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BACKGROUND: Sclerosing stromal tumors (SST) are rare ovarian neoplasms that often appear as solid unilateral tumors of the ovary with no specific clinical or radiological presentation. The definitive treatment is surgical removal. CASE PRESENTATION: Our article presents four cases of female patients with sclerosing stromal ovarian tumor with clinical characteristics mimicking malignant ovarian lesions. Interestingly, two of our cases had elevated levels of inhibin B. All patients were treated with surgery (oophorectomy) and had no disease recurrence. CONCLUSION: Tumors' macroscopic features are usually non-specific and often suggestive of possible malignancy, therefore diagnosis is always based on histopathological report.

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Abnormal uterine bleeding is a term used to describe any irregular bleeding from the uterus that is not part of a woman's normal menstrual cycle and can happen during different life periods. Abnormal uterine bleeding can have structural etiologies (polyp, adenomyosis, leiomyoma, malignancy) or nonstructural etiologies (coagulopathy, ovulatory dysfunction, and not-classified). The post- and pre-menopausal period requires a detailed investigation to establish the etiology of the bleeding because the chances that the woman has a malignancy are plentiful in this period. The treatment plan is determined based on the underlying cause of the bleeding. The main objective of this paper was to determine the prevalence of endometrial carcinoma in different periods, focusing on the postmenopausal period. This research was a cross-sectional study and included 79 cases of abnormal uterine bleeding in different periods of women's lives. Our study found that abnormal uterine bleeding occurs more frequently during the premenopausal period (59%) and that the causes of irregular bleeding during this period were mainly benign. Our study focused on the postmenopausal period, where we found that 32.9% of irregular uterine bleeding occurs during this period, and the leading causes were malignant pathologies (83.3%), mainly endometrial adenocarcinomas. The average age was 66.7 years. During the study, it was observed that 50% of women with abnormal uterine bleeding due to malignancy were classified as overweight, 25% were obese, and 25% had normal weight. It was confirmed that obesity is a co-factor of malignancy in the postmenopausal period, and the pathophysiological mechanism is well understood now. Our study also found a high number of co-morbidities among women with abnormal uterine bleeding due to malignancy. We came to the conclusion that any abnormal uterine bleeding should be initially investigated in a multidisciplinary manner, an accurate diagnosis should be determined, and then a treatment plan should be established. The treatment strategy should be determined depending on the cause of abnormal bleeding.

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OBJECTIVE: Vaginal atrophy, the second most common complication of menopause, can lead to sexual dysfunction. This study evaluated the effect of a vitamin D vaginal suppository on sexual functioning in postmenopausal women. METHODS: This three-arm randomized controlled trial was conducted between August 2019 and August 2020. The sample comprised 105 postmenopausal women who were referred to comprehensive health service centers to receive postmenopausal care. The inclusion criteria were as follows: (i) being menopausal for at least 1 year, (ii) being married, (iii) being sexually active, and (iv) having sexual desire. Participants were randomly assigned to three groups for 8 weeks of treatment: intervention (vaginal suppository containing 1,000 units of vitamin D3), placebo (vaginal suppository placebo), or control (no treatment). The main outcome measure was sexual functioning, which was assessed using the Female Sexual Function Scale (FSFI) 4 times during the study (i.e., 1 month before the intervention, immediately after the intervention, 1 month after the intervention, and 2 months after the intervention). RESULTS: Immediately and 1 month after the trial, the intervention group had the highest FSFI score, followed by the placebo group, both of which were significantly higher than those of the control group (P<0.05). At the 2-month follow-up, the intervention and placebo groups had similar FSFI scores (P=0.08), both of which were significantly higher than those in the control group (P=0.001 and P=0.03, respectively). CONCLUSION: Vitamin D vaginal suppositories were more effective at improving sexual functioning among postmenopausal women in the short-term and appeared to prevent aging-related sexual functioning decline in the long term.

