Early administration of menopausal hormone-replacement therapy as prevention of clinical manifestations of pre- and menopause
Patients and methods. A total of 90 women aged 45–55 years were examined in connection with hot flashes and irregularities in the menstrual cycle of various types. The functional state of the ovaries and the ovarian reserve using endocrine markers were studied.
Results. The effectiveness of using the complex of endocrine markers “inhibin B, FSH and AMG" for predicting possible menopausal disorders has been revealed. Functional status of ovaries significantly differs in women with vegetative disorders that subsequently develop and without them (p < 0.05). The level of FSH more than 23 mIU/ml, determined for 2 years before menopause, predicts the occurrence of climacteric disorders with a specificity of 62% and a sensitivity of 54%. The ovarian reserve, determined by the amount of AMG and inhibin B, is a more accurate prognostic sign of the development/absence of vasomotor manifestations in the following 2 years: a decrease in AMG to 0.4 ± 0.02 ng/ml, and inhibin B to 26.3 ± 3, 2 pg/ml indicates a pathological course of premenopause with a sensitivity of 85% and a specificity of 66%. The state of the vascular wall in patients with vasomotor disorders at pre-menopausal age is characterized by a tendency to increase (p > 0.05) in the speed of pulse wave propagation in the carotid-femoral segment (on average, 8.1 ± 0.5 m / s versus 7.9 ± 0.8 m/s in women without such). The mineral density of bone tissue is comparable to normal values with a marked tendency to decrease in patients with vasomotor disorders (–0.16 ± 0.09 and 0.44 ± 0.08 in L1–L4 and –0.90 ± 0.07 and 0.35 ± 0.09 in the femoral neck, respectively) with significant (p < 0.05) differences in comparison with women without such.
Сonclusion. The effectiveness of the prophylactic use of MHT in premenopausal patients was evaluated and justified. Appointment of Femoston 1/10 patients with a high risk of development of vasomotor manifestations of menopausal syndrome at pre-menopausal age can effectively effect the prevention of vasomotor manifestations of menopausal syndrome in 96% of patients, contributes to a decrease in MMI from 26,0 ± 2,64 to 9,0 ± 0,93 (p < 0.05), improvement of the quality of life from 41.4 to 21.4 on the NHP scale (p < 0.05).
Key words: menopause, inhibin B, follicle-stimulating hormone, antimulylerov hormone, climacteric disorders, femostone.
For citation: Kotikova N.P. Early administration of menopausal hormone-replacement therapy as prevention of clinical manifestations of pre- and menopause. Vopr. dietol. (Nutrition). 2017; 7(3): 28–32. (In Russian).