Quality of women’s life in perimenopause – possibilities of non-hormonal correction

Objective of the study: to evaluate the effectiveness of antistress therapy and sleep quality improvement on the course of climacteric syndrome (CS) and quality of life of perimenopausal women.Materials and methods: The study included 90 women aged 42–55 with moderate CS. Group I consisted of 30 women receiving Metida (elemental magnesium 300 mg, vitamin B6 30 mg), Group II included 30 women treated with Melani (two-stage release melatonin 2,95 mg), and Group III received combined therapy with both drugs. Patients underwent testing using the Spielberg-Hanin scale and PSM-25 scale before treatment, after 1 and 3 months of therapy, and SF-36, MRS, PSQI, ESS scales at baseline and after 3 months of therapy. Follicle-stimulating hormone (FSH) and prolactin levels were assessed at the study’s start, with FSH measured again after 3 months. Results. Magnesium effectively reduced situational and trait anxiety in women with CS after 3 months of therapy; however, a similar effect was achieved within 1 month when it was combined with melatonin. The combined administration of magnesium and melatonin significantly reduced psychological stress levels from high to moderate according to PSM-25 scale (107.5 ± 8.6 compared to 167 ± 9.6; p < 0.05). Combined therapy also substantially improved the quality of life, particularly in psychological well-being and overall health perception according to SF-36 questionnaire. Symptoms of CS, as assessed by the MRS scale, significantly decreased within 1 month of melatonin monotherapy for psychological symptoms, with somatovegetative symptoms improving by 3 months. Combined therapy improved both symptom components within 1 month, but the difference was likely to be significant at 3 months compared to the 1-month examination (2.1 ± 0.34 and 2.6 ± 0.22 compared to 4.4 ± 0.42 and 3.7 ± 0.49, respectively; p < 0.05). Combined therapy with magnesium and melatonin significantly lowered FSH levels after 3 months (31.6 ± 6.3 vs. 44.1 ± 7.1; p < 0.05). Enhanced sleep quality, depth, and duration were noted within 3 months of combined therapy without causing daytime sleepiness.Conclusions. The two-stage release melatonin reduces CS symptoms by improving sleep quality, lowering psychomotional symptoms, and reducing psychological stress. Combined therapy with magnesium and melatonin positively affects the hypothalamic-pituitary-ovarian axis, significantly alleviating psychomotional symptoms of CS and adjusting the somatovegetative component by enhancing sleep quality and depth, reducing psychological stress, and improving overall health perception.