Менопауза: вверх по лестнице, ведущей вниз

Postmenopause is an important stage in physiological aging of women, which is associated with a whole complex of vegetative-vascular, mental, and metabolic-endocrine disorders that develop against the background of the ovarian failure and general age-related involution of the body. While there are general mechanisms of development, the clinical symptoms of postmenopause are quite individual and their severity depends not only on endocrine changes, but also on the external factors (living conditions, health status, social functioning and subjective perception of aging). The review describes the most typical symptoms of the menopausal transition: vasomotor (hot flashes and excessive sweating), urogenital (vaginal dryness, dyspareunia, dysuria), psychoemotional (irritation, unfounded aggression, sleep disturbances), cognitive disorders (memory loss, concentration problems). The management of postmenopausal symptoms is important and should be carried out using hormone replacement therapy. The combined drugs containing 17p-estradiol and drospirenone have proved to be effective in reducing menopausal symptoms and safe in use, therefore they can be the drugs of choice to treat menopausal symptoms. The multicentre post-marketing study showed that the long-term use of low-dose E2 and DRSP in postmenopausal women significantly improved menopausal symptoms in 86% of respondents. In addition to prescribing pathogenetic therapy, an important aspect of specialized medical care provided to women in the peri- and postmenopausal period is the need to raise their awareness of the menopause problems, change their attitude to their own health, manage menopausal symptoms and improve the quality of life.