Vaginal end cervicalchanges in postmеnopause on the background of use of different doses of systemic mnopausal hormonal therapy
DOI: 10.22138/2500-0918-2018-15-4-530-539
Т.А. Oboskalova, M.V. Koval
Ural State Medical University, Yekaterinburg, Russian Federation
Abstract. In order to assess the state of the vaginal and cervical epithelium, a prospective cohort study of 180 patients with menopausal syndrome was performed in women in early postmenopausal women with systemic menopausal hormone therapy (SMGT) at various dosages. There are 3 groups, depending on the dosage and the use of menopausal hormone therapy. Patients of group 1 (n = 60) were prescribed a low-dose preparation of estradiol 1 mg / drospirenone 2 mg, 2 groups (n = 60), an ultra-low-dose preparation of estradiol 0.5 mg / drospirenone 0.25 mg was prescribed. Patients of group 3 (n = 60) refused to receive SMGT, they did not use homeopathic and herbal products containing phytoestrogens. Clinical and anamnestic examination with assessment of vasomotor symptoms (Green scale) and genitourinary symptoms (counting of vaginal health indices, maturation of vaginal epithelium, cytological examination of cervical epithelium, bacterioscopy of vaginal smears, video-colposcopy) was performed. Comparisons were carried out at 3 and 9 months of hormone therapy. It was revealed that moderate-to-moderate menopausal disorders effectively stopped in the background of SMGT, regardless of the dosage of the drug. In the epithelium of the vagina and cervix, against the background of treatment, atrophic changes significantly regained, epithelial proliferation and normal biocenosis were restored. The absence of MGT negatively affected the state of the cervical and vaginal epithelium, contributing to the progression of atrophy, the appearance of abnormal cytological and colposcopic patterns. It is concluded that SMGT, along with effective relief of vasomotor symptoms, improves the condition of the vaginal mucosa and cervix for 9 months of use. Moreover, positive dynamics was observed after 3 months against a low-dose drug, a similar therapeutic effect with the use of ultra-low-dose was achieved not earlier than 9 months of therapy.
Keywords: menopausal hormone therapy, genitourineral syndrome, urogenital atrophy
Received 17.05.2018
For citation:
Oboskalova T.A., Koval M.V. Vaginal end cervicalchanges in postmеnopause on the background of use of different doses of systemic mnopausal hormonal therapy. Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2018, Vol. 15, no. 4, pp. 530–539. DOI: 10.22138/2500-0918-2018-15-4-530-539 (In Russ)
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Authors
Tat'yana A. Oboskalova
Ural State Medical University
Dr. Sci. (Med.), Professor, Head of the Department of Obstetrics and Gynecology
Russian Federation, 620028, Yekaterinburg, ul. Repina 3
oboskalova.tat@yandex.ru
Marina V. Koval
«MFC» Rubin «, city of Kamensk-Uralsky
Obstetrician-gynecologist
Post-graduate student of the third year of the Department of Obstetrics and Gynecology
Ural State Medical University
Russian Federation, 623400, Sverdlovskaya oblast, Kamensk-Ural'skij, ul. Kamenskaya 25
marinakoval1203@gmail.com
