scholarly journals Uterine fibroids in premenopausal women

2019 ◽  
pp. 123-128
Author(s):  
Yu. E. Dobrokhotova ◽  
I. Yu. Ilina

Uterine fibroids are one of the commonest benign pelvic tumours with an estimated incidence of 20–40% in women during their reproductive years. Incidence rates for uterine fibroid diagnoses were highest in premenopausal age. The gynecologists are frequently faced with need for the administration of menopausal hormone therapy (MHT) in this group of patients with the onset of symptoms associated with estrogen deficiency; however, uterine fibroids represent a relative contraindication for the administration of MHT. In the present paper, we point out the need for conservative therapy of uterine fibroids in premenopausal patients to prepare for the administration of MHT. The paper reflects the efficacy of the drug treatment of uterine fibroids using antigestagens (gynestril).

2020 ◽  
pp. 26-30
Author(s):  
L. V. Tkachenko ◽  
N. I. Sviridova

The period of the menopausal transition from 40–45 years to menopause – is the crucial period of a woman’s life, in which, against the background of increasing estrogen deficiency, in addition to the appearance of vasomotor, psychological, and urogenital symptoms, complications and exacerbations of accumulated extagenital diseases occur. The loss of the natural balance of sex hormones leads to hyperplastic processes in hormone-dependent tissues, which leads to cancer risks. In solving this problem, menopausal hormone therapy (MHT) can play a crucial role, but this will become possible if, when choosing drugs for MHT, preference will be given to the safest dosage forms that provide the whole spectrum of compensatory reactions, including the prevention of dramatic situations of this age.


2019 ◽  
Vol 17 (6) ◽  
pp. 465-473 ◽  
Author(s):  
Jan J. Stepan ◽  
Hana Hruskova ◽  
Miloslav Kverka

Abstract Purpose of Review The goal of the review is to assess the appropriateness of menopausal hormone therapy (MHT) for the primary prevention of bone loss in women at elevated risk in the early years after menopause. Recent Findings Estrogen alone or combined with progestin to protect the uterus from cancer significantly reduces the risk of osteoporosis-related fractures. MHT increases type 1 collagen production and osteoblast survival and maintains the equilibrium between bone resorption and bone formation by modulating osteoblast/osteocyte and T cell regulation of osteoclasts. Estrogens have positive effects on muscle and cartilage. Estrogen, but not antiresorptive therapies, can attenuate the inflammatory bone-microenvironment associated with estrogen deficiency. However, already on second year of administration, MHT is associated with excess breast cancer risk, increasing steadily with duration of use. Summary MHT should be considered in women with premature estrogen deficiency and increased risk of bone loss and osteoporotic fractures. However, MHT use for the prevention of bone loss is hindered by increase in breast cancer risk even in women younger than 60 years old or who are within 10 years of menopause onset.


ASJ. ◽  
2021 ◽  
Vol 1 (56) ◽  
pp. 28-33
Author(s):  
O. Kalinkina ◽  
Yu. Tezikov ◽  
I. Lipatov

87 patients aged 40-69 years in the period of pre- and postmenopause were examined. In the analysis of age-related dynamics of bone mineral density (BMD) It was found that densitometry indicators corresponding to osteoporosis directly correlate with age and duration of the postmenopausal period. It is advisable in women of this age group with a decrease in bone mineral density, the combined appointment of menopausal hormone therapy (MGT) and non-hormonal therapy affecting bone metabolism (calcitonin). For the purpose of MGT in premenopausal women, the use of femostone 2/10 is effective, in postmenopausal women - femostone 1/10 and femostone 1/5, which does not cause withdrawal bleeding. If there are contraindications to menopausal hormone therapy, the prevention and treatment of osteoporosis should be guided by the appointment of nonhormonal drugs, in particular, calcitonin.


