Preview

Obstetrics, Gynecology and Reproduction

Advanced search

Menopausal hormone therapy affects quality of life in multimorbid late postmenopausal women

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.221

Abstract

Aim: to evaluate an impact of menopausal hormone therapy (MHT) on late postmenopausal multimorbid women’s quality of life (QoL).

Materials and Methods. 132 late postmenopausal women were enrolled to the study and were divided into two groups: group 1 consisted of 66 subjects with moderate multimorbidity and Charlson Comorbidity Index (CCI) < 3; group 2 (66 patients) had high multimorbidity (CCI ≥ 3). Women receiving or not MHT were subdivided in both groups. SF-36 questionnaire was used to assess QoL, Hospital Anxiety and Depression scale (HADS) – for evaluating emotional status, MMSE test (Mini-Mental State Examination) – for cognition evaluation. Modified Menopausal Index (MMI) was calculated as well.

Results. Women with a low level of comorbidity who had previously received MHT have a significantly higher QoL. The median age for subjects was 69 [65; 71] years, median CCI score was 3.5 [2.5; 5.0]. In addition, in group 2 there were found significantly lower physical functioning (p < 0.001), role-physical functioning (p = 0.028), physical health (p = 0.002) domains, as well as more severe persistent menopausal symptoms (p = 0.011) and depression (p = 0.043). History of MHT in group 1 was associated with higher levels of physical functioning (p = 0.033) and role-physical functioning (p = 0.023), whereas in group 2 MHT was associated with better cognition (p = 0.028) and lower depression symptoms compared with those lacking history of MHT.

Conclusion. Multimorbidity in late postmenopausal women was associated with impaired QoL physical domains. MHT allows to effectively improve QoL in women with moderate multimorbidity and to protect cognitive state to higher level as well as reduce depression symptoms in women with severe multimorbidity.

About the Authors

N. V. Izmozherova
Ural State Medical University, Health Ministry Russian Federation
Russian Federation

Nadezhda V. Izmozherova – MD, Dr Sci Med, Associate Professor, Head of the Department of Pharmacology and Clinical Pharmacology

3 Repina Str., Еkaterinburg 620028

 



A. A. Popov
Ural State Medical University, Health Ministry Russian Federation
Russian Federation

Artem A. Popov – MD, Dr Sci Med, Associate Professor, Head of the Department of Hospital Therapy and Emergency Medical Care

3 Repina Str., Еkaterinburg 620028



T. A. Oboskalova
Ural State Medical University, Health Ministry Russian Federation
Russian Federation

Tatiana A. Oboskalova – MD, Dr Sci Med, Professor, Head of the Department of Obstetrics and Gynecology

3 Repina Str., Еkaterinburg 620028



V. M. Bakhtin
Ural State Medical University, Health Ministry Russian Federation
Russian Federation

Victor M. Bakhtin – MD, Postgraduate Student, Department of Pharmacology and Clinical Pharmacology

3 Repina Str., Еkaterinburg 620028



A. V. Verkhoturtseva
Ural State Medical University, Health Ministry Russian Federation
Russian Federation

Anna V. Verkhoturtseva – 5th year Student, Faculty of Treatment and Prophylactic

3 Repina Str., Еkaterinburg 620028



A. A. Vikhareva
Ural State Medical University, Health Ministry Russian Federation
Russian Federation

Anna A. Vikhareva – MD, Assistant, Department of Pharmacology and Clinical Pharmacology

3 Repina Str., Еkaterinburg 620028



E. A. Safyanik
Ural State Medical University, Health Ministry Russian Federation
Russian Federation

Elena A. Safyanik – MD, Assistant, Department of Pharmacology and Clinical Pharmacology

3 Repina Str., Еkaterinburg 620028



V. E. Taranov
Ural State Medical University, Health Ministry Russian Federation
Russian Federation

Vladimir E. Taranov – 5th year Student, Faculty of Treatment and Prophylactic

3 Repina Str., Еkaterinburg 620028



References

1. Andreeva E.N., Grigoryan O.R. Menopause with endocrinopathies (evidence base). [Menopauza pri endokrinopatiyah (dokazatel'naya baza)]. Moscow, 2017. 40 p. (In Russ.).

