Particularities of clinic and treatments of postovarioectomic syndrome

Abstract

The particularities of the current postovarioectomic syndrome (POES) studied in 32 women after the total ovariectomy in transitional age (after 45 years) on the background of preserved cycle. The syndrome frequency has formed 78% (25 women). Distinctive was a faster development in the comparison with the age menopause as early, so late climacteric disorders. In the structure of first prevailed the vegetative symptoms: hot flushes - 100%, profuse sweating - 64%, headache - 24%, palpitations - 32% of women.

Full Text

The particularities of the current postovarioectomic syndrome (POES) studied in 32 women after the total ovariectomy in transitional age (after 45 years) on the background of preserved cycle. The syndrome frequency has formed 78% (25 women). Distinctive was a faster development in the comparison with the age menopause as early, so late climacteric disorders. In the structure of first prevailed the vegetative symptoms: hot flushes - 100%, profuse sweating - 64%, headache - 24%, palpitations - 32% of women. Postoperative hypertension is developed in 36%, hypotension - 12%, sympathoadrenal crises - in 8% of patients. The frequency of psychic symptoms was in 2,2 times above (72%), then under the age menopause. Amongst them is prevailing the asthenic syndrome (32%). The depressive state has formed 8%, the reduction of libido - 20% of cases. In the large part of patients (64%) the syndrome is developed during 1 month after operation, in 16% - during following 2-4 months. The patients dominated in the structure POES with heavy and average degree of gravity of syndrome - 56%. The elevated frequency and gravity of early climacteric disorders under POES is, at our glance, the result of unreconstruction of neurohypothalamic centres after the acute switching off the gonads function, as well as disadvantage premorbidity background, based on the heavy gynecological pathology and connected with her operative interference. There noted that faster development and late postmenopausal disorders. Symptoms of dryness in the vagina, itching, dyspareunia, dysuric disorders after 1st post operating year presented 12%, after 2nd - already 60% of women. Atrophic vaginitis revealed in 52%, urethral syndrome - 28%, arthralgia and myalgia - in 20% of patients. Gain of mass after operation over 10 kg is was noted in 24% of patients. As a whole somatotropic symptoms after 2 years post operation are revealed in 72% of women. The quick development of such tissue processes wholly explicable by the progressive deficit of sexual steroids on the background of the total removing of gonads. The acute deficit of estrogens in the organism witnesses by colpocytology. The index of maturation varied from 40/60/0 to 20/70/10. Similar factors should be taken in account for selecting corrective HRT in this contingent of patients. The best results of treatments of early climacteric disorders under POES are reached by using the facilities of HRT with the greater gestogen component, potentiating the therapeutic effect of estrogens. The prophylaxis of late disorders in patients with the hysterectomy could be conducted by the isolated using of estrogens.