RESOLUTION OF THE VI INTERNATIONAL FORUM OF EXPERTS ON MENOPAUSE

РЕЗОЛЮЦІЯ VI МІЖНАРОДНОГО ФОРУМУ ЕКСПЕРТІВ ІЗ ПИТАНЬ МЕНОПАУЗИ
Aghababyan L.R. Begimbekova L.Z. Gafurova F.A. Grebennikova H.O. Grishchuk K.O. Gromova O.L. Dzhaimbetova A.P. Yermolenko T.O. Yefimenko O.O. Zakharenko N.F. Kopobayeva I.L. Kosei N.V. Kristesashvili D.I. Mirzabekova G.T. Pedachenko N.Y. Persoyan I.G. Pirogova V.I. Plaksieva K.D. Rozhkovska N.M. Sarmuldaeva S.K. Stavinska L.V. Tagieva S. Tatarchuk T.F. Ukibasova T.M. Yashina O.G.
31 March 2025 LTD Trilist

Reproductive Endocrinology
2025 Issue 76 8 - 18 pp.

On November 27, 2024, the VI International Forum of Experts on Menopause was held with the support of the Ukrainian Association of Gynecologists-Endocrinologists. Leading specialists from Azerbaijan, Armenia, Georgia, Kazakhstan, Uzbekistan and Ukraine took part in the event. The experts reviewed the criteria for the Menopausal Hormone Therapy (MHT) acceptance, the features of the appointment of this therapy and its safety profile in menopausal women with endometriosis, in patients with uterine fibroids, discussed new studies on menopause and the MHT. Regarding oncological risks, there are no restrictions on the MHT use in women with ovarian and colon cancer. In women with endometrial, cervical, lung cancer, melanoma, with BRCA1 and BRCA2 gene mutations and negative HR receptors, the benefits of MHT outweigh the risks. In case of venous thromboembolism/pulmonary embolism in the anamnesis, the absence of a progestogen component in the composition of MHT is important. In patients with migraines without aura, both estrogen and combined MHT can be used. Combined MHT with metabolically neutral dydrogesterone can be prescribed for tension headache. There are no contraindications to MHT in metabolic syndrome and diseases of the digestive system. MHT is limited in acute hepatitis and inflammatory bowel diseases, and contraindicated in liver cirrhosis. When MHT interacts with other drugs, the effectiveness of estrogens and progestogens may be impaired. MHT can be used simultaneously with many drugs, with the exception of aromatase inhibitors, selective estrogen receptor modulators, anticonvulsants, antineoplastic drugs and immunosuppressive drugs. A large number of women with endometriosis have symptoms of menopause and need MHT. Such therapy should be individualized taking into account the needs of the patient, it is necessary to take into account the possible recurrence of endometriosis and the risk of malignancy in menopause. MHT can be prescribed for asymptomatic uterine fibroids in the absence of indications for surgical treatment. MHT is safest for «old» nodes of stable size. During the MHT an ultrasound monitoring of the nodes growth is needed and therapy should be discontinued if growth is detected. The analysis of the MHT safety showed that ultra-low doses of estradiol and dydrogesterone have a beneficial effect on vasomotor symptoms and quality of life of postmenopausal women, are well tolerated without an increase in the frequency of side effects compared to placebo.

dydrogesterone , endometriosis , estradiol , International Forum of Experts on Menopause , menopausal hormone therapy , resolution , uterine fibroids