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PURPOSE: We aimed to examine the possible effects of the postmenopausal period on retinal and choroidal microvascular circulation using swept-source optical coherence tomography angiography (SS-OCTA). METHODS: This cross-sectional study included 45 eyes of 45 subjects in menstrual group and 40 eyes of 40 subjects in postmenopausal group. SS-OCTA was used for the assessment of vessel density (VD), foveal avascular zone (FAZ), choroidal thickness (CT), choriocapillaris VD, central macular thickness (CMT), nerve fiber layer thickness (RNFL), and ganglion cell layer (GCL) measurements. RESULT: The VDs of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) measurements were similar in both group. FAZ area was wider in postmenopausal group (0.305 mm2 (range, 0.212-0.498 mm2)) compared to menstrual group (0.271 mm2 (range, 0.131-0.464 mm2)) (p = 0.013). Choriocapillaris VD was significantly lower in postmenopausal group (p = 0.049). CT was thicker in the postmenopausal group, but with no statistically significant difference (p = 0.066). Central macular thickness, RNFL, and GCL were similar in both groups. CONCLUSION: This is the first study in the literature to evaluate the retinochoroidal microcirculation in the menstrual and postmenopausal periods with SS-OCTA. We observed an increase in both superficial and deep FAZ area and a decrease in choroidal blood flow in the postmenopausal period. We think that this enlargement in the FAZ area may be related to the decreased amount of estrogen.

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In recent years, many studies have been initiated to characterise the human gut microbiome in relation to different factors like age, lifestyle, and dietary habits. This study aimed to evaluate the impact of yoghurt intake on the gut microbiome among postmenopausal women and how overall dietary habits modulate the gut microbiome. In total, 52 participants were included in the study and two groups-a control (n = 26) and experimental group (n = 26)-were established. The study was eight weeks long. Both study groups were allowed to consume a self-selected diet, but the experimental group had to additionally consume 175 g of plain organic milk yoghurt on a daily basis for eight weeks. In addition, a series of questionnaires were completed, including a questionnaire on the subject's sociodemographic background, health status, and lifestyle factors, as well as a food frequency questionnaire. Stool samples were collected for the analysis of the gut microbiome (both prior to and after the eight weeks of the study). Sequencing of V4-V5 regions of the 16S rRNA gene was used to determine the bacterial composition of stool samples. The dominant phylum from the gut microbiome was Firmicutes (~70% to 73%), followed by Bacteroidota (~20% to 23%). Although no significant changes in the gut microbiome were related to daily consumption of yoghurt, we report that consumption of food products like grains, grain-based products, milk and milk products, and beverages (tea, coffee) is associated with differences in the composition of the gut microbiome. Establishing nutritional strategies to shape the gut microbiome could contribute to improved health status in postmenopausal women, but further research is needed.

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Objective: To explore the risk factors for nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with type 2 diabetes mellitus (T2DM) and the correlation with bone mineral density (BMD) in different areas of the body. Methods: A total of 434 postmenopausal women with T2DM were enrolled and categorized as 198 patients in the NAFLD group and 236 patients in the non-NAFLD group based on color Doppler ultrasound of the liver. The BMD of the lumbar spine, femoral neck, and total hip were measured by dual-energy X-ray absorptiometry. Results: In postmenopausal women with T2DM, the prevalence of NAFLD was 45.6%. The body mass index (BMI), systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), triacylglycerol (TG), uric acid (UA), and homeostatic model assessment for insulin resistance (HOMA-IR) C-peptide (CP) were significantly higher in the NAFLD group than in the non-NFALD group, and the duration of diabetes, and high-density lipoprotein cholesterol (HDL-C) were lower than in the non-NAFLD group (P < 0.05). Logistic regression analysis revealed that BMI (odds ratio [OR] = 1.303, 95% confidence interval [CI]: 1.152-1.346), HbA1c (OR = 1.263, 95% CI: 1.095-1.392), TG (OR = 1.263, 95% CI: 1.031-1.601), and SUA (OR = 1.005, 95% CI: 1.001-1.007) were correlated with NAFLD (P < 0.05). The BMD of the total hip and femoral neck in the NAFLD group was higher than in the non-NAFLD group (P < 0.05). Conclusion: Complicated NAFLD in postmenopausal women with T2DM is associated with weight gain, poor blood glucose control, abnormal lipid metabolism, and elevated UA levels. In addition, the NAFLD group had higher femoral neck and total hip BMD than the non-NAFLD group, suggesting NAFLD in postmenopausal women with T2DM may reduce the risk of osteoporosis.

