Method of treating climacteric and urogenital disorders in women in postmenopause at background of hypothyroidism

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to gynaecology, and can be used for the treatment of urogenital disorders at the background of hypothyroidism in women in postmanopause. The method consists in the application of local hormonal therapy. Depending on a degree of expression of clinical symptoms in the determination of the Modified Menopausal Index (MMI) and the Vaginal Health Index (VHI) in case of a mild degree of severity an intake of the medication Estrocard is administered vaginally in a dose of 1 suppository per night for 3 weeks, then 1 suppository per week for a year. In case of a severe degree an intake of the medication Angelic is administered with an additional daily intake of the medication Estrocard in the form of vaginal suppositories for 3 weeks continuously. Then, 1 suppository per week is prescribed for 12 months with administration of a daily intake of 50 mg of L-thyroxine.

EFFECT: method ensures the elimination of clinical manifestations of a urogenital disorder, normalisation.

1 ex

 

The invention relates to medicine, namely to obstetrics and gynecology. Climacteric period attribute symptoms that affect most body systems, and the most manifest its clinical manifestations is called "menopausal syndrome" (COP) or according to foreign literature "menopausal syndrome", including vasomotor, metabolic-endocrine and emotional disorders (Tikhomirov A. L., 2003; Tumilovich L. G., 2009). About 50% of women suffer from severe, and each third from medium current COP (Basson R., 2006).

The second largest after the KS problem are post-menopausal urogenital disorders (PEM) is growing due to oestrogen deficiency complex vaginal and urinary symptoms associated with the development of atrophic and dystrophic processes in estrogenozawisimah tissues and structures of the lower third of the urinary tract (Gal E. C., 2007; Serov, C. N., 2010; Barlow D. H., 1997). According to statistics, 55-60 years almost every second woman is suffering from symptoms of symptoms of PEM, and after 75-80 years are unlikely to find a woman without those or other symptoms of PEM (Tikhomirov E. C., 2006).

Post-menopause is often characterized by the exacerbation of existing and emergence of new endocrine diseases (Petunia N. A., 2007; Stratford G. A., 2000; Yen, S. C., 1999). Some of these & the krinō diseases are diseases of the thyroid gland. Hypothyroidism is the most common manifestation of iodine deficiency diseases in areas of severe endemic, and, according to literature data, it is more affected women aged 40 to 60 years (Dedov I. I., 2004; Melnichenko, A., 2005; Bashmakov N. In., 2008). In this regard, an interesting question for the clarification of the relationships in postmenopausal women between climacteric and urogenital disorders and thyroid gland in norm and at a pathology of thyroid status under conditions of relative iodine deficiency.

To analogues of the offer as the invention of the method include: work Halonen Kaya, Lauri Kangas, DeGregorio Michael C. "a Method for the treatment of menopausal disorders in women during or after menopause" (patent RU 2268035), Rajabova W. W., Omarova C.-M. A., Melnichenko, A., Abusiva S. A. "prevention of hypothyroidism in pregnant women" (patent RU 2414891)

CRITICISM ANALOGS

The drawbacks include the lack of a differentiated approach to therapy depending on the clinical manifestations and laboratory parameters.

The PROTOTYPE INVENTIONS

As a prototype we have taken the way authors Halonen Kaya, Lauri Kangas, DeGregorio Michael C. "a Method for the treatment of menopausal disorders in women during or after menopause" (patent RU 2268035). To ensure dryness was enclosed the schA and sexual dysfunction in women during or after menopause enter (diaminophenoxy)toremifene, or its salts or esters in the range of doses from 25 to 100 mg per day oral or transdermal. The method provides effective treatment of vaginal dryness and sexual dysfunction, with resistance to other types of hormonal therapy due to multicomponent effects on the pathogenesis of the disease.

CRITICISM PROTOTYPE

The drawbacks include the lack of a differentiated approach to therapy depending on the clinical manifestations and laboratory parameters.

The PURPOSE of the INVENTION

The aim of the invention is to increase the effectiveness of the treatment of women with climacteric and urogenital disorders and normalization of thyroid function in postmenopausal women, the provision of a differentiated approach to the treatment depending on the severity of clinical manifestations and laboratory parameters.

The INVENTION

The essence of the invention consists in the following. Patients women with climacteric and urogenital disorders define a Modified Menopausal Index (MMI), on the basis of indicators which define the severity of these manifestations. Appoint combined hormone therapy drugs system (angelic - 1 mg of estradiol and 2 mg of drospirenone) and local (Astrocat - estriol 500 mg) actions connected with the eating of the drug thyroid hormone (L-thyroxine (levothyroxine 50 mg).