2. Bryukhina E.V., Usoltseva E.N., Ivanova O.V. The quality of life in women according to climacteric syndrome. [Kachestvo zhizni zhenshchin v zavisimosti ot proyavlenij klimaktericheskogo sindroma]. Akusherstvo i ginekologiya. 2014;(10):52–8. (In Russ.).

3. Gileva V.V., Khammad E.V., Mursalov S.U. A pathological menopause: its role in polymorbidity. [Patologicheskij klimaks: rol' v formirovanii polimorbidnosti]. Sovremennye problemy nauki i obrazovaniya. 2015;(6):96. (In Russ.).

4. Izmozherova N.V., Popov A.A., Andreev A.N. et al. Cardiovascular system status in women with severe climacteric syndrome. [Sostoyanie serdechno-sosudistoj sistemy u zhenshchin s tyazhelym klimaktericheskim sindromom]. Rossijskij kardiologicheskij zhurnal. 2007;12(1):62–4. (In Russ.).

5. Schneider H.P.G., Birkhäuser M. Quality of life in climacteric women. Climacteric. 2017;20(3):187–94. https://doi.org/10.1080/13697137.2017.1279599.

6. Makovski T.T., Schmitz .S, Zeegers M.P. et al. Multimorbidity and quality of life: Systematic literature review and meta-analysis. Ageing Res Rev. 2019;53:100903. https://doi.org/10.1016/j.arr.2019.04.005.

7. US Preventive Services Task Force, Grossman D.C., Curry S.J. et al. Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: US Preventive Services Task Force Recommendation Statement. JAMA. 2017;318(22):2224–33. https://doi.org/10.1001/jama.2017.18261.

8. Cobin R.H., Goodman N.F.; AACE Reproductive Endocrinology Scientific Committee. American association of clinical endocrinologists and american college of endocrinology position statement on MENOPAUSE-2017 update [published correction appears in Endocr Pract. 2017;23(12):1488]. Endocr Pract. 2017;23(7):869–80. https://doi.org/10.4158/EP171828.PS.

9. Oganov R.G., Simanenkov V.I., Bakulin I.G. et al. Comorbidities in clinical practice. Algorithms for diagnostics and treatment. [Komorbidnaya patologiya v klinicheskoj praktike. Algoritmy diagnostiki i lecheniya]. Kardiovaskulyarnaya terapiya i profilaktika. 2019;18(1):5–66. (In Russ.). https://doi.org/10.15829/1728-8800-2019-1-5-66.

10. Charlson M.E., Pompei P., Ales K.L., MacKenzie C.R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83. https://doi.org/10.1016/0021-9681(87)90171-8.

11. Brazier J.E., Harper R., Jones N.M. et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305(6846):160–4. https://doi.org/10.1136/bmj.305.6846.160.

12. Smetnik V.P., Tkachenko N.M., Glezer G.A., Moskalenko N.P. Climacteric syndrome. [Klimaktericheskij sindrom]. Moscow: Medicina, 1988. 285 p. (In Russ.).

13. Folstein M.F., Folstein S.E., McHugh P.R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98. https://doi.org/10.1016/0022-3956(75)90026-6.

14. Zigmond A.S., Snaith R.P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x.

15. Wilson S., Sharp C.A., Davie M.W. Health-related quality of life in women referred for bone density assessment: relationships with bone mineral density, fracture and co-morbidity. Qual Life Res. 2015;24(5):1235–43. https://doi.org/10.1007/s11136-014-0851-0.

16. Mirhaghjou S.N., Niknami M., Moridi M. et al. Quality of life and its determinants in postmenopausal women: a population-based study. Appl Nurs Res. 2016;30:252–56. https://doi.org/10.1016/j.apnr.2015.10.004.

