Development of di(2‐ethylhexyl) phthalate‐containing thioglycolic acid immobilized chitosan mucoadhesive gel as an alternative hormone therapy for menopausal syndrome

Physiological loss of ovarian function during the menopausal transition often leads to the development of unfavorable symptoms associated with vulvovaginal atrophy, recurrent urinary tract infections and dyspareunia. Currently, the scientific community is actively discussing the risks and benefits of prescribing menopausal hormone therapy to relieve the consequences of estrogen deficiency. The study of vaginal microbiota in dynamics made it possible to take a deeper look at the development of genitourinary menopausal syndrome and associate several microorganisms with specific undesirable manifestations. The link between recurrent urinary tract infections during menopause and physiological replacement of microbiota by opportunistic flora with the development of unpleasant symptoms resolves doctors to resort to irrational courses of antibiotic therapy. The review is devoted to the generalization of information on microbiological changes in the vagina during perimenopause, the possibilities of choosing the optimal hormone therapy for the correction of symptoms, the use of new promising methods, including management by modulating the vaginal microbiota.

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The effects of menopausal hormone therapy on proinflammatory cytokines and immunoglobulins in perimenopausal patients with type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD)

Terapevticheskii arkhiv ◽

10.26442/terarkh201890104-83 ◽

2018 ◽

Vol 90 (10) ◽

pp. 79-83

Author(s):

A S Panevina ◽

N S Smetneva ◽

A M Vasilenko ◽

M V Shestakova

Keyword(s):

Blood Serum ◽

Hormone Therapy ◽

Proinflammatory Cytokines ◽

Lavage Fluid ◽

Menopausal Hormone Therapy ◽

Chronic Obstructive ◽

Menopausal Syndrome ◽

Obstructive Pulmonary Disease ◽

Tnf Α

Aim. To determine the effects of menopausal hormone therapy dosage on levels of proinflammatory cytokines and immunoglobulins in bodily fluids of patients with type 2 diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) during perimenopause. Materials and methods. The study included 119 perimenopausal females with moderate type 2 DM and stable COPD with signs of menopausal syndrome. Cytokine levels in bronchoalveolar lavage fluid and blood serum were measured with flow cytofluorometry (Вeckman Coulter FC500, USA) using a multiplex kit for human cytokines (BMS810FF) in adherence to the manufacturer’s instructions. The lower limit of quantification was 2.5-52.7 pg/mL. The following cytokines were studied: IL-1β, IL-6, IL-8, TNF-α and IF-γ. The data was analyzed with Flow CytomixProver 3.0 manufacturer-licensed software package. IgМ, IgG and IgА in the blood serum (Vektor-Best, Russia) were detected using an immunoenzymatic assay (Stat Fax 3200Analyzer, Awareness Technology, USA). Menopausal hormone therapy (MHT) with 17 beta-estradiol/dydrogesterone (standard - 2 mg, low - 1 mg, ultralow - 0.5 mg): 0.5/2.5 (estradiol 0.5 mg/dydrogesterone 2.5 mg) - ultralow-dose MHT, 1/10 (estradiol 1 mg/dydrogesterone 10 mg) - low-dose MHT; 2/10 (estradiol 2 mg/dydrogesterone 10 mg) - standard-dose MHT. Саrbohydrate metabolism was assessed in three groups. Results and discussion. While 2/10 MHT yielded the most prominent decrease in IL-1β, IL-6, IL-8, TNF-α and IF-γ levels in bronchoalveolar lavage fluid and blood serum, the effect was statistically insignificant compared to 0.5/2.5 and 1/10 MHT. Initially decreased IgM, IgG and IgA levels were elevated in all the three dosage groups with no significant differences between them. As to carbohydrate metabolism target values of glycemia were achieved in all three groups taking MHT. Conclusion. Standard-, low - and ultralow-dose MHT has positive effects on levels of proinflammatory cytokines and immunoglobulins characteristic of the association between type 2 DM, COPD and menopausal syndrome. The differences between the three dosage groups were statistically insignificant. Different dosage of MHT with dydrogesterone provide for improving impaired carbohydrate metabolism.

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Opportunities for prevention and correction of genitourinary menopausal syndrome

GYNECOLOGY ◽

10.26442/2079-5696_2018.2.18-22 ◽

2018 ◽

Vol 20 (2) ◽

pp. 18-22 ◽

Cited By ~ 1

Author(s):

I S Zakharov

Keyword(s):

Bone Mass ◽

Hormone Therapy ◽

Clinical Efficacy ◽

Menopausal Hormone Therapy ◽

Low Risk ◽

Menopausal Syndrome ◽

Leading Role ◽

Number Of Publications ◽

Condition Of Women ◽

Positive Effect

In the manifestation and development of urogenital atrophic processes associated with the onset of menopause, the leading role is played by the growing deficiency of estrogens. An important circumstance is the fact that genitourinar menopausal disorders are often accompanied by other climacteric disorders. In this regard, a key place in the prevention and correction of hypoestrogenic conditions is systemic menopausal hormone therapy. Among the representatives of systemic menopausal hormone therapy, clinical efficacy and low risk of possible complications were demonstrated by preparations containing 17b-estradiol in combination with drospirenone. In the literature there is a significant number of publications reflecting the positive effect of these drugs on the condition of women with vasomotor, psychoemotional climacteric disorders, with a decrease in bone mass. Also, these drugs are used in the therapy and prevention of atrophic processes of the urogenital tract. This allows us to apply this combination of hormones in the complex correction of systemic and local genitourinary menopausal disorders.

