Krychman M., Graham S., et al. The Women’s EMPOWER Survey: identifying women’s perceptions on vulvar and vaginal atrophy and its treatment. J Sex Med. 2017;14:413–24.
  30. Briggs P. Genitourinary syndrome of menopause. Post Reprod Health. 2019;23:41–4. doi: 10.1177/2053369119884144.
  31. Griebling T.L., Liao Z., Smith P.G. Systemic and topical hormone therapies reduce vaginal innervation density in postmenopausal women. Menopause. 2012;19:630–35.
  32. Zilio Rech C.M., Clapauch R., Bouskela E. Sexual function under adequate estrogen therapy in women after oophorectomy versus natural menopause. J Womens Health. 2019;28(8):1124–32.
  33. Taylor H.S., Tal A., Pal L., et al. Effects of oral vs transdermal estrogen therapy on sexual function in early postmenopause: ancillary study of the Kronos Early Estrogen Prevention Study (KEEPS). JAMA. Intern Med. 2017;177(10):1471–79.
  34. Mei Z., Hu H., Zou Y., Li D. The role of vitamin D in menopausal women’s health. Front Physiol. 2023;14:1211896. Doi: 10.3389/ fphys.2023.1211896.
  35. Ромих В.В. Гиперактивный мочевой пузырь: на перекрестке урологии и гинекологии. Гинекология. 2007;9(4):34–7. [Romikh V.V. Overactive bladder: at the crossroads of urology and gynecology. Gynecology. 2007;9(4):34–7. (In Russ.)].
  36. Garzon S., Apostolopoulos V., Stojanovska L., et al. Non-oestrogenic modalities to reverse urogenital aging. Prz Menopauzalny. 2021;20(3):140–47. doi: 10.5114/pm.2021.109772.
  37. Куликов И.А., Аполихина И.А., Геворкян Г.А. Фототермическая реконструкция тканей и применение фитоэстрогенов в лечении генитоуринарного менопаузального синдрома. Медицинский совет. 2024;18(4):156–67. [Kulikov I.A., Apolihina I.A., Gevorkyan G.A. Photothermal tissue reconstruction and the use of phytoestrogens in the treatment of genitourinary menopausal syndrome. Meditsinskii sovet. 2024;18(4):156–67. (In Russ.)].
  38. Доброхотова Ю.Э., Ильина И.Ю., Венедикто- ва М.Г. и др. Локальная негормональная терапия больных с генитоуринарным менопаузальным синдромом. Российский вестник акушера-гинеколога. 2018;18(3):88–94. [Dobrokhotova Yu.E., Ilyina I.Yu., Venediktova M.G., et al. Local nonhormonal therapy in patients with genitourinary menopausal syndrome. Rossiiskii vestnik akushera-ginekologa=Rus Bull Obstet-Gynecol. 2018;18(3):88–94 (In Russ.)]. doi: 10.17116/rosakush201818388-94.
  39. American College of Obstetricians and Gynecologists. Female sexual dysfunction. Practice Bulletin No. 213. Obstet Gynecol. 2019;134(1).

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2024 Bionika Media

This website uses cookies

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

About Cookies