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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">akusherstvo</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics, Gynecology and Reproduction</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство, Гинекология и Репродукция</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7347</issn><issn pub-type="epub">2500-3194</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2313-7347/ob.gyn.rep.2020.173</article-id><article-id custom-type="elpub" pub-id-type="custom">akusherstvo-781</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW ARTICLES</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НАУЧНЫЕ ОБЗОРЫ</subject></subj-group></article-categories><title-group><article-title>Early menopause and premature ovarian insufficiency: problems and perspectives</article-title><trans-title-group xml:lang="ru"><trans-title>Ранняя менопауза и преждевременная недостаточность яичников: проблемы и перспективы</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3367-9844</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Блинов</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Blinov</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Блинов Дмитрий Владиславович - к.м.н., руководитель по медицинским и научным вопросам, врач-невролог, преподаватель, кафедра неврологии, психиатрии и наркологии</p><p>127006 Москва, ул. Садовая-Триумфальная, д. 4–10</p><p>143081 Московская область, Одинцовский район, Лапино, 1-е Успенское шоссе, д. 111</p><p>123056 Москва, 2-я Брестская улица, д. 5, стр. 1–1а</p><p>Researcher ID: E 8906-2017</p><p>RSCI: 9779-8290</p><p> </p></bio><bio xml:lang="en"><p>Dmitry V. Blinov - MD, PhD, MBA, Head of Medical and Scientific Affairs</p><p>4–10 Sadovaya-Triumfalnaya Str., Moscow 127006</p><p>1st Uspenskoye Highway, 111, Moscow Region, Odintsovo District, Lapino 143081</p><p>5, 1–1a 2nd Brestskaya Str., Moscow 123056</p></bio><email xlink:type="simple">blinov2010@googlemail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хазан</surname><given-names>П. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Hasan</surname><given-names>P. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хазан Петр Леонидович - к.м.н., врач-уролог, клинический фармаколог, старший научный сотрудник группы воспалительных заболеваний и клинической фармакологии</p><p>105425 Москва, ул. 3-я Парковая, д. 51, стр. 1</p></bio><bio xml:lang="en"><p>Peter L. Khazan - MD, PhD</p><p>51 bldg. 1, Str. 3rd Parkovaya, Moscow 105425</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мнацаканьян</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Mnatsakanyan</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мнацаканьян Анна Никитична - к.ф.н., доцент</p><p>101000 Москва, ул. Мясницкая, д. 20</p><p>RSCI: 7380-7790</p></bio><bio xml:lang="en"><p>Anna N. Mnatsakanyan - MD, PhD</p><p>20 Myasnitskaya Str., Moscow 101000</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0459-0488</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Корабельников</surname><given-names>Д. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Korabelnikov</surname><given-names>D. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Корабельников Даниил Иванович - к.м.н., профессор кафедры внутренних болезней с курсами семейной медицины, функциональной диагностики, инфекционных болезней, ректор</p><p>123056 Москва, 2-я Брестская улица, д. 5, стр. 1–1а</p><p>RSCI: 7380-7790</p></bio><bio xml:lang="en"><p>Daniil I. Korabelnikov - MD, PhD, Professor</p><p>5, 1–1a 2nd Brestskaya Str., Moscow 123056</p><p>RSCI: 7380-7790</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3880-4701</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сафаров</surname><given-names>А. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Safarov</surname><given-names>A. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сафаров Алиаскар Турсунович - к.м.н., доцент, зав. кафедрой акушерства и гинекологии факультета усовершенствования врачей</p><p>140100 Самарканд, ул. Амира Тимура, д. 18</p><p> </p></bio><bio xml:lang="en"><p>Aliaskar T. Safarov - MD, PhD, Associate Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Advanced Training for Doctors</p><p>18 Amir Temur Str., Samarkand 140100</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8909-8707</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Павлова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Pavlova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Павлова Надежда Викторовна - к.м.н.</p><p>127473 Москва, Делегатская ул., 20, стр. 1</p></bio><bio xml:lang="en"><p>Nadezhda V. Pavlova - MD, PhD</p><p>20/1 Delegatskaya Str., Moscow 127473</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7607-5330</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захарова</surname><given-names>Н. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharova</surname><given-names>N. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захарова Наталья Сергеевна - врач акушер-гинеколог отделения патологии беременности</p><p>117292 Москва, ул. Вавилова, д. 61</p></bio><bio xml:lang="en"><p>Natalya S. Zakharova - MD, Obstetrician-Gynecologist, Department of Pregnancy Pathology, City Clinical Hospital named after V.V. Vinogradov</p><p>18 Amir Temur Str., Samarkand 140100</p></bio><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8643-6520</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пономарев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ponomarev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пономарев Дмитрий Анатольевич - зав. филиалом</p><p>117421 Москва, ул. Новаторов, д. 3</p></bio><bio xml:lang="en"><p>Dmitry A. Ponomarev - MD</p><p>3 Novatorov Str., Moscow 117421</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5849-5585</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Петренко</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Petrenko</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Петренко Дарья Андреевна - студент 5-го курса</p><p>119991 Москва, ул. Трубецкая, 8, стр. 2</p></bio><bio xml:lang="en"><p>Daria A. Petrenko - 5th year Student</p><p>8 bldg. 2, Trubetskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-9"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Институт Превентивной и Социальной Медицины;&#13;
Клинический Госпиталь Лапино;&#13;
Автономная некоммерческая организация дополнительного профессионального образования «Московский медико-социальный институт имени Ф.П. Гааза»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute for Preventive and Social Medicine;&#13;
Lapino Clinic Hospital, MD Medical Group;&#13;
