Gasparyan S A, Chotchaeva A M, Karpov S M
Stavropol State Medical University.
Probl Endokrinol (Mosk). 2023 Feb 25;69(1):86-95. doi: 10.14341/probl13205.
The increasing of older age group in the population determines studying of age related diseases and emergence of new investigations in this area. In Female body, entering the menopausal transition is the start of «aging» of reproductive function and linked with decreasing of sex hormons levels. A direct connection between changes of estrogen, progesterone, androgen ratios and cognitive function of women was revealed. The anatomical localization of sex hormone receptors, the mechanisms of interaction of hormones with these receptors determine the ways of implementing biological effects of steroids on the CNS. Modern theories of «healthy nerve cells» and «eu-estrogenemia» explains the role of additional criteria, such as the absence of neurological diseases history and the duration of hypoestrogenia, to the outcome of menopausal hormone therapy. Additional factors that can affect to MHT action include: the composition of hormone therapy, administration methods, regimens (cyclic, continuous), duration of treatment, history of endocrine diseases, diabetes mellitus, gynecological history (parity, menarche age, COC use), heredity. The sections present the effect of menopausal transition on the development of depression, mood changes, sleep disturbances and mental disabilities. The explanation of negative effects of menopausal hormone therapy to cognitive health is also described by modern point of view. The ambivalent opinions of researchers, the potential of new reading of the results of earlier studies, confirms the necessity of continuing study of this topic.
人口中老年群体的增加决定了对与年龄相关疾病的研究以及该领域新研究的出现。在女性体内,进入更年期过渡是生殖功能“衰老”的开始,并与性激素水平下降有关。雌激素、孕激素、雄激素比例变化与女性认知功能之间的直接联系已被揭示。性激素受体的解剖定位、激素与这些受体的相互作用机制决定了类固醇对中枢神经系统产生生物学效应的方式。“健康神经细胞”和“正常雌激素血症”的现代理论解释了诸如无神经疾病史和雌激素缺乏持续时间等额外标准对更年期激素治疗结果的作用。其他可能影响更年期激素治疗作用的因素包括:激素治疗的组成、给药方法、方案(周期性、连续性)、治疗持续时间、内分泌疾病史、糖尿病、妇科病史(产次、初潮年龄、口服避孕药使用情况)、遗传。各章节阐述了更年期过渡对抑郁症发展、情绪变化、睡眠障碍和精神残疾的影响。现代观点也描述了更年期激素治疗对认知健康的负面影响的解释。研究人员的矛盾观点、对早期研究结果新解读的潜力,证实了继续研究该主题的必要性。