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Specifics of prescribing menopausal hormonal therapy in patients with the anamnestic endometriosis

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.165

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Abstract

Administration of menopausal hormone therapy (MHT) in patients with genital endometriosis (GE) is a controversial issue requiring a patient-personalized approach. Current principles for MHT selection and prescription in patients with anamnestic endometriosis are presented, which are based on the guidelines of the International Menopause Society (IMS), The European Menopause and Andropause Society, local and foreign publications retrieved from electronic data bases PubMed, Cyberleninka. The data of our study on observing 724 patients with GE treated with diverse MHT types were presented and analyzed (428 women in perimenopausal period, 296 in postmenopausal period). Patients with endometriosis in perimenopausal and postmenopausal periods showed more prominent manifestations of climacteric and post-ovariectomy syndromes, as well as high risk of reduced bone mineral density (BMD) due to repeated surgery on the ovaries and preceding long-term “antiestrogen therapy”. Custom-compounded MHT based on components combinations, dosage and administration route provides a significantly improved quality of life for patients with endometriosis, prevents loss of BMD and reduces risk of cardiovascular diseases. Using low and ultra-low dose estrogen bioidentical to natural substances in this patient group minimizes a risk of disease recurrence.

About the Authors

M. I. Yarmolinskaya
Ott Research Institute of Obstetrics, Gynecology and Reproductology; Mechnikov North-Western State Medical University, Health Ministry of Russian Federation
Russian Federation

Maria I. Yarmolinskaya – MD, Dr Sci Med, Professor of RAS, Head of the Department of Gynecology and Endocrinology, Head of the Сenter «Diagnostics and Treatment of Endometriosis»;

Professor, Department of Obstetrics and Gynecology

Scopus Author ID: 7801562649. Researcher ID: P-2183-2014. SPIN-код: 3686-3605

3 Mendeleevskaya Liniya, Saint Petersburg 199034;

41 Kirochnaya Str., Saint Petersburg 191015



M. A. Shalina
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation

Maria A. Shalina – MD, PhD, Senior Researcher, Department of Gynecology and Endocrinology

3 Mendeleevskaya Liniya, Saint Petersburg 199034



C. I. Seyidova
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation

Chimnaz I. Seyidova – MD, Clinical Intern

3 Mendeleevskaya Liniya, Saint Petersburg 199034



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For citation:


Yarmolinskaya M.I., Shalina M.A., Seyidova Ch.I. Specifics of prescribing menopausal hormonal therapy in patients with the anamnestic endometriosis. Obstetrics, Gynecology and Reproduction. 2020;14(6):675-684. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.165

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