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OBJECTIVE: To determine the value of endometrial thickness (ET) and Doppler indices of uterine artery (UtA) as sonographic markers in predicting endometrial cancer (EC) among postmenopausal bleeding (PMB) women in low-resource settings as Vietnam. METHODS: This cross-sectional study was conducted at the Hue University Hospital and Hue Central Hospital between June 2016 and June 2019. The study enrolled all women who complained of PMB and were followed by transvaginal Doppler ultrasound. Their definitive histopathological examination was the gold standard for comparison. RESULTS: The UtA Doppler indices, including resistance index (RI), pulsatility index (PI), and peak systolic velocity (PSV), were significantly lower in the malignant group than in the benign group. The threshold values of the UtA, RI ≤0.73 and PI ≤1.42, were found with an area under receiver operating characteristic curve (AUC) of 0.85-0.88, and the sensitivity and specificity were 91.3% and 83.3%, respectively. Unlike PSV, the diagnostic value was the lowest, with an AUC of 0.72. ET was a good predictor for the diagnosis of EC, with an AUC of 0.89. In women with PMB, when using the cutoff value of EC more than 12.5 mm, the sensitivity and specificity were 93.8% and 77.8%, respectively. In addition, the higher the stage of EC, the lower the RI and PI and the greater the EC. CONCLUSION: ET, and RI, PI, and PSV of the UtA could help in differentiating malignant from benign endometrial changes. Pulsed ultrasonic Doppler velocimetry seems to play a role in predicting the higher stages of EC. Further studies are needed to confirm these findings.

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Context: It is uncertain which cardiovascular risk factors are associated with sex hormone levels in postmenopausal women. Objective: This work aimed to investigate the association between cardiometabolic risk factors and sex hormones in a cross-sectional, observational population study. Methods: In this Swedish population study, participants were physically examined from 2002 to 2004, and endogenous sex hormones were analyzed by liquid chromatography-tandem mass spectrometry. Women aged 55 years or older with estradiol levels below 20 pg/mL and not using any hormonal therapy were eligible for inclusion in the study (N = 146). Variable selection and bootstrap stability analyses were performed and linear regression models presented, with each of the 8 hormones as outcome variables. Results: Body mass index (BMI) was positively associated with estradiol (ß = 0.054, P < .001), but negatively associated with 17-α-hydroxyprogesterone (ß = -0.023, P = .028). Waist-to-hip ratio (WHR) was negatively associated with dihydrotestosterone (ß = -2.195, P = .002) and testosterone (ß = -1.541, P = .004). The homeostatic model assessment of insulin resistance was positively associated with androstenedione (ß = 0.071, P = .032), estradiol (ß = 0.091, P = .009), estrone (ß = 0.075, P = 0.009), and 17-α-hydroxyprogesterone (ß = 0.157, P = .001). Age was positively associated with testosterone (ß = 0.017, P = .042). C-reactive protein showed an inverse association with progesterone (ß = -0.028, P = .037). Lower low-density lipoprotein cholesterol was associated with higher estradiol levels (ß = -0.093, P = .049), whereas lower triglycerides were associated with higher concentrations of dihydrotestosterone (ß = -0.208, P = .016). Conclusion: In postmenopausal women, WHR was strongly inversely associated with androgens, while BMI was positively associated with estrogens.

