Пошук шляхів корекції неспецифічних вагінітів у жінок клімактеричного віку з ожирінням

Objective — to increase the effectiveness of treatment of nonspecific vaginitis in menopausal women with excess body weight and obesity through long-term lifestyle modification. Materials and methods. 1178 patients aged 45—55 years were examined, including 317 with nonspecific vaginitis, who were divided into 3 study groups: with a healthy body weight, overweight and obesity. Each group was divided into three subgroups of comparison with standard therapy and three study groups that applied long-term lifestyle modification (actively and systematically used behavioral therapy, physical activity and a low-calorie diet) for 6 months. The control group consisted of 72 volunteers. Results and discussion. In the study subgroups of women who used long-term lifestyle modification, recurrences of nonspecific vaginitis were less frequent than in the corresponding comparison subgroups. Thus, after 6 months, in subgroups of women with a healthy body weight, the difference in the frequency of relapses after treatment was 40 % greater (34.2 vs 20.5 %), with excess body weight — 31.1 % (41.2 vs 28.4 %), with obesity — 29.8 % (55.1 vs 38.7 %). A significant deterioration in the state of the microbiota in menopausal patients with increased body weight and the effectiveness of the use of long-term lifestyle modification on its condition were established. It was proven that excess body weight and obesity in women negatively affected the frequency of nonspecific vaginitis, clinical picture, decreased quality of life, and frequency of relapses. Active and systematic use of behavioral therapy, physical activity, and a low-calorie diet in patients with nonspecific vaginitis in menopause had significant advantages in preventing relapses, compared to standard therapy, and in preserving and improving the quality of life of obese patients. Conclusions. Overweight and obese women are more likely than healthy women to suffer from nonspecific vaginitis, which is more severe and recurrent, accompanied by a decrease in quality of life and a disruption of the vaginal and skin biotope. After 6 months in obese postmenopausal women, the use of long-term lifestyle modification contributes to the restoration of the vaginal and skin microbiome, a decrease in the frequency of recurrences of nonspecific vaginitis and an improvement in quality of life compared with subgroups. with standard therapy. The best effect of treatment was observed in women with a healthy body weight, and the worst in the presence of obesity.