Moscow Haass Medical - Social Institute</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-исследовательский институт урологии и интервенционной радиологии имени Н.А. Лопаткина - филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Institute of Urology and Interventional Radiology named after N.А. Lopatkin - branch of National Medical Research Radiological Centre, Health Ministry of Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГАОУ ВО «Национальный исследовательский университет «Высшая школа экономики»»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Research University «Higher School of Economics»</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Автономная некоммерческая организация дополнительного профессионального образования «Московский медико-социальный институт имени Ф.П. Гааза»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Haass Medical - Social Institute</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Самаркандский государственный медицинский институт</institution><country>Узбекистан</country></aff><aff xml:lang="en"><institution>Samarkand State Medical Institute</institution><country>Uzbekistan</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ФГБОУ ВО «Московский государственный медико-стоматологический университет имени А.И. Евдокимова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow State University of Medicine and Dentistry named after А.I. Evdokimov, Health Ministry of Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ГБУЗ «Городская клиническая больница имени В.В.&#13;
Виноградова Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Samarkand State Medical Institute</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>Родильный дом № 4 - филиал ГБУЗ «Городская клиническая больница имени В.В. Виноградова Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Maternity Hospital № 4 - Branch of City Clinical Hospital named after V.V. Vinogradov, Moscow Healthcare Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>24</day><month>09</month><year>2020</year></pub-date><volume>14</volume><issue>3</issue><fpage>328</fpage><lpage>345</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Blinov D.V., Hasan P.L., Mnatsakanyan A.N., Korabelnikov D.I., Safarov A.T., Pavlova N.V., Zakharova N.S., Ponomarev D.A., Petrenko D.A., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Блинов Д.В., Хазан П.Л., Мнацаканьян А.Н., Корабельников Д.И., Сафаров А.Т., Павлова Н.В., Захарова Н.С., Пономарев Д.А., Петренко Д.А.</copyright-holder><copyright-holder xml:lang="en">Blinov D.V., Hasan P.L., Mnatsakanyan A.N., Korabelnikov D.I., Safarov A.T., Pavlova N.V., Zakharova N.S., Ponomarev D.A., Petrenko D.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.gynecology.su/jour/article/view/781">https://www.gynecology.su/jour/article/view/781</self-uri><abstract><p>In this review we summarize current data on prevalence, etiology and pathogenesis resulting in premature ovarian insufficiency (POI). In particular, genetic, autoimmune, metabolic, iatrogenic disorders as well as unfavorable impact of environmental factors represent key pathogenetic mechanisms underlying POI development. Clinical picture of this disease is mainly manifested by oligo- and amenorrhea as well as genitourinary menopausal syndrome (GUMS). Special attention is paid to a link between such clinical signs and psychosocial discomfort not being a life-threatening condition but still able to markedly lower quality of woman’s life and considered as a comorbidity with type 2 diabetes mellitus, osteoporosis and cardiovascular diseases. Hormone replacement therapy (HRT) serves as the first-line therapeutic approach for treating POI, which is performed according to the principles similar to those used to perform menopausal hormone therapy (MHT) in case of natural menopause that should be continued until reaching at least the average age for the onset of menopause. Topical estriol therapy eliminates GUMS symptoms, which in turn positively affects sexual function and woman’s psychosocial status and contributes to improved quality of life. The data from recent studies examining topical estriol therapy in POI demonstrated high efficacy and safety. Finally, we also discuss diverse strategies to support reproductive function in women with POI.</p></abstract><trans-abstract xml:lang="ru"><p>В обзоре обобщены современные данные о распространенности, этиологии и патогенезе преждевременной недостаточности яичников (ПНЯ). Ключевыми патогенетическими механизмами ПНЯ являются генетические, аутоиммунные, метаболические, ятрогенные нарушения, а также неблагоприятное воздействие факторов окружающей среды. В клинической картине ведущими проявлениями являются олиго- или аменорея, а также генитоуринарный менопаузальный синдром (ГУМС). Особое внимание уделено связи данных проявлений с явлениями психосоциального дискомфорта, не являющегося жизнеугрожающим состоянием, но способным существенно снизить качество жизни женщины, а также коморбидным заболеваниям: сахарный диабет 2-го типа, остеопороз и сердечно-сосудистые заболевания. Основным методом лечения ПНЯ является заместительная гормональная терапия (ЗГТ), проводящаяся по тем же принципам, что и менопаузальная гормональная терапия (МГТ) при естественной менопаузе, которую следует продолжать как минимум до среднего возраста наступления менопаузы. Локальная терапия эстриолом устраняет симптомы ГУМС, что в свою очередь положительно влияет на сексуальную функцию и психосоциальный статус женщины, способствует повышению качества жизни. Результаты недавних исследований местной терапии эстриолом при ПНЯ продемонстрировали высокую эффективность и безопасность. Также в обзоре рассмотрены различные стратегии реализации репродуктивной функции у женщин с ПНЯ.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>преждевременная недостаточность яичников</kwd><kwd>ПНЯ</kwd><kwd>генитоуринарный менопаузальный синдром</kwd><kwd>ГУМС</kwd><kwd>качество жизни</kwd><kwd>психосоциальный дискомфорт</kwd><kwd>заместительная гормональная терапия</kwd><kwd>ЗГТ</kwd><kwd>менопаузальная гормональная терапия</kwd><kwd>МГТ</kwd><kwd>эстриол</kwd><kwd>репродуктивная функция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>premature ovarian insufficiency</kwd><kwd>POI</kwd><kwd>genitourinary menopausal syndrome</kwd><kwd>GUMS</kwd><kwd>quality of life</kwd><kwd>psychosocial discomfort</kwd><kwd>hormone replacement therapy</kwd><kwd>HRT</kwd><kwd>menopausal hormone therapy</kwd><kwd>MHT</kwd><kwd>estriol</kwd><kwd>reproductive function</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Conway G.S. 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