HEALTH OF WOMAN. 2018.8(134):26–29; doi 10.15574/HW.2018.134.26

Levenets S. O. , Udovikova N. O. , Novokhatskaya S. V. , Kashkalda D. A. , Sheludko O. Yu.
SE «Institute of Health Care of Children and Adolescents of the National Academy of Medical Sciences of Ukraine», Kharkiv

The objective: to allocate the clinico-anamnestic and hormonal and metabolic indicators influencing the remote results of treatment Spironolactonum.

Materials and methods. 78 girls at the age of 13–17.5 years with a hypomenstrual syndrome are surveyed (НMS: an oligomenorrhea – OHM, a secondary amenorrhea – VA) in 2 years and more after an initiation of treatment Spironolactonum (3 ten-day courses). The menstrual age (MA), the perinatal anamnesis, НMS duration prior to treatment, the index of body weight (IBW), uterus volume according to ultrasonic examination (US) of organs of a small pelvis, degree of expression of a hirsutism, contents in a cow of gonadotrophic, sex hormones, рrolactinum (PRL), insulin were studied by an immunoenzymatic method. The prognostic coefficient (PC) and its informational content were defined (I). The criterion of efficiency of treatment is an independent regular menstrual cycle.

Results. The remote efficiency of treatment at OHM reached 62.9%, at VA – only 20.1% (Р < 0.001). The most prognostically significant relatively positive takes of treatment is the MV up to 2 years (PC = +5.13; I = 0.542), rather negative results – VA (PC = – 3.54; I = 0.545), a hirsutism of the II–III Art. on Ferrimana-Gаlvey’s scale, the increased LG level (PC = – 3.52; I = 0.59) and the lowered contents in blood estradiolum (PC = – 3.68; I = 0.36).

Conclusions. The separated efficiency of treatment Spironolactonum within three months is 3 times better at OHM, than at VA. Girls with НMS demand inspection and treatment in the first 1–1.5 years after a menarche. Special attention should be paid to girls with the expressed hirsutism, to at what disorders of menstrual function remain within 2 years and more, with the LG high initial level and the lowered content in blood estradiolum.

Key words: teenage girls, hypomanstrual syndrome, spironolactone, long-term effectiveness, гирсутизм, estradiol.

REFERENCES

1. Vihlyaeva EM. (2004). Guide to the diagnosis and treatment of uterine leiomyoma. M, MEDpress-inform:399.

2. Gubler EV. (1978). Computational methods of analysis and recognition of pathological processes. L, Medicina:294.

3. Grodnickaya EE, Kurcer MA. (2012). Hirsutism: pathogenesis, clinic, diagnosis, treatment. Akusherstvo i ginekologiya. 4/1:87-90.

4. Zobina LYu. (2008). Pathology pubertal as an unfavorable background for a complicated course of pregnancy in the future. Reproduktivnoe zdorove molodezhi – zdorove sleduyushih pokolenij: tez. dokl. XI Evropejskogo kongressa detskih i podrostkovyh ginekologov. SPb:21.

5. Kulikova LF, Koren NS. (1985). Treatment of menstrual dysfunction in adolescent girls with spironolactone. Mediko-psihologicheskie aspekty braka i semi: materialy nauch.-prakt konf. s mezhdunar. uchastiem. K:123.

6. Levenec SO, Nachotova TA, Udovikova NO, Kashkalda DA. (2017). Hormonal and metabolic parameters in adolescent girls with hypomenstrual syndrome with different efficacy of non-hormonal treatment. Ukrayinskij zhurnal dityachoyi endokrinologiyi 1:24.

7. A.s. No. 65984, UA. Method of forecasting the effectiveness of non-hormonal treatment of adolescent girls with secondary amenorrhea. T.A. Nachotova (UA). N 66479; stated on 07.04.16; published on 10.06.16, by Bull. 28.

8. Parashuk YuS, Lisova MA, Zobina LYu. (2009). Realization of reproductive potential in women with a history of menstrual disorders. Zdorove zhenshiny 8:152-154.

9. Pat. 2442170, RU, MPK G01N33/53 G01N33/49. A method for predicting the restoration of menstrual function in patients with anorexia nervosa. V.O. Andreeva et al.; applicant and patent holder Federal State Institution Rostov Research Institute of Obstetrics and Pediatrics, Ministry of Health and Social Development of the Russian Federation. – 2016132277; stated on 04.08.2016; published on 08.08.2017, by Bull. 12.

10. Pat. 2363002, RU, MPK G01N33/74. Method for predicting the recovery of menstrual function in patients with anorexia nervosa. VO Andreeva et al. Аpplicant and patent holder Federal State Institution Rostov Research Institute of Obstetrics and Pediatrics, Ministry of Health and Social Development of the Russian Federation. N 2008121776/15; stated on 30.05.2008; published on 27.07.2009.

11. Pat. 2427842, RU, MPK G01N33/74 A61P3/10. The method of predicting the effectiveness of treatment of patients with polycystic ovary syndrome metformin and/or weight loss. P.V Popova et al; applicant and patent holder State Educational Institution of Higher Professional Education St. Petersburg State Medical University named after Academician I.P. Pavlova Federal Agency for Health and Social Development. – stated on 30.03.10; published on 27.08.11.

12. Trushkevich OO. (2004). Features of menstrual function in the reproductive period in women with pathologic progress of puberty. Pediatriya, akusherstvo ta ginekologiya 5:81-85.

13. Chebotaryova YuYu. (2011). Mechanisms of the formation of the polycystic ovary syndrome in the period of puberty, clinical course, prevention and treatment. Endokrinnaya ginekologiya 6:105-114.

14. Sheludko OYu. (2000). The use of veroshpiron in the treatment of menstrual dysfunction in adolescent girls. Buk. med. visnik. 4;2-3:135-137.

15. Shilova OYu, Krulikovskaya TN. (2007). Differential-diagnostic and therapeutic approaches to the management of adolescents with oligomenorrhea. Reproduktivnoe zdorove detej i podrostkov 6:22-29.

16. Lanzo E, Monge M, Trent M. (2015). Diagnosis and Management of Polycystic Ovary Syndrome in Adolescent Girls. Pediatr Ann. 44(9):223-230. https://doi.org/10.3928/00904481-20150910-10; PMid:26431241 PMCid:PMC5659205