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TOFISOPAM: PROSPECTS FOR NON-HORMONAL THERAPY OF NEURO-VEGETATIVE AND PSYCHO-EMOTIONAL DISORDERS ASSOCIATED WITH MENOPAUSAL SYNDROME

Medical Council ◽

10.21518/2079-701x-2017-2-88-91 ◽

2017 ◽

pp. 88-91 ◽

Cited By ~ 1

Author(s):

Y. E. Dobrokhotova ◽

L. V. Saprykina

Keyword(s):

Hormone Therapy ◽

Emotional Disorders ◽

Hormonal Therapy ◽

Hormonal Treatment ◽

Climacteric Syndrome ◽

Efficacy And Safety ◽

Review Of Literature ◽

Menopausal Syndrome ◽

Number Of Factors ◽

Perimenopausal Women

Despite the proven effect of menopausal hormone therapy on menopausal syndrome, a number of factors prevent perimenopausal women from receiving the treatment. The article is a review of literature on the possibility of non-hormonal treatment with tofisopam for neuro-vegetative and psycho-emotional disorders associated with climacteric syndrome. The article tells about the efficacy and safety of the drug taking into account its pharmacodynamic properties.

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Efficiency of Menopausal Hormone Therapy in Women with Menopausal Syndrome

Doctor Ru ◽

10.31550/1727-2378-2020-19-1-38-41 ◽

2020 ◽

Vol 19 (1) ◽

pp. 38-41

Author(s):

E.A. Vinokurova ◽

◽

I.E. Gorodnicheva ◽

M.A. Kiseleva ◽

◽

...

Keyword(s):

Hormone Therapy ◽

Menopausal Hormone Therapy ◽

Menopausal Syndrome

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Survey-based evaluation of the awareness of pharmaceutical specialists on the pharmacotherapy of climacteric syndrome

PHARMACOECONOMICS Modern pharmacoeconomics and pharmacoepidemiology ◽

10.17749/2070-4909/farmakoekonomika.2021.031 ◽

2021 ◽

Vol 14 (2) ◽

pp. 225-233

Author(s):

M. A. Chernyavskaya ◽

I. A. Narkevich

Keyword(s):

Hormone Therapy ◽

Medical Information ◽

Personal Characteristics ◽

Cardiovascular Effects ◽

Menopausal Hormone Therapy ◽

Climacteric Syndrome ◽

Menopausal Syndrome ◽

Survey Results ◽

Important Intermediate ◽

The Difference

Objective: to evaluate the awareness of pharmaceutical specialists on the pharmacotherapy of climacteric syndrome based on survey results.Material and methods. The authors analyzed 394 surveys of pharmaceutical specialists in Saint-Petersburg. The survey consisted of 13 questions, covered the personal characteristics of the participants (age, education, professional experience) and their knowledge about special medicines and food supplements to control climacteric symptoms, indications, and contraindications.Results. The results showed that pharmaceutical specialists saw the difference between combined oral contraceptives and menopausal hormone therapy, but they do not know about the protective cardiovascular effects of menopausal hormone therapy. Most specialists consider menopausal hormone therapy more effective than phytoestrogens, but they have no idea how it works. For most of them, there is hardly any difference between various classes of phytoestrogens. In their opinion, medical representatives and scientific conferences are the main providers of medical information.Conclusion. The analysis of the level of awareness of pharmaceutical specialists about the pharmacotherapy of menopausal syndrome based on the results of the survey revealed insufficient knowledge among pharmacy workers on a number of fundamental issues. Therefore, it is necessary to develop methodological recommendations on menopausal hormone therapy preparations and phytoestrogens-based drugs for pharmaceutical specialists who act as an important intermediate between a doctor and a patient.

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Possible ways to correct severe forms of climacteric syndrome in women with endometriosis

HEALTH OF WOMAN ◽

10.15574/hw.2018.132.96 ◽

2018 ◽

pp. 96-101

Author(s):

N.F. Zakharenko ◽

◽

N.V. Kovalenko ◽

I.N. Retunska ◽

◽

...

