Somatic and Gynecological Status of Women with Climacteric Syndrome Associated with Somatoform Disorders

In clinical practice patients with somatoform disorders are observed quite often and quite often there are certain difficulties concerning their nosological evaluation. Patients in menopause and especially with pathological menopause symptoms seek medical help with a variety of complaints from cardiologist, endocrinologist, gynecologist, general practitioners. Thus, it is important to provide representatives of such medical specialties with information on the clinical picture of women's menopause. The purpose of this study is to examine the clinical characteristics of women with climacteric syndrome in the background of somatoform disorders and assessment of their somatic and gynecological status. For this purpose 105 women with climacteric light severity syndrome (29%) and moderate severity (71%) were examined. Criteria for inclusion in the study were: 1) age 45-55 years; 2) the presence of certain pathological climacteric syndrome of vegetative disorders, which at the time coincided with the appearance of other signs of climacteric syndrome. All the examined women's anamnesis of life, gynecological and general-somatic history were studied to detect extragenital pathology. In women with abnormal course of climacteric syndrome severe autonomic dysfunction was observed, and it progressively intensified with increasing severity of menopausal symptoms. Vein's vegetative dysfunction syndrome is found in all women included in the study. Calculation of the vegetative Kerdo index made it possible to establish the presence of sympathicotonia (positive index) in most women (79%). Vagotonia (negative Kerdo index) was detected at 15%, eytony (the Kerdo index is zero) – in 6% of cases. It was found out that in postmenopausal women daily blood pressure variability was characterized by higher values of blood pressure during the day, a day and night, as well as higher value of the morning blood pressure rise vs women with preserved menstrual function. The dynamics of circadian rhythm in women varied with age – daily index values decreased, indicating a rise in blood pressure at night, which is a clinically adverse factor. In studying the structure of reproductive system disorders in patients (with hipoestrohennymy types of abuse), hipoestrohenic anovulation was detected in 92% of women with estradiol levels in the second phase of the cycle was 158,22 ± 74,55 pmol / L and progesterone – 1,29 ± 0.18 nmol / l, which is evidence of an age-related decline in the steroid ovarian function. The severity of neurolective, metabolic and psychoemotional symptoms did not differ significantly in the groups of women with varying degrees of severity of the climacteric syndrome, however, there was a tendency to increase the severity of neurovergetative symptoms with an increase in the severity of menopause and their duration, indicating a deeper level of damage to the system of adaptation. Thus, pathological menopause can cause a significant risk of diseases associated with age and requires timely, reasonable pathogenic correction based on physiological characteristics of women. The presence of climacteric disorders in women, having psychogenic and vegetatively determined symptoms, the complexity of their adequate evaluation, can make this issue one of the most important.