Therapeutic approaches to the correction of vasomotor and psychoemotional menopausal symptoms

DOI: https://doi.org/10.29296/25877305-2020-11-07
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Issue: 
11
Year: 
2020

E. Petrova(1), Candidate of Medical Sciences, Associate Professor; D. Chizh(1); N. Herzog(2);
I. Metalnikova(2); E. Panina(1), Candidate of Medical Sciences; Professor V. Strukov(3), MD; M.
Skorodelova(1); D. Elistratov(4) (1)Penza State University (2)Department Clinical Hospital, Penza Station,
Open JSC «Russian Railroads», Penza (3)Penza Institute for Advanced Training of Physicians – Branch of
Russian Medical Academy of Continuing Professional Education, Ministry of Health (4)OOO «Parafarm», Penza

Some of the most common symptoms during menopause are vasomotor disorders in the form of hot flashes and night sweats, and psychoemotional disorders that negatively affect the quality of life of women. Due to the ongoing problems of menopausal hormone replacement therapy (MHT), the search of alternative therapies continues. Objective: Study of efficiency of the dietary supplement «Femo-clim» in the correction of vasomotor and psychoemotional menopausal symptoms. Materials and methods. A randomized placebo-controlled study was conducted involving 40 women with climacteric syndrome (CS) of moderate severity. The patients were randomly divided into two groups: group 1 consisting of 20 women with CS of moderate severity received «Femo-clim» 2 tablets 3 times a day for three month. Group 2 consisting of 20 women with CS of moderate severity received placebo with the same regimen. The dynamics of the symptoms of climacteric syndrome was monitored according to Greene Climacteric Scale (GCS) and Hospital Anxiety and Depression Scale (HADS). The final result was assessed after 3 months of therapy (on the 90th day). Results. At the end of the treatment, a statistically significant decrease in the severity of climacteric syndrome was shown in the group administered with «Femo-clim» where the indicator of disease severity was 9.4±1.7 versus baseline 17.3±1.25 (p
Keywords: 
menopause
climacteric syndrome
vasomotor symptoms
hot flashes
night sweats
psychoemotional disorders
quality of life in menopause
hot flashes therapy
Femo-Clim

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References: 
  1. Menopauzal'naja gormonal'naja terapija i sohranenie zdorov'ja zhenschin zrelogo vozrasta. Klinicheskie rekomendatsii (protokol lechenija). M.: FGBU NTsGAiP, 2015; 49 s. [Menopausal hormonal therapy and preserving health in women of mature age (Treatment protocol). M.: Scientific Center for Obstetrics, Gynecology and Perinatology, 2015; 49 p. (in Russ.)].
  2. Dvorjanskij S.A., Emel'janova D.I., Jagovkina N.V. Klimaktericheskij sindrom: sovremennoe sostojanie voprosa (obzor literatury). Vjatskij med. vestn. 2017; 1 (53): 7–15 [Dvoryanskiy S.A., Emelyanova D.I., Yagovkina N.V. Climacteric syndrome: current status of the issue (literature review). Vyatskii med. vestn. 2017; 1 (53): 7–15 (in Russ.)].
  3. Bohan N.A., Luk'janova E.V., Simutkin G.G. Depressivnye rasstrojstva u zhenschin v klimaktericheskom vozraste (obzor zarubezhnoj literatury za 2012–2016 gg.). Bjulleten' sibirskoj meditsiny. 2018; 17 (2): 100–13 [Bokhan N.A., Lukiyanova E.V., Simutkin G.G. Depressive disorders in women of climacteric age (review of foreign literature for 2012–2016). Bulletin of Siberian Medicine. 2018; 17 (2): 100–13 (in Russ.)]. DOI: 10.20538/1682-0363-2018-2-100-113
  4. Ebzieva Z.H. Differentsirovannyj podhod k vedeniju zhenschin v postmenopauze s narusheniem sna. Diss. … kand. med. nauk. M., 2020; 114 s. [Ebzieva Z.H. Differentiated approach to the treatment of postmenopausal women with sleep disorders. Dissertation dor the scientific degree of Candidate of Medical Sciences. M., 2020; 114 p. (in Russ.)]
  5. Prilepskaja V.N. Klimaktericheskij sindrom: innovatsii v menopauzal'noj terapii. RMZh. 2017; 25 (2): 105–8 [Prilepskaya V.N. Climacteric syndrome: novel modalities for menopausal therapy. RMJ. 2017; 25 (2): 105–8 (in Russ.)].
