Sokol I. New aspects of pathogenesis and evaluation of the effectiveness of treatment of women with climacteric syndrome in perimenopause

The dissertation is devoted to the study of the features of the course of perimenopause in women with climacteric syndrome in order to increase the efficiency of diagnosis and treatment based on the improvement and implementation of the algorithm of diagnostic and therapeutic and preventive measures. A woman spends a third of her life in menopause. Perimenopause is a transitional period of a woman's life with a large fluctuation of sex hormones. Known diagnostic methods consist of a complex of instrumental and laboratory research methods, and the examination of immunological markers is also important. Therefore, the introduction of new diagnostic methods would help in a differential approach to the treatment of climacteric syndrome in perimenopausal women. The purpose of this work is to increase the effectiveness of diagnosis and treatment of climacteric syndrome in women in perimenopause based on the improvement and implementation of the algorithm of diagnostic and therapeutic and preventive measures. Objectives of the study: 1.To study the frequency and features of the clinical course of climacteric syndrome in perimenopausal women. 2.To establish the main factors of climacteric syndrome in women in perimenopause. 3.To determine the main features of the diagnosis of climacteric syndrome in women in perimenopause. 4.Analyze and provide an estimate of the level of anti-HSP60 antibodies during the treatment of climacteric syndrome. 5.To improve and evaluate the effectiveness of the differential approach and to develop an algorithm regarding the management tactics of women in perimenopause against the background of various variants of the course of the climacteric syndrome. Following the purpose of the study and to solve the tasks, the work was performed in 4 stages. At the first stage, involved conducting a prospective study of the anamnestic and clinical laboratory data of 158 patients with climacteric syndrome in perimenopause who underwent examination and treatment. To determine the effectiveness of treatment of climacteric syndrome in perimenopausal women, 158 patients were involved. All patients were divided into 2 groups: - 1-st group (main group) consisted of 80 patients (average age – 50 years), who agreed to treatment and received it according to the standard scheme (combined treatment in cyclic mode (estrogens (17β- estradiol) + progestogens (dydrogesterone)); - group 2 (comparison group) consisted of 78 women (average age - 50.5 years) who refused treatment due to estrogen deficiency. At the second stage of the study, the selection for the treatment of patients was carried out, which included: analysis of clinical and anamnestic characteristics and analysis of laboratory and instrumental studies. According to the goals and objectives, patients were included according to the inclusion/exclusion criteria. Criteria for inclusion in the study: women who had the first climacteric symptoms (menstrual cycle change, symptoms of estrogen deficiency) up to two years after the last, independent menstruation and age from 45 to 53 years. Exclusion criteria from the study: patients with extragenital pathology (diseases of the cardiovascular system, blood coagulation disorders, viral hepatitis, neurological disorders, oncological diseases, etc.).