Characteristics of consultations for patients aged over 45 years

Dubrovina S.O.

Rostov State Medical University, Ministry of Health of Russia, Rostov-on-Don, Russia

There are currently more than 30 million women aged over 45 in the Russian Federation. More than one million women reach menopause every year. Therefore, it is necessary for obstetricians and gynecologists to provide competent counseling and rationally assess the potential risks caused by estrogen deficiency. The change in the hormonal balance of androgens, estrogens and progesterone during peri- and postmenopause causes pathological changes in the cardiovascular, musculoskeletal and nervous systems. Peri- and postmenopausal women are at a higher risk of developing obesity which can also affect the unfavorable outcome of the clinical picture. It is important to pay special attention to patients with signs of hypoestrogenism in order to provide timely counseling and take therapeutic and preventive measures. The paper presents practical aspects that a clinician should take into account.
Conclusion: The key aspect for obstetricians and gynecologists about a menopausal woman is to improve the quality of her life and increase its duration. Menopausal hormone therapy (MHT) and its timely prescription reduces the risk of overall mortality by 31%, the risk of developing type 2 diabetes by 30%, and the risk of fractures by 30%. When choosing MHT, it is necessary to consider the safety profile of estrogens and progestogens included in the medication. When menopausal transition begins, the production of endogenous estradiol decreases, and a state of relative hyperandrogenism develops. It is important to find a balance between all hormones by selecting an adequate dosage of estrogen and a selective progestogen in MHT. It is worth noting that the progestogenic component should not decrease, but rather enhance, the beneficial effects of estrogen. Due to the completion of estrogen levels and the high selectivity of the progestogen, MHT with dydrogesterone helps to ensure a balance of activity of all three sex hormones, namely estrogens, progestogens and endogenous androgens in the female body.

Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Dubrovina S.O. Characteristics of consultations for patients aged over 45 years.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (4): 39-50 (in Russian)


estradiol deficiency
premature ovarian insufficiency
eating behavior
hormonal imbalance
hormone replacement medications
healthy endothelium
bone mineral density
thromboembolic risks
genitourinary syndrome
insulin resistance


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Received 10.04.2024

Accepted 23.04.2024

About the Authors

Svetlana O. Dubrovina, Dr. Med. Sci., Professor, Chief Researcher at the Obstetrics and Pediatrics Research Institute, Rostov State Medical University, Ministry of Health of Russia,,

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