Kovalenko N. Peculiarities of clinics, diagnostics and treatment of Climacteric syndrome of women with endometriosis.

The work aims to increase the effectiveness of treatment of Climacteric syndrome of women with endometriosis by developing differentiated measures for its correction, prevention of early development, and improving the quality of life of this contingent of women. To identify the frequency of climacteric syndrome patients with endometriosis, a prospective survey (from 2004) of 1055 late-reproductive and premenopausal women aged 39 to 55 years was conducted, including 520 patients with endometriosis (main group) and 535 – without endometriosis (comparison group). Аt the next stage of the study, 323 women aged 39 to 55 years were examined, of which 170 patients with endometriosis and 153 women – without this pathology. Subsequently, the patients were divided into groups depending on the presence or absence of Climacteric syndrome (CS): I group consisted of 106 patients with endometriosis and CS, IInd group – 64 women with endometriosis without symptoms of CS, IIId group – 83 patients without endometriosis with appearance of CS, IVth group – 70 women without endometriosis and symptoms of CS. In this work a clinical and statistical analysis of patients’ data was performed, the structure, peculiarities of clinical appearance of CS of women with endometriosis and the peculiarities of the clinical course of endometriosis of women with perimenopause, as well as the characteristics of hormone homeostasis were studied. The risk factors for the development of severe forms of CS in women with endometriosis were determined and a mathematical model for its prediction was developed. Based on the revealed features, the principles of a differentiated approach to the treatment of women with different degrees of severity of climacteric syndrome of women with endometriosis have been developed and substantiated. Thus, in the presence of symptoms of CS of light and medium severity in the context of endometriosis, the expediency of simultaneous use of antistress and detoxification drugs together with the vitamin and mineral complex, which increases the effectiveness of therapy in 2,38 times compared with the administration of drugs only anti-strains orientation proved. Women with severe manifestations of CS on the background of endometriosis, the prescription of MGT in the form of a combination of transdermal estrogen and intrauterine system with levonorgestrel along with the use of antistress drugs, allows almost twice the effectiveness of taking hormone therapy, which indicates a faster rate of elimination of CS symptoms when using developed medical complex.