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THE AIM OF THE STUDY: Was to assess the clinical effectiveness of the course of ketoprofen lysine salt after its oral application in postmenopausal women with vitamin D deficiency in the complex therapy of inflammatory periodontal diseases. MATERIALS AND METHODS: The study comprised 100 women with decreased bone mineral density and chronic generalized mild to moderate periodontitis. The average age was 55.3±1.9 years with menopause lasting for more than 5 years (6.0±0.8) and the average age for the onset of menopause of 48.9±1.5 years. The study participants were divided into four groups (two main groups and two comparison groups). The patients underwent periodontal treatments and received native vitamin D prescriptions in accordance with clinical guidelines and treatment protocols. RESULTS: Serum vitamin D for the patents of the first and second groups was 11.4±1.9. Vitamin D level in the comparison groups was 34.6±3.2. The study reveals the direct correlation of chronic periodontitis, the level of bone mineral density and vitamin D deficiency in older female patients. The effects are proved by reduction of indices like PMA, Mulleman bleeding index and periodontal index for all study groups. Correlation of anti-inflammatory activity of the solution with the reduction in pockets depths was 0.46 mm along with improvements in syalometry. Organoleptic properties of the tested oral solution of ketoprofen lysine salt were positively evaluated by all participants, subjective assessments of «color¼, «treatment effect¼ and «prolonged analgesic effect¼ received the highest scores. CONCLUSION: Ketoprofen lysine salt solution has shown significant anti-inflammatory, antioedemic and hemostatic activity of the drug in therapy of chronic generalized mild to moderate periodontitis in older female patients.

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Pelvic organ prolapse (POP) is a common condition in menopausal and postmenopausal women. POP is a chronic, slowly progressive disease that leads to physical and psycho-emotional discomfort, brings physical and moral suffering to the patient and reduces the quality of life. Among the factors contributing to the development of this pathology, there is a history of obstetric trauma, obesity, heavy physical labor, as well as genetically determined connective tissue dysplasia. Conservative methods of treating POP are known, but the low frequency of their use is due to low efficiency and late diagnosis of this pathology. The main method of treatment is surgical. Currently, more than 500 methods of surgical correction of POP in women have been described. However, the relapse rate reaches 38%. The introduction of mesh implants also did not solve this problem due to the development of implant-associated complications. Thus, it is currently relevant to further study the causes of pelvic organ prolapse, taking into account the genetic, phenotypic and clinical-anamnestic risk factors of the patient, as well as to develop a personalized approach to choosing the optimal method of surgical treatment in each individual case.

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The prevalence of hyperprolactinemia in postmenopausal women is unknown and has been estimated as infrequent by many studies. Prolactinomas found after menopause are usually macroadenomas and remain unrecognized for a long time due to atypical clinical signs or their absence. The growth potential of prolactinomas persists after menopause, most of them are invasive and accompanied by high prolactin levels. Treatment with dopamine agonists is usually long-term, the goals of which are to reduce tumor size, normalize prolactin levels and the negative effects of hyperprolactinemia. Treatment with cabergoline makes it possible to achieve remission of the disease in the first years after discontinuation, however, the proportion of relapses in postmenopausal women increases 5 years after discontinuation of the drug. Remission of prolactinomas is not evident in postmenopausal women. The modern management of patients with prolactinoma and/or hyperprolactinemia does not have clear positions in the postmenopausal period. Controversial issues remain: an ambiguous relationship between prolactin levels and breast cancer, there are no convincing conclusions on the improvement of bone mineral density and/or a decrease in the risk of fractures with normalization of prolactin levels, there are no data on metabolic parameters after the end of treatment with dopamine agonists, conflicting information about the relationship of prolactin levels and the severity of the manifold manifestations of the climacteric syndrome. The use of estrogen-progestin drugs in women with hyperprolactinemia/prolactinomas is also not well understood. Thus, the problem of hyperprolactinemia in the perimenopausal and postmenopausal period is underestimated and requires additional research, as well as the development of diagnostic and therapeutic strategies for potential benefits in terms of weight loss, improving insulin sensitivity, reducing the risk of fractures, maintaining sexuality and psycho-emotional well-being.

