Multitarget non-hormonal complexes in modern algorithms for managing patients during the menopausal transition and postmenopause

DOI

https://dx.doi.org/10.18565/aig.2026.80

Shikh E.V., Grebenshchikova L.Yu., Makhova A.A.
1) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia; 2) Tver State Medical University, Ministry of Health of Russia, Tver, Russia

According to the latest international and Russian clinical guidelines for managing menopausal and postmenopausal women (IMS, NAMS, Russian clinical guidelines, 2025), menopausal hormone therapy (MHT) is considered the first-line treatment for moderate to severe vasomotor symptoms when there are no absolute contraindications. The recommendations specifically emphasize the importance of non-hormonal methods for managing menopausal symptoms. It is worth noting that non-hormonal therapy can be used as an independent approach or in combination with other strategies in the following clinical situations: at the beginning of MHT, before its full clinical effects are achieved; during a temporary interruption of MHT (e.g., during surgery or when risk factors temporarily increase); when patients have mild vasomotor symptoms after administration of a necessary dose of MHT but increase in the hormonal dose is not desirable; in cases when there are low doses of estrogen in MHT and there is no possibility of increasing them; when the hormone dose decreases due to the increase in the age and postmenopausal period. Current clinical guidelines emphasize the importance of a personalized approach to managing women during the menopausal transition and postmenopause. This approach takes into account factors such as the age, stage of reproductive aging, severity of menopausal symptoms, concomitant pathology and reproductive expectations of the patient.
Multitarget non-hormonal complex that contains phytoestrogens and micronutrients has a pathophysiological effect on the menopausal syndrome. Phytoestrogens, such as soy isoflavones, are involved in the modulation of ERβ-predominant receptors and determine vasoprotective effects. I3C/DIM regulate the profile of estrogen metabolites. Vitex agnus-castus extract performs dopaminergic/axial regulation of the psycho-vegetative and vasomotor domains, L-5-HTP supports the serotonergic axis of neurotransmitter balance. Osteotropic components (K1/boron, soy isoflavones) prevent a decrease in bone mineral density.
Conclusion: The use of rationally formulated complexes, which include phytoestrogens, plant extracts, vitamins, and trace elements, corresponds to the principles of personalized medicine, minimizing risks and improving the quality of life. This approach should become an essential component of modern strategies for preventing and managing menopausal symptoms.

Authors’ contributions: Shikh E.V., Grebenshchikova L.Yu., Makhova A.A. – developing the concept and design of the study, collecting and processing the materials, selecting the literature on the issue, writing the text, editing the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Shikh E.V., Grebenshchikova L.Yu., Makhova A.A. Multitarget non-hormonal complexes in modern algorithms for managing patients during the menopausal transition and postmenopause.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (3): 164-174 (in Russian)
https://dx.doi.org/10.18565/aig.2026.80

menopausal syndrome

menopause

non-hormonal therapy

phytoestrogens

soy isoflavones

micronutrients

Full text (in Russian)

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Received 05.03.2026

Accepted 19.03.2026

Evgenia V. Shikh, Dr. Med. Sci., Professor, Corresponding Member of RAS, Head of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases,
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bldg. 2,
+7(495)609-19-91, shikh_e_v@staff.sechenov.ru, https://orcid.org/0000-0001-6589-7654
Lyudmila Y. Grebenshchikova, PhD, Head of the Department of Reproductive Medicine and Perinatology, Tver State Medical University, Ministry of Health of Russia,
170100, Russia, Tver, Sovetskaya str., 4, +7(4822)368550, ludmilazdrav@mail.ru, klinika.concilium@mail.ru, https:// orcid.org/0000-0003-2815-1882
Anna А. Makhova, Dr. Med. Sci., Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bldg. 2, +7(495)609-19-91, makhova_a_a@staff.sechenov.ru, https://orcid.org/0000-0001-9817-9886

Multitarget non-hormonal complexes in modern algorithms for managing patients during the menopausal transition and postmenopause

Shikh E.V., Grebenshchikova L.Yu., Makhova A.A.

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