Many women approach menopause with underlying disease of the endocrine system, in particular, endocrinopathy. In a study of women peri-and postmenopausal complaints, typical for the climacteric syndrome, without a history of diseases of the endocrine system, was found a high prevalence of thyroid disease: 40% of women have nodules and hypothyroidism. This fact should be noted, particularly in iodine deficiency that existed in many regions of our country. Is now generally recognized that iodine deficiency disorders - it is usually hidden hypothyroidism. Hyperplastic thyroid tissue only for a time able to maintain euthyroid state, with elevated body's need for thyroid hormone, which occurs during adaptation to new conditions, manifested hypothyroidism.

Lack of specific symptoms in most elderly patients, and more similarity of clinical manifestations of menopause with symptoms of hypothyroidism can mask or exacerbate the clinic of one of the diseases.

Over the past few years in the treatment of menopausal disorders has been significant progress. The main method of their correction and prevention is a hormone replacement therapy (HRT) analogues of sex hormones. Despite the availability of proven benefits of HRT in menopause, in practice doctors often fear the use of HRT due to the presence of extragenital pathology in women of this age, including the thyroid gland.

One of the most modern drugs for HRT is Femoston, containing 17-b-estradiol (2 mg) of plant origin, in conjunction with the cyclical use of dydrogesterone (10 mg), an analog of natural progesterone. After using one pack should immediately take the following, which provides continuous taking the drug. Dydrogesterone is characterized by the metabolic stability and absence of estrogen, androgen and mineralocorticoid activity, high bioavailability after oral administration.

The purpose of the study

Evaluate the clinical efficacy and acceptability of drug Femoston HRT in postmenopausal women with hypothyroidism.

Materials and methods

In the department of Gynecological Endocrinology (Centre for Women's Health after 40 years) and in Nalchik surveyed 252 women aged 45 to 60 years, indicating a history of thyroid disease. All patients climacteric syndrome arose as a result of natural ovarian failure. In 72 (28.6%) of them on the background of various thyroid gland was diagnosed hypothyroidism. At the present time to ascertain the cause of primary hypothyroidism does not significantly alter the algorithm of its treatment. Given this fact, all patients pending the appointment of HRT was carried out payment of hypothyroidism with levothyroxine drug in individually selected dose (50-150 mg / day).. 35 people took part in further study, were divided into two groups: Group 1 (21 patients) were treated with Femoston, in group 2 (14 women), HRT was not conducted due to the presence of absolute contraindications to it.

To assess the severity of the climacteric syndrome (CS) used the Kupperman menopausal index to modify Uvarovoy EV (1982). Were also provided clinical and laboratory research methods: determination of the concentration of TSH, T3, T4, T4sv baseline and after 3, 6 and 12 months of therapy, ultrasound volume and structure of the thyroid gland, blood lipid profile.