  6. Gold E., Colvin A., Avis N. et al. Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the men-opausal transition: Study of Women’s Health Across the Nation. Am J Public Health. 2006; 96 (7): 1226–35. DOI: 10.2105/AJPH.2005.066936
  7. Williams R., Kalilani L., Di Benedetti D. et al. Healthcare seeking and treatment for menopausal symptoms in the United States. Maturitas. 2007; 58 (4): 348–58. DOI: 10.1016/j.maturitas.2007.09.006
  8. Assaf A., Bushmakin A., Joyce N. et al. The relative burden of menopausal and postmenopausal symptoms versus other major conditions: a retrospective analysis of the Medical Expenditure Panel Survey data. Am Health Drug Benefits. 2017; 10 (6): 311–21.
  9. Sarrel P., Portman D., Lefebvre P. et al. Incremental direct and indirect costs of untreated vasomotor symptoms. Menopause. 2015; 22 (3): 260–6. DOI: 10.1097/GME.0000000000000320
  10. Lucas R., Ganio M., Pearson J. et al. Brain blood flow and cardiovascular responses to hot flashes in postmenopausal women. Menopause. 2013; 20 (3): 299–304. DOI: 10.1097/GME.0b013e31826e45f0
  11. Pines A. Vasomotor symptoms and cardiovascular disease risk. Climacteric. 2011; 14: 535–6. DOI: 10.3109/13697137.2011.599058
  12. Skrapits K., Borsay B., Herczeg L. et al. Neuropeptide co-expression in hypothalamic kisspeptin neurons of laboratory animals and the human. Front Neurosci. 2015; 9: 29. DOI: 10.3389/fnins.2015.00029
  13. Fergani C., Navarro V. Expanding the role of tachykinins in the neuroendocrine control of reproduction. Reproduction. 2016; 153 (1): 1–14. DOI: 10.1530/REP-16-0378
  14. Rance N., Dacks P., Mittelman-Smith M. et al. Modulation of body temperature and LH se- cretion by hypothalamic KNDy (kisspeptin, neurokinin B and dynorphin) neurons: a novel hypothesis on the mechanism of hot flushes. Front Neuroendocrinol. 2013; 34 (3): 211–27. DOI: 10.1016/j.yfrne.2013.07.003
  15. Padilla S., Johnson C., Barker F. et al. A neural circuit underlying the generation of hot flushes. Cell Rep. 2018; 24 (2): 271–7. DOI: 10.1016/j.celrep.2018.06.037
  16. Skorupskaite K., George J., Anderson R. The kisspeptin-GnRH pathway in human reproductive health and disease. Hum Reprod Update. 2014; 20 (4): 485–500. DOI: 10.1093/humupd/dmu009
  17. Ruka K., Burger L., Moenter S. Both estrogen and androgen modify the response to activation of neurokinin-3 and k-opioid receptors in arcuate kisspeptin neurons from male mice. Endocrinology. 2016; 157 (2): 752–63. DOI: 10.1210/en.2015-1688
  18. Rometo A., Krajewski S., Voytko M. et al. Hypertrophy and increased kisspeptin gene expression in the hypothalamic in- fundibular nucleus of postmenopausal women and ovariectomized monkeys. J Clin Endocrinol Metab. 2007; 92 (7): 2744–50. DOI: 10.1210/jc.2007-0553
  19. Gomez-Santos C., Saura C.B., Lucas J.A.R. et al. Menopause status is associated with circadian- and sleep-related alterations. Menopause. 2016; 23: 682. DOI: 10.1097/GME.0000000000000612
  20. Radzinskij V.E., Ordijants I.M. Lechenie klimaktericheskih rasstrojstv v menopauze. RMZh. 2018; 5 (I): 37–40 [Radzinsky V.E., Ordiyants I.M. Treatment of climacteric disorders in menopause. RMJ. 2018; 5 (I): 37–40 (in Russ.)].
  21. Sturdee D.W., Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010; 13 (6): 509–22. DOI: 10.3109/13697137.2010.522875
  22. Smetnik V.P. Zamestitel'naja gormonoterapija v klimakterii. StatusPraesens. Ginekologija. Akusherstvo. Besplodnyj brak. 2011. 2 (5): 50–4 [Smetnik V.P. Hormone replacement therapy in menopause. StatusPraesens. Gynecology. Obstetrics. Infertile marriage. 2011; 2 (5): 50–4 (in Russ.)].
  23. Grant M.D., Marbella A., Amy M.S., et al. Menopausal Symptoms: Comparative Effectiveness of Therapies. Comparative Effectiveness Review. 2015; 147: 1–106.
