Hormonal, metabolic and clinical manifestations of the climacteric syndrome as a marker of ecological trouble in the region

In the early 90s, academician E.K. Ailamazyan formulated the main provisions of general ecological reproductive science and the concept arising from them, according to which indicators of the reproductive function of women can act as criteria for assessing the ecological situation in the region. In 1995, an employee of the Institute of Obstetrics and Gynecology. D.O. Ott.

Sleep quality and its relationship with climacteric symptoms and quality of life in women on menopausal transition

Background: Climacteric syndrome, occurring during menopausal transition, plays a key role in the alteration of women's quality of life. Aims: This study investigated the relationship between perimenopausal symptoms, sleep quality, quality of life, and food behavior in women on menopausal transition in western Algeria. Subjects and Methods: The study included 131 perimenopausal women (Mean age = 48 ± 3 years). The climacteric syndrome and quality of life were assessed by the menopause rating scale (MRS) questionnaire. The quality of sleep was evaluated by the Pittsburgh sleep quality index (PSQI) and food consumption by the 24h recall method. Results: The mean score of psychological (9.63 ± 2.93) and somatic (10.74 ± 3.43) symptoms were significantly higher (p= 0.000) and the total score of MRS was 24 ± 6, which means that women have an impaired quality of life. A high significance (p= 0.000) was also noted in subscales scores of sleep components; sleep disturbances (1.69± 0.62), subjective sleep quality (1.55± 0.93), and sleep latency (1.40 ± 1.23), compared to other sleep components. Poor sleep quality was explained by a high score of PSQI (8 ± 4). The MRS subscale scores showed a significant correlation with total PSQI score (r =0.600, p=0.01). A positive energy balance was also recorded with a high protein (13% of TEI) and polyunsaturated fatty acids intake (33%) and low lipids (23% of TEI), monounsaturated fatty acids (41%), and animal protein intake (26%). Conclusions: Perimenopause is a difficult period in a woman's life, disrupting her quality of life and sleep quality leading to disturbances in eating behavior and body weight gain. Keywords: Climacteric symptoms, menopausal transition, quality of life, sleep quality, food behavior.

Can fibromyalgia be considered a characteristic symptom of climacterium?

Fibromyalgia syndrome (FMS) is a chronic pain syndrome, characterised by diffuse pain in musculoskeletal system and accompanied by stiffness, fatigue, tender points, sleep disturbances and cognitive and gastrointestinal symptoms. It affects middle-aged women (between 40 and 65) predominantly. Climacteric syndrome, which is characterised by vasomotor, somatic (headache, sleep disorders, myalgia and arthralgia) and psychical (mood changes) symptoms, results from the change in brain neurotransmitter concentrations due to gradual decline of ovarian hormone levels. Currently, studies focus on the similarities of FMS and climacteric syndrome in terms of age of occurrence, epidemiology, etiopathogenesis, symptomatology and treatment. Hormonal fluctuation during menopausal transition is likely the triggering factor for both syndromes. Therefore, hormone replacement therapy is a favourable approach in the treatment of FMS due to the antiallodynic, anti-inflammatory and neuroprotective effect of oestrogen. In this review, we emphasise the similarity of FMS and climacteric syndrome and suggested that FMS could be considered as a characteristic symptom of climacterium.

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

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.

Search of ways to menopausal hormonal therapy and correction of bacterial vaginosis against the climacteric syndrome

Study objective: optimization of the treatment of climacteric syndrome (CS) and improvement of the life quality in women with bacterial vaginosis (BV) during menopause. Materials and methods. 58 women with natural menopause were examined, 38 of whom were diagnosed with BV. To correct the CS patient used the drug 17β-estradiol Divigel transdermal in combination with micronized progesterone orally. Patients with BV were divided into 2 subgroups: 15 women received standard treatment with metronidazole gel (comparison subgroup), 23 women additionally used Lactagel (main subgroup). The control group included 20 patients with CS without BV. The severity of CS was assessed with MRS scale. Microscopic and bacteriological examination of vaginal discharge was performed to determine the infectious agent, and the species composition of pathogens was determined with a polymerase chain reaction. BV was diagnosed according to Amsel criteria. CQLS questionnaire was used to assess the quality of life of patients with BV. The treatment effectiveness was assessed after 1 and 3 months from the start of treatment.Results. Divigel in women with uterus in combination with oral micronized progesterone has shown high efficiency in the CS correction within a month from the start of treatment. The most significant was the decrease in neurovegetative and psychoemotional symptoms after 3 months from the start of treatment. Lactagel in the therapy of patients with BV on the background of CS allowed increasing the lactobacilli content to the value in patients without BV, restoring the normal vaginal biotope and preventing of the disease recurrence, in contrast to the subgroup of patients who received standard treatment. Lactagel made it possible to improve the life quality of patients to an average level and to increase the overall level of life satisfaction, in contrast to the subgroup with standard treatment where these levels have remained low.Conclusions. Developed approaches to menopausal hormone therapy and BV therapy against the background of natural menopause allows optimizing treatment, improving the life quality of patients, which allows recommending them for widespread use in clinical practice.