Management of menopausal disorders in women at risk: potential and advantages of transdermal estrogen

Background. Global trends of increasing life expectancy against the background of a decrease in the average age of natural menopause highlight the problem of qualified management of this contingent of women. The menopausal period can be associated with many clinical signs, such as vasomotor symptoms, genitourinary problems and additional psychological disorders (anxiety, mood swings and sleep disorders). Ignoring the first symptoms of age-related changes can lead to a decrease in the quality of life, workforce productivity and general health deterioration. Objective of the review: to analyze modern approaches to the management of patients with menopausal disorders in risk groups; to study the possibilities and benefits of transdermal estrogen.Analysis of literary data. The key link in the pathogenesis of menopausal disorders is objectively considered to be a decrease in estrogen synthesis in the ovaries, which leads to the development of clinical symptoms of menopause and a significant increase in the risk of developing cardiovascular diseases, obesity, diabetes, bone loss, osteoporosis, etc. Timely administration of menopausal hormone therapy is currently considered the most effective method of treating vasomotor symptoms, genitourinary syndrome, sleep disorders and emotional changes in women. The management of this women contingent requires the mandatory consideration of absolute and relative contraindications to the appointment of hormonal therapy. The general management strategy of women with menopausal disorders, including genitourinary menopausal syndrome, involves a comprehensive approach to diagnosis and treatment. Its important component is the use of menopausal hormone therapy, taking into account contraindications in women at risk of developing cardiovascular, thrombotic, and metabolic complications. Educating health care professionals about the benefits of hormone therapy, including transdermal estrogens potential, will optimize menopausal management and reduce the various risks and adverse effects of oral administration. In this context, the use of the transdermal form of 17β-estradiol (Estrogel) and the original micronized progesterone medication (Utrozhestan) in menopausal disorder management regimens, given their proven efficacy, is gaining clinical significance for the correction of estrogen deficiency and its symptoms, particularly in risk groups. Conclusions. Management of patients with menopausal disorders is a matter of a personalized approach to choosing the optimal treatment regimen with adherence to the principles: timely, effective and as safe as possible.