Shcherbina I. Clinical and pathogenetic approaches to diagnostics, treatments and prophylaxises of perimenopausal disorders.

Work is devoted to determination of features of pathogenesis of perimenopausal disorders depended on immunological, hormonal status, state of urodinamical, neurovegetative, psychoemotional and musculoskeletal systems, genetic and morphological changes, and development of the scientifically-grounded approaches to early complex diagnostics and differentiated medical tactic directed on the improvement of qualities of life of woman. On the base of complex examination of 315 women with the different forms of perimenopausal disorders, the scale of new criteria of heaviness of perimenopausal disorders were developed. It is proved that perimenopausal disorders arise up on a background the decline of general reactivity of organism, damage of mechanisms of cellular and humoral immunoregulation, that predefined by disfunction of the immune system. Increase in five-seven times the level of proinflammation cytocins is typical to neurovegetative, psychoemotional disorders. Development of urogenital disorders is connected with decline of antimicrobial immunity and damade of in the phagocytosis system. Metabolic disorders, which are the maine symptomps of metabolic syndrome, show up the increase of low-density lipoproteins, triglycerids, general cholesterol and leptyn. In addition, a metabolic syndrome is associated with disfunction of thymus and active products of ovarial аuto antibodies. Perimenopausal disorders are accompanied by damage products of monoamines and maintenance of melatonyne. It was confirm serotonin and dopamine disfunction and disorganization of immunoregulation system. Also there is activating of processes lipid peroxidation on a background the decline of activity of the antioxidant system. Perimenopausal disorders and his clinical variants have a genetic sense. Tactic of the differentiated treatment of perimenopausal disorders were working with the account of their pathogenetic features. Stable clinical effects were the results of including immunocorrection in medical complex in comparison with traditional therapy.