Keyword(s):

Hormone Therapy ◽

Therapy Group ◽

Elimination Rate ◽

Reproductive Function ◽

Clinical Effectiveness ◽

Menopausal Hormone Therapy ◽

Climacteric Syndrome ◽

Menopausal Syndrome ◽

Short Period ◽

Transdermal Estrogen

Modern demographic changes in society are accompanied by an increase of women of the older age group in the general population. During this age period, along with the elimination of reproductive function in women, a complex of pathological symptoms often develops – climacteric syndrome (CS), which displays the maladaptation of various organs and systems that have estrogen receptors. An extremely topical problem of climacteric syndrome is for patients with endometriosis whose quantity is about 50% of the population. The objective: the determination of the effectiveness of the complex of medical therapy developed by us in women with severe forms of COP in the context of endometriosis. Materials and methods. Within 3 months we actively observed 60 women with an endometriosis in the anamnesis and manifestations of severe CS. By randomization, the women were divided into 2 groups depending on the chosen therapy: group 1 consisted of 30 women who, taking into account the above mentioned advantages, received the transdermal estrogen Estrogel, group 2 – 30 patients, whom a therapy by estrogen, phenibut and mebicar was assigned. Patients of both groups were given an intrauterine system with levonorgestrel. In order to conduct a comparative assessment of the clinical effectiveness of various treatment methods, the integral pathology index (IPI) was used in dynamics – before treatment, after 1, 2 and 3 months of therapy. The improvement degree (ID) of the disease clinical picture was also determined. Statistical analysis of the data was carried out on a personal computer using the programs SPSS 2000 (SPSSInc., USA) and Exel 2000 (MicrosoftInc., USA). Results. Our analysis found that as a result of the therapy received, a significant improvement in the scores was observed among patients of both subgroups. During the first two months, the effectiveness of combining menopausal hormone therapy with anti-stress medications in women with severe CS was almost 2 times greater than monotherapy with menopausal hormone therapy (Coefficient of Efficacy 1 = 2.68, Coefficient of Efficacy 2 = 1.62), indicating a faster elimination rate of CS’ symptoms using this combination. The overall effectiveness of the combination of phenybut with mebikar against the background of the use of Estrogel with an intrauterine system with levonorgestrel was 1.41 times higher compared to effectiveness of Estrogel and the levonorgestrel intrauterine system only use. Conclusion. Administration of anti-stress drugs Fenibut&Mebikar combination along with use of menopausal hormone therapy allows to reduce quickly the severity of CS manifestations, especially psychoemotional disorders almost to their full elimination in a relatively short period of time. The proposed scheme of treatment helps to eliminate quickly the symptoms of menopausal syndrome in women with endometriosis, improve and stabilize their psychological profile, restore working capacity, improve adaptation and quality of life. Key words: climacteric syndrome, endometriosis, anti-stress therapy, phenibut, mebicar, transdermal estrogen, Estrogel, intrauterine system with levonorgestrel.

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Efficacy and Safety of Acupuncture Vs. Hormone Therapy for Menopausal Syndrome: A Systematic Review and Meta-Analysis

The American Journal of Chinese Medicine ◽

10.1142/s0192415x21500853 ◽

2021 ◽

pp. 1-20

Author(s):

Qi-Da He ◽

Zheng-Hong Zhong ◽

Meng-Nan Liu ◽

Zi-Yan Tong ◽

Qi-Biao Wu ◽

...

Keyword(s):

Side Effects ◽

Hormone Therapy ◽

Meta Analysis ◽

Effective Rate ◽

Current Evidence ◽

Efficacy And Safety ◽

Menopausal Syndrome ◽

Pharmaceutical Therapy ◽

Kupperman Index ◽

Gynecological Disorder

Menopausal syndrome (MPS) is a common gynecological disorder around the time of menopause, and hormone therapy (HT) is the first-line treatment for it. However, HT is prone to cause adverse reactions in MPS patients treated with HT. Acupuncture is a popular non-pharmaceutical therapy for MPS, but the differences in the efficacy and safety between acupuncture and HT remain unclear. The purpose of this evidence-based study is to address this issue. Five databases were searched for potentially eligible RCTs. All RCTs comparing acupuncture with HT in the treatment of MPS were included in this study. The clinical effective rate was the primary outcome. Kupperman index, serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E[Formula: see text], and side effects were the secondary outcomes. A total of 15 RCTs recruiting 1376 MPS patients were included. Results of meta-analysis showed that compared with HT, acupuncture significantly improved clinical effective rate (RR = 1.09, 95% CI 1.03 to 1.16, [Formula: see text] = 0.005), decreased the Kupperman index (WMD = −2.55, 95% CI = −2.93 to −2.17, [Formula: see text] < 0.00001) and the incidence of side effects (RR = 0.14, 95% CI = 0.06–0.32, [Formula: see text] < 0.00001). There were no statistically significant differences in serum FSH (WMD = −1.36, 95% CI = −3.25–0.53, [Formula: see text] = 0.16), E2(WMD = −1.11, 95% CI = −2.59–0.37, [Formula: see text] = 0.14), or LH (WMD = −1.87, 95% CI = −4.58–0.83, [Formula: see text] = 0.17) between the acupuncture and HT groups. Based on the current evidence, manual acupuncture is safer and more effective than HT and is recommended for the treatment of MPS, but the evidence for the efficacy of other types of acupuncture is inconclusive.

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