DYNAMICS OF HORMONAL INDICATORS IN WOMEN WITH CLIMATHERIC SYNDROME AND HYPOTYTREOSIS UNDER THE INFLUENCE OF COMPLEX PHYSIOTHERAPEUTIC TREATMENT
About the author:
Pavlovska M. O.
Heading:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Scentific article
Annotation:
Physiological decline of thyroid function in climacteric, as well as more severe course and early onset of climacteric syndrome in thyroid pathology, indicate the need for early diagnosis and treatment of thyroid dysfunction. When detecting hypothyroidism in women with climacteric syndrome, an adequate correction with the appointment of thyroid drugs in individually selected doses is necessary. The aim of the work is to compare the effectiveness of complex methods of treatment of climacteric syndrome in patients with concomitant hypothyroidism, by analyzing hormonal indices before and after complex therapy using physiotherapeutic procedures. As standard indicators in analyzing the results of laboratory studies, the standards of biochemical laboratories were used. 68 patients aged 45-55 years with a climacteric syndrome and concomitant hypothyroidism were screened. Duration of hypothyroidism – from 1 to 5 years, on average (3,8 ± 0,4 years). Patients received substitution therapy with L – thyroxine. The patients were divided into 2 groups (in the 1st group there were 30 patients with hypothyroidism on the background of climacteric syndrome, receiving only basic therapy; the second group included 38 patients who, in addition to the basic therapy, received physical therapy). The scientific substantiation of the choice of therapeutic and prophylactic measures for the development of programs for the rehabilitation of this category of patients was provided by studies that showed the effectiveness of ultrasound therapy and balneotherapy both in eliminating the risk factors for complications of the climacteric syndrome, as well as correction of its manifestations. Analysis of changes in hormonal parameters was used to analyze the adequacy of complex therapy in patients with climacteric syndrome and concomitant hypothyroidism. The statistical processing of the obtained results is carried out in the statistical package “STATISTICA 6.1” using parametric and non-parametric methods for evaluating the obtained results. In the study of the history of the disease in the examined women, it was found that in patients with concomitant hypothyroidism, all three components of the climacteric syndrome were equally significant and more pronounced. That is, in determining the severity of COP in patients with concomitant hypothyroidism, mild forms were not detected, the average and severe forms were 51 (75%) and 17 (25%) respectively. Under the influence of complex therapy with the use of physiotherapy methods, the level of TSH significantly decreased, reaching the norm after the second course of treatment. No significant dynamics of osteocalcitonin content was detected under the influence of the courses of treatment. Yet in the second group the indicator was closer to the norm. In assessing the overall effectiveness of treatment, it turned out that using base therapy, the effectiveness was 58%, with the use of complex treatment with the use of contrast baths and ultrasound therapy – 75%. In this case, the use of basic therapy in 25% of patients did not lead to objective improvement of the state, and in 17% of patients, observed a deterioration of well-being. In the group of patients who were prescribed a complex with physiotherapeutic procedures, the number of patients who completed the course of treatment without dynamics was significantly lower than 16%. Also, the number of patients with negative treatment outcomes was 9%.
Tags:
hypothyroidism, climacteric syndrome, basic therapy, physiotherapy procedures
Bibliography:
- Deryabina YeG, Bashmakova NV. Shchitovidnaya zheleza i menopauza. Yekaterinburg; 2012. 141 s. [in Russiаn].
- Del Ghianda S, Tonacchera M, Vitti P. Thyroid and menopause. Climacteric. 2014 Jun;17(3):225-34.
- Serov VN, Prilepskaya VN, Ovsyannikova TV. Ginekologicheskaya endokrinologiya. 6-ye izd. M.: MEDpress-inform; 2017. 504 s. [in Russiаn].
- Smetnik VP, redaktor. Meditsina, klimakteriya. M.: Litera; 2006. 847 s. [in Russiаn].
- Manukhin IB, Tumilovich LG, Gevorkyan MA, Manukhina YeI. Ginekologicheskaya endokrinologiya: klinicheskiye lektsii. 4-ye izd., pererab. i dop. M.: GEOTAR-Media; 2017. 296 s. [in Russiаn].
- Khashayeva TKh, Esedova E. Primeneniye preparata Klimen v lechenii klimaktericheskikh rasstroystv u zhenshchin s endemicheskim zobom. Ginekologiya. 2001;3(1):14-7. [in Russiаn].
- Hernández Valencia M, Córdova Pérez N, Zárate A, Basurto L, Manuel Apolinar L, Ruiz M, et al. Hypothyroidism associated to menopause symptoms worsening change with thyroid substitution therapy. Ginecol Obstet Mex. 2008 Oct;76(10):571-5.
- Gafurova FA. Osobennosti techeniya klimaktericheskogo sindroma u zhenshchin s gipofunktsiyey shchitovidnoy zhelezy. V: Sb. st. Mezhdunar. nauch.-prakt. konf. Analiz sovremennykh tendentsiy razvitiya nauki, 2017 Iyul’ 05, Volgograd. V 2-kh ch. Ufa: NITS AETERNA; 2017. Ch. 1, s. 252-6. [in Russiаn].
- Pearce EN. Thyroid dysfunction in perimenopausal and postmenopausal women. Menopause Int. 2007 Mar;13(1):8-13.
- Acar B, Ozay AC, Ozay OE, Okyay E, Sisman AR, Ozaksoy D. Evaluation of thyroid function status among postmenopausal women with and without osteoporosis. Int J Gynaecol Obstet. 2016 Jul;134(1):53-7.
- Gietka-Czernel M. The thyroid gland in postmenopausal women: physiology and diseases. Prz Menopauzalny. 2017 Jun;16(2):33-7.
- Badawy A, State O, Sherief S. Can thyroid dysfunction explicate severe menopausal symptoms? J Obstet Gynaecol. 2007 Jul;27(5):503-5.
- Ceresini G, Milli B, Morganti S, Maggio M, Bacchi-Modena A, Sgarabotto MP, et al. Effect of estrogen therapy for 1 year on thyroid volume and thyroid nodules in postmenopausal women. Menopause. 2008 Mar-Apr;15(2):326-31.
- Lambrinoudaki I, Armeni E, Rizos D, Georgiopoulos G, Kazani M, Alexandrou A, et al. High normal thyroid-stimulating hormone is associated with arterial stiffness in healthy postmenopausal women. J Hypertens. 2012 Mar;30(3):592-9.
- Korolevskaya LI, Turova YeA, Tenyayeva YeA. Programmy vosstanovitel’noy meditsiny v korrektsii proyavleniy klimaktericheskogo sindroma i profilaktiki osteoporoza. Vestn. vosstanovit. meditsiny. 2009;2:88-90. [in Russiаn].
Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 165-170 pages, index UDK 618-053.87:616.441-008.64-085.83:577.17