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Early menopause and premature ovarian insufficiency: problems and perspectives

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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.

About the Authors

D. V. Blinov
Institute for Preventive and Social Medicine; Lapino Clinic Hospital, MD Medical Group; Moscow Haass Medical - Social Institute
Russian Federation

Dmitry V. Blinov - MD, PhD, MBA, Head of Medical and Scientific Affairs

4–10 Sadovaya-Triumfalnaya Str., Moscow 127006

1st Uspenskoye Highway, 111, Moscow Region, Odintsovo District, Lapino 143081

5, 1–1a 2nd Brestskaya Str., Moscow 123056

P. L. Hasan
Research Institute of Urology and Interventional Radiology named after N.А. Lopatkin - branch of National Medical Research Radiological Centre, Health Ministry of Russian Federation
Russian Federation

Peter L. Khazan - MD, PhD

51 bldg. 1, Str. 3rd Parkovaya, Moscow 105425

A. N. Mnatsakanyan
National Research University «Higher School of Economics»
Russian Federation

Anna N. Mnatsakanyan - MD, PhD

20 Myasnitskaya Str., Moscow 101000

D. I. Korabelnikov
Moscow Haass Medical - Social Institute
Russian Federation

Daniil I. Korabelnikov - MD, PhD, Professor

5, 1–1a 2nd Brestskaya Str., Moscow 123056

RSCI: 7380-7790

A. T. Safarov
Samarkand State Medical Institute

Aliaskar T. Safarov - MD, PhD, Associate Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Advanced Training for Doctors

18 Amir Temur Str., Samarkand 140100

N. V. Pavlova
Moscow State University of Medicine and Dentistry named after А.I. Evdokimov, Health Ministry of Russian Federation
Russian Federation

Nadezhda V. Pavlova - MD, PhD

20/1 Delegatskaya Str., Moscow 127473

N. S. Zakharova
Samarkand State Medical Institute
Russian Federation

Natalya S. Zakharova - MD, Obstetrician-Gynecologist, Department of Pregnancy Pathology, City Clinical Hospital named after V.V. Vinogradov

18 Amir Temur Str., Samarkand 140100

D. A. Ponomarev
Maternity Hospital № 4 - Branch of City Clinical Hospital named after V.V. Vinogradov, Moscow Healthcare Department
Russian Federation

Dmitry A. Ponomarev - MD

3 Novatorov Str., Moscow 117421

D. A. Petrenko
Sechenov University
Russian Federation

Daria A. Petrenko - 5th year Student

8 bldg. 2, Trubetskaya Str., Moscow 119991


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For citation:

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. Early menopause and premature ovarian insufficiency: problems and perspectives. Obstetrics, Gynecology and Reproduction. 2020;14(3):328-345. (In Russ.)

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