In light of the severity of menopausal syndrome appoint continuous oral administration of the drug angelic within 12 months, with moderate and severe degrees of severity to the drug angelic add a daily intake of the drug Astrokid in the form of vaginal suppositories for 3 weeks at a time, then 1 suppository per week for 12 months. If it is accompanied by hypothyroidism - L-thyroxine 50 mg daily under the control of the hormonal spectrum of blood every 3 months.

A SPECIFIC EXAMPLE of the METHOD

Patient A., 58 years old, came in Municipal women's clinic №4, Makhachkala with a diagnosis of "post-menopause. Atrophic vaginitis. Hypothyroidism". Was defined MMI patient. Detected status - mild degree of urogenital disorders. Appointment of the drug Astrocat vaginally on 1 suppository for the night for 3 weeks, then 1 suppository per week during the year. Given the concomitant hypofunction of the thyroid gland, prescribed daily dose of 50 mg of L-thyroxine. After 3 months of therapy positive dynamics is the elimination of the clinical manifestations of the disease. The patient took smears on flora and Cytology at the beginning of treatment and after 3, 6 and 12 months. The patient's condition was satisfactory, no complaints, disease recurrence is not marked.

Patient Magomedov H. W., 62 th is and, appealed to the Municipal women's clinic №4, Makhachkala with a diagnosis of "post-menopause. Climacteric syndrome". Was defined MMI patient. Detected status - average degree of menopausal syndrome. When moderate prescribe medication angelic and additionally daily intake of the drug Astrokid in the form of vaginal suppositories for 3 weeks at a time, then 1 suppository per week for 12 months. Control definition MMG has allowed to define a positive trend in the condition of the patient. Treatment results: the improvement of health, the patient was able earlier to go to work, the treatment time was reduced to 7 days.

Patient Ibragimov M,, 54 years old, appealed to the Municipal women's clinic №4, Makhachkala with a diagnosis of "post-menopause. Atrophic zestoretic severe. Hypothyroidism". Was defined MMI and Vaginal Health Index (Ives), the patient. Detected status - severe urogenital disorders. Prescribed drug angelic and additionally daily intake of the drug Astrokid in the form of vaginal suppositories for 3 weeks at a time, then 1 suppositories per week for 12 months. Given the concomitant hypofunction of the thyroid gland assigned to a daily intake of 50 mg of L-thyroxine.

In this patient after 6 months the yli eliminated severe symptoms of atrophic zestoretic, and after 12 months they wore only a light character. Given that this disease is very long, heavy, chronic in nature, the results obtained from the proposed method of treatment, can be considered the most effective.

The features of the INVENTION, the DISTINCTIVE features of the PROTOTYPE

The proposed method of treatment differs from the prototype method differentiated approach depending on the presence or absence of hypofunction of the thyroid gland and the severity of clinical manifestations, depending on the severity of clinical symptoms (MMI and Ives) prescribe the drug angelic and additionally daily intake of the drug Astrokid in the form of vaginal suppositories for 3 weeks at a time, then 1 suppository per week for 12 months, and considering the accompanying hypofunction of the thyroid gland, prescribed daily dose of 50 mg of L-thyroxine. In the prototype method is prescribed for the treatment of vaginal dryness and sexual dysfunction in women during or after menopause enter (diaminophenoxy) toremifene, or its salts or esters in the range of doses from 25 to 100 mg per day oral or transdermal.

The POSITIVE EFFECT FROM the use of INVENTIONS

The positive effect of the application of differential treatment of menopausal and urogenital disorders on the background of the GUI is Teresa and without him is to eliminate their heavy and moderate clinical manifestations, normalization of laboratory parameters (hormonal, lipid spectrum of blood, Cytology smear and others).

Sources of information

Radjabov W. W., lobster, S.-M. A., Melnichenko, A., Abuses S. A. "prevention of hypothyroidism in pregnant women" (patent RU 2414891).

Halonen Kaya, Lauri Kangas, DeGregorio Michael C. "a Method for the treatment of menopausal disorders in women during or after menopause" (patent RU 2268035) prototype.

A method of treating urogenital disorders in the face of hypothyroidism in postmenopausal women, including using local hormone therapy, however, depending on the severity of clinical symptoms in the determination of the Modified Menopausal Index (MMI) and Vaginal Health Index (Ives) with mild severity prescribe the drug Astrocat vaginally on 1 suppository for the night for 3 weeks, then 1 suppository per week during the year, when severe prescribe the drug angelic and additionally carry out daily intake of the drug Astrokid in the form of vaginal suppositories for 3 weeks continuously, then 1 suppository per week for 12 months and is prescribed a daily dose of 50 mg of L-thyroxine.



 

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