Antoniuk K. Peculiarities of perimenopausal period in women with extragenital pathology and correction of violations.

The dissertation presents a theoretical generalization and a new solution to the scientific problem of modern gynecology, which is to increase the effectiveness of treatment of menopausal disorders in women with extragenital pathology by substantiating, developing and implementing a personalized preventive and therapeutic complex based on the study of clinical and paraclinical, mountainous, reproductive system during menopausal transition. The pathophysiological relationship between vitamin D deficiency and extragenital pathology in perimenopausal women has been studied. It was found that climacteric syndrome of varying severity develops in 73.4 % of patients aged 40 to 55 years. Existing data on extragenital pathology, which is found in 57.9 % of perimenopausal women: the most common are diseases of the cardiovascular system (40.0 %), gastrointestinal tract (28.8 %), varicose veins of the lower extremities (23.8 %), endocrine pathology (20.0 %) in the presence of one patient with more than 2 diseases. Among women with climacteric syndrome, women with overweight (53.0 %) and obesity I-II predominate (40.5 %). Extragenital pathology and obesity in perimenopausal women increase the risk of severe menopausal syndrome - RR=5.305 (95 % CI 2.425-11.603, NNT 2.246) and RR=1.394 (95 % CI 1.088-1.786; NNT 4.646), respectively. In 62.8 % of women with EGP, the onset of menopausal symptoms precedes the average age of menopause in Ukraine by an average of 5.5±2.9 years. A direct strong (p<0.00001) relationship between MC disorders in 39-41 years and early menopause (?=0.742,) was proved, while the relative risk of early menopause in this category of patients is RR=2.198, 95 % CI 0.474-10.192; NNT 22.544. It was found that the level of gonadotropic and sex steroid hormones in perimenopause correlates with the nature of MC disorders (?=0.967, p<0.00001), and the level of AMG, which is considered a marker of menopause in the next four years, is probably reduced in women with menopausal symptoms and extragenital diseases (0.82±0.06 ng/ml) (p<0.00001 compared with controls) at 1.05±0.23 ng/ml in patients of group II (p=0.0015 compared with controls).