17. Sitlinger A., Shelby R.A., Van Denburg A.N., et al. Higher symptom burden is associated with lower function in women taking adjuvant endocrine therapy for breast cancer. J Geriatr Oncol. 2019;10(2):317–21. https://doi.org/10.1016/j.jgo.2018.11.008.

18. Balan V.E., Andreeva E.N., Yureneva S.V. et al. Risks and benefits of menopausal hormone therapy. [Risk i pol'za menopauzal'noj gormonal'noj terapii]. Akusherstvo i ginekologiya. 2020;(3):33–41. (In Russ.). https://doi.org/10.18565/aig.2020.3.33-41.

19. Madyanov I.V., Madyanova T.S. Menopausal hormone therapy. To help therapist and general practitioner. [Menopauzal'naya gormonal'naya terapiya. V pomoshch' terapevtu i vrachu obshchej praktiki]. Moscow: GEOTAR-Media, 2020. 160 p. (In Russ.).

20. Shishkova V.N. Comorbidity and polypharmacy: focus on cytoprotection. [Komorbidnost' i polipragmaziya: fokus na citoprotekciyu]. Consilium Medicum. 2016;18(12):73–9. (In Russ.).

21. Langer R.D. The evidence base for HRT: what can we believe? Climacteric. 2017;20(2):91–6. https://doi.org/10.1080/13697137.2017.1280251.

22. Ekström H., Hovelius B. Quality of life and hormone therapy in women before and after menopause. Scand J Prim Health Care. 2000;18(2):115– 21. https://doi.org/10.1080/028134300750019025.

23. Popov A.A., Izmozherova N.V., Retyunsky K.Yu., Oboskalova T.A. Impact of depression on adherence to hormone therapy in perimenopause. [Vliyanie depressii na priverzhennost' gormonal'noj terapii v perimenopauze]. Ural'skij medicinskij zhurnal. 2007;(2):52–5. (In Russ.).

24. Protasova A.E., Yureneva S.V., Bairamova N.N., Komedina V.I. Menopause, obesity and comorbidity: possibilities of menopausal hormone therapy. [Menopauza, ozhirenie i komorbidnost': vozmozhnosti menopauzal'noj gormonal'noj terapii]. Akusherstvo i ginekologiya. 2019;(5):43–8. (In Russ.). https://org/10.18565/aig.2019.5.43-48.

25. Miller V.M., Naftolin F., Asthana S. et al. The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned? Menopause. 2019;26(9):1071–84. https://doi.org/10.1097/GME.0000000000001326.

26. Maki P., Hogervorst E. The menopause and HRT. HRT and cognitive decline. Best Pract Res Clin Endocrinol Metab. 2003;17(1):105–22. https://doi.org/10.1016/s1521-690x(02)00082-9.

27. Gava G., Orsili I., Alvisi S. et al. Cognition, mood and sleep in menopausal transition: the role of menopause hormone therapy. Medicina (Kaunas). 2019;55(10):668. https://doi.org/10.3390/medicina55100668.

28. Gasparyan S.A., Drosova L.D., Karpov S.M., Khripunova A.A. Use of menopausal hormone therapy in the correction of cognitive impairment in menopausal women. [Ispol'zovanie menopauzal'noj gormonal'noj terapii v korrekcii kognitivnyh narushenij u zhenshchin v klimaktericheskom periode]. Akusherstvo i ginekologiya. 2018;(12):157–62. (In Russ.). https://doi.org/10.18565/aig.2018.12.157-162.


Review

For citations:


Izmozherova N.V., Popov A.A., Oboskalova T.A., Bakhtin V.M., Verkhoturtseva A.V., Vikhareva A.A., Safyanik E.A., Taranov V.E. Menopausal hormone therapy affects quality of life in multimorbid late postmenopausal women. Obstetrics, Gynecology and Reproduction. 2021;15(5):515-524. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.221

Views: 773


ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)