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Department of Obstetrics and Gynecology, Faculty of Advanced Training of Doctors, Samarkand Medical Institute, Samarkand, Uzbekistan
Department of Obstetrics, Gynecology and Pediatrics, Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent, Kazakhstan
Department of Obstetrics, Gynecology and Perinatal Medicine, Tashkent Institute of Advanced Medical Education, Tashkent, Uzbekistan
Institute of Reproductive Medicine, executive director of the Kazakhstan Association of Sexual and Reproductive Health, Almaty, Kazakhstan
Verum Expert Clinic, Kyiv, Ukraine
Obstetrics and Gynecology Department of Postgraduate Education, О.О. Bogomolets National Medical University, Kyiv, Ukraine
Institute of Reproductive Medicine, master’s degree, expert of the Kazakhstan, Association for Sexual and Reproductive Development, consultant of the United Nations Population Fund (UNFPA), Almaty, Kazakhstan
Department of Obstetrics and Gynecology, Odessa National Medical University, Odessa, Ukraine
Endocrine Gynecology Department, SI «All-Ukrainian Centre for Motherhood and Childhood of the NAMS of Ukraine», Kyiv, Ukraine
Endocrine Gynecology Department, SI «All-Ukrainian Centre for Motherhood and Childhood of the NAMS of Ukraine», head of the scientifi board of the clinic, Institute of Family Planning, Kyiv, Ukraine
Department of Obstetrics, Gynecology and Perinatology, National Academic National University «Karaganda Medical University, Karaganda branch of the Kazakhstan Association for Sexual and Reproductive Development, Karaganda, Kazakhstan
Department of Reproductive Health, SSI“Center for Innovative Medical Technologies of the NAS of Ukraine», Kyiv, Ukraine
deputy director of the University Clinic, Tbilisi, Georgia
Center for Molecular Medicine, Almaty, Kazakhstan
Department of Obstetrics, Gynecology and Perinatology, P.L. Shupyk National Institute of Health of Ukraine, Kyiv, Ukraine
head of the Anti-Aging Gynecology Service, Beglaryan Medical Center, president of the Armenian Anti-Aging Medical Association, Yerevan, Armenia
Department of Obstetrics, Gynecology and Perinatology, Faculty of Postgraduate Education, Lviv National Medical University named after Danylo Halytsky, Lviv, Ukraine
Department of Endocrine Gynecology, SI «All-Ukrainian Center for Maternity and Childhood of the NAMS of Ukraine», Department of Reproductive Health, «Center for Innovative Medical Technologies of the NAS of Ukraine», Kyiv, Ukraine
Department of Obstetrics and Gynecology, Odessa National Medical University, Odessa, Ukraine
Department of Obstetrics and Gynecology No. 1б Kazakhstan National Medical University, Independent Expert of the Scientific Foundation of the Republic of Kazakhstan, deputy director for service quality of the IRM Clinic, Kazakhstan
Department of Obstetrics and Gynecology, Nicolae Testemițanu State University of Medicine and Pharmacy, Chisinau, Moldova
deputy director of the Oxygen clinic, Baku, Azerbaijan
Endocrine Gynecology Department, SI «All-Ukrainian Centre for Motherhood and Childhood of the NAMS of Ukraine», Department of Reproductive Health, SSI“Center for Innovative Medical Technologies of the NAS of Ukraine», Kyiv, Ukraine
National Scientific Center for Maternity and Childhood of the «University Medical Center», Astana, Kazakhstan
Medicom Clinic, Kyiv, Ukraine

Department of Obstetrics and Gynecology
Department of Obstetrics
Department of Obstetrics
Institute of Reproductive Medicine
Verum Expert Clinic
Obstetrics and Gynecology Department of Postgraduate Education
Institute of Reproductive Medicine
Department of Obstetrics and Gynecology
Endocrine Gynecology Department
Endocrine Gynecology Department
Department of Obstetrics
Department of Reproductive Health
deputy director of the University Clinic
Center for Molecular Medicine
Department of Obstetrics
head of the Anti-Aging Gynecology Service
Department of Obstetrics
Department of Endocrine Gynecology
Department of Obstetrics and Gynecology
Department of Obstetrics and Gynecology No. 1б Kazakhstan National Medical University
Department of Obstetrics and Gynecology
deputy director of the Oxygen clinic
Endocrine Gynecology Department
National Scientific Center for Maternity and Childhood of the «University Medical Center»
Medicom Clinic

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