  24. Pinkerton J., Santoro N. Compounded bioidentical hormone therapy: identifying use trends and knowledge gaps among US women. Menopause. 2015; 22 (9): 926–36. DOI: 10.1097/GME.0000000000000420
  25. Tao M., Teng Y., Shao H. et al. Knowledge, perceptions and information about hormone therapy (HT) among menopausal women: a systematic review and meta-synthesis. PLoS One. 2011; 6 (9): e24661. DOI: 10.1371/journal.pone.0024661
  26. Torshin I.Ju., Gromova O.A., Limanova O.A. Bystryj effekt klimalanina (β-alanina) pri prilivah: sravnitel'noe issledovanie vzaimodejstvij beta-alanina, taurina i glitsina s glitsinovymi retseptorami. Ginekologija. 2012; 2: 25–9 [Torshin I.Y., Gromova O.A., Limanova O.A. Rapid effect of beta-alanine in the therapy of hot flashes: a comparative biophysical modeling of interactions beta-alanine, taurine and glycine with the glycine receptors. Gynecology. 2012; 2: 25–9 (in Russ.)].
  27. Petrova E.V., Kalistratov V.B., Polubojarinov P., i dr. Primenjaemyj pri klimakse preparat Femo-Klim – luchshee negormonal'noe reshenie gormonal'nyh problem. Vrach. 2019; 30 (1): 46–8 [Petrova E., Kalistratov V., Polyboyarinov P. et al. The menopause drug Femo-Klim is the best nonhormonal solution of hormonal problems. Vrach. 2019; 30 (1): 46–8 (in Russ.)]. https://doi.org/10.29296/25877305-2019-01-08
  28. Dzhouns O., Strukov V.I. Komorbidnyj osteoporoz: problemy i novye vozmozhnosti terapii (Ch. 2). Vrach. 2017; 11: 25–8 [Jones O., Strukov V., Kislov A. et al. Comorbid osteoporosis: challenges and new diagnostic opportunities (Part 2). Vrach. 2017; 11: 25–8 (in Russ.)].
  29. Potupchik T.V. Vozmozhnosti primenenija preparata Femo-Klim v klimaktericheskom periode. Vrach. 2019; 30 (8): 80–5 [Potupchik T. Possibilities of using Femo-Klim in the menopausal period. Vrach. 2019; 30 (8): 80–5 (in Russ.)]. https://doi.org/10.29296/25877305-2019-08-17
  30. Gartoulla P., Han M.M. Red clover extract for alleviating hot flushes in postmenopausal women: a meta-analysis. Maturitas. 2014; 79 (1): 58–64 DOI: 10.1016/j.maturitas.2014.06.018
  31. Cegiela U., Folwarczna J., Pytlik M. et al. Effects of Extracts from Trifolium medium L. and Trifolium pratense L. on Development of Estrogen Deficiency-Induced Osteoporosis in Rats. Evid Based Complement Alternat Med. 2012; 12: 921684. DOI: 10.1155/2012/921684
  32. Hwang J., Wang J., Morazzoni P. et al. The phytoestrogen equol increases nitric oxide availability by inhibiting superoxide production: an antioxidant mechanism for cell-mediated LDL modification. Free Radic Biol Med. 2003; 34: 1271–82. DOI: 10.1016/s0891-5849(03)00104-7
  33. Milan M.T., Dotlic J., Maricic S. Influence of red clover-derived isoflavones on serum lipid profile in postmenopausal women. J Obstet Gynaecol Res. 2009; 35 (6): 1091–5. DOI: 10.1111/j.1447-0756.2009.001059.x
  34. Campbell M.J., Woodside J.V., Honour J.W. et al. Effect of red clover-derived isoflavone supplementation on insulin-like growth factor, lipid and antioxidant status in healthy female volunteers: a pilot study. Eur J Clin Nutr. 2004; 58: 173–9. DOI: 10.1038/sj.ejcn.1601764
  35. Plaksina N.D., Simonovskaja H.Ju. Vozmozhnosti negormonal'noj korrektsii vazomotornyh paroksizmov v postmenopauze. StatusPraesens. Ginekologija. Akusherstvo. Besplodnyj brak. 2014; 19: 60–5 [Plaksina N.D., Simonovskaya Kh.Yu. The possibilities of non-hormonal correction of vasomotor paroxysms in menopause. StatusPraesens. Gynecology. Obstetrics. Infertile marriage. 2014; 19: 60–5 (in Russ.)].