2019 ◽  
Vol 23 (3) ◽  
pp. 458-464
Author(s):  
O. O. Efimenko

In modern conditions, the peak of professional activity of many women falls precisely during the period of perimenopause. Therefore, maintaining physical fitness, beauty, health, sexuality, femininity, learning ability, self-improvement and interest in life is very important during this period. Menopausal hormone therapy (MHT) is prescribed for the prevention and elimination of menopausal disorders. It is very important to differentiate the selection of IHT, taking into account the state of health of the woman and the study of concomitant pathology, as well as the modes of its appointment. An individualized approach to the administration of MHT will help to maximize its therapeutic and prophylactic potential, reducing the number of adverse reactions and complications. The aim is to examine the relationship between anamnestic data (obstetric and gynecological and somatic status) and the risk of complications from menopausal hormone therapy. The authors conducted a survey on a specially designed questionnaire of 178 perimenopausal women: had some complications on the background of its use and 80 women of the same age who had no complications from MHT — the control group. During the study, the chances of the occurrence of a particular pathology in women were calculated on the background of taking MHT in the presence of various diseases. It was found that in patients with a history of PMS, DMZ, migraine, unstable blood pressure, overweight, gynecological diseases, namely inflammatory diseases, uterine fibroids, endometriosis, varicose veins, swelling, transmitted diseases the risk of developing complications from MHT is much higher than that in healthy women, which allows them to be put at risk. These complications can be minimized by choosing the optimal treatment regimen, and the benefits of using it can be maximized by taking into account the relationships found. Taking into account the identified links between the studied factors will prevent complications from the use of MHT in each individual woman at the stage of MHT selection and will allow to isolate such patients in the risk group of development or will allow to predict the occurrence of one or another disease depending on the presence of a disease.


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 42-47
Author(s):  
O V Yakushevskaya ◽  
S V Yureneva ◽  
A E Protasova ◽  
G N Khabas ◽  
M R Dumanovskaya

The aim of the work is to conduct a systematic analysis of the available research results on the possibility of using menopausal hormone therapy (MHT) in patients who successfully completed the treatment of endometrial cancer (EC). Materials and methods. The review includes data from foreign articles published in PubMed and Medline, and domestic works published on elibrary.ru over the past 40 years. Results. The results obtained allow us to consider MHT as an independent method of medical rehabilitation for women who have undergone EC. A clear patient profile should be established, allowing the use of this method, with strict adherence to health monitoring. Conclusion Patients who have successfully completed the treatment of EC require the creation of special rehabilitation conditions in the interests of maintaining health and quality of life and should be under the close attention of the doctor. Argumented approaches to the appointment of MHT in such patients will avoid complications associated with estrogen deficiency after surgery, radiation with or without systemic (cytostatic) treatment methods.


GYNECOLOGY ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 50-54
Author(s):  
Zukhra Kh. Ebzieva ◽  
Svetlana V. Yureneva ◽  
Tatiana Yu. Ivanets

Aim. To conduct a comparative analysis of serum orexin A levels in women of different age periods with and without sleep disorder and vasomotor symptoms. To evaluate the dynamics of orexin A levels under menopausal hormone therapy. Materials and methods. The study included 50 postmenopausal women and 30 women of reproductive age with a regular menstrual cycle. Using block randomization, patients are divided into 3 groups: group 1 (main group), n=25, -STRAW+ 10 (+1b and +1c), patients with sleep disorder and vasomotor symptoms; group 2 (comparison group), n=25, STRAW+ 10 (+1b and +1c), patients with vasomotor symptoms without sleep disorder; group 3 (control group), n=30, STRAW+ 10 (-4), women of reproductive age without sleep disorder. Group 1 patients were given menopausal hormone therapy. A comparative analysis was carried out using the questionnaire for assessing menopausal symptoms severity by the Greene Scale (the Greene Climacteric Scale) and Rating Scale for subjective sleep characteristics. After 12 weeks of treatment, a control examination was performed. Results. In group 1 women, the serum orexin A levels were significantly higher compared to the women without the symptoms. The link between the orexin A levels and menopause syndrome severity was established. A significant decrease in the menopausal symptoms severity after 12 weeks of menopausal hormone therapy was shown. It was accompanied by a 1,3-fold decrease in orexin A levels. Conclusions. The obtained data indicate the possible role of orexin A and the orexin neuropeptide system in the pathogenesis of sleep disorder and vasomotor symptoms in postmenopausal women.


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