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Background: In this study, we aimed to assess the cognitive determinants of weight control behaviors by dietary patterns among postmenopausal women with osteoporosis. Methods: This cross-sectional study, based on the theory of planned behavior (TPB) was conducted from July to December 2017 among 240 postmenopausal women with osteoporosis in Tabriz, Iran. A validated and reliable TPB-based instrument, namely Weight-CuRB, and the food frequency questionnaire (FFQ) were used. Results: The results of exploratory factor analysis (EFA) indicated three dietary patterns (total variance explained=24.44%); healthy (n=71), mixed (n=78), and western (n=91). In addition, food items consumed by participants were classified into twenty-two food groups for dietary pattern analysis. In the healthy and western dietary patterns, attitude (ß: 0.140, P <0.001) and subjective norms (SNs) (ß: 0.498, P <0.01) were the only predictors of weight control behavior, respectively. In the women with healthy and western patterns, the TPB-based variables altogether explained 11% and 16% of variations in the behavior, respectively. Among all patients, the TPB-based variables explained 12.2% of variations in weight control behavior, within which SNs were the only significant predictor of the behavior (ß=-0.199, P <0.01). Conclusion: Our findings highlighted the remarkable role of dietary patterns in the associations between weight control and its cognitive determinants. Dietary patterns should be considered while designing weight control educational interventions among women with osteoporosis. In such interventions, promoting SNs and perceived behavioral control (PBC) should be considered as the core strategies to promote the behaviors among the patients who follow an unhealthy diet.

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AIMS: There is much controversy regarding whether cardiovascular events increase in women with polycystic ovary syndrome (PCOS) with aging. Considering the lack of possibility of certain investigations in humans, animal models of PCOS may be suitable resources to obtain the useful data needed. In this study; we aimed to investigate whether cardiac function and tolerance to ischemia/reperfusion (I/R) injury worsen in postmenopausal rats, who had PCOS at younger ages, compared to controls. MAIN METHODS: The hearts of aged rats with a history of PCOS and their controls were isolated and perfused in a Langendorff apparatus. Values of hemodynamic parameters, including left ventricular systolic pressure (LVSP), left ventricular developed pressure (LVDP), rate pressure product (RPP) and peak rates of positive and negative changes in left ventricular pressure (±dp/dt) were recorded using a power lab system. Blood serum levels of total testosterone (TT) and estradiol (E2) were determined by ELISA kits. Generalized Estimating Equation Model and t-student unpaired test results were used to compare the findings documented between two groups. KEY FINDINGS: No statistically significant differences were observed in hemodynamic parameters of the heart including, LVSP, LVDP, RPP and ±dp/dt, between the rats of two groups of study, at baseline or before ischemia and after I/R. Nor were any significant differences observed in the levels of two hormones between the two groups (p > 0.05). SIGNIFICANCE: History of PCOS during reproductive ages should not be considered an important risk factor for reduction in cardiac contractile function or less tolerance to I/R injury during the postmenopausal period.

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Objectives Chronic periodontitis is one of the most common diseases in the world. Periodontitis occurs more frequently in postmenopausal women due to hormonal changes and in patients with osteoporosis. Thus, the aim of our study was to compare levels of alveolar bone loss of mandible and maxilla and bone tissue remodeling markers in women of reproductive and postmenopausal periods. Methods Fifty-nine women aged 25-68 years were enrolled in a cross-sectional study and divided into two groups. Group I consisted of 42 women of reproductive age and Group II included 17 women in their postmenopausal period. The level of alveolar bone loss of mandible and maxilla was assessed using dental panoramic radiography, and the level of bone remodeling markers (Beta C-terminal telopeptide of type I collagen [ß-CTx] and osteocalcin) was obtained in both groups. Results Women in the postmenopausal period have higher level of alveolar bone loss in mandible and maxilla than women of reproductive age. The level of ß-CTx and osteocalcin was significantly higher in Group II, compared to Group I (p=0.002 and p=0.005, respectively). Conclusions In postmenopausal women, on the background of significantly higher bone remodeling, an increase of alveolar bone loss of mandible and maxilla was observed.

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OBJECTIVE: Because it is difficult to diagnose accurately whether uterine corporeal mesenchymal tumors are benign or malignant before surgery, an understanding of the characteristics of patients with uterine sarcomas occurring in the postmenopausal period is required. METHODS: We retrospectively reviewed the cases of women who underwent surgery for uterine mesenchymal tumors at our hospital. RESULTS: Among 487 operated cases, 447 tumors occurred in the premenopausal period and 40 occurred in the postmenopausal period. Uterine sarcomas were observed in 5 cases (1.1%) during the premenopausal period and in 11 cases (28%) during the postmenopausal period. Among the postmenopausal patients, age, age at menopause, body mass index (BMI), tumor size, incidence of abnormal vaginal bleeding, serum tumor marker levels (cancer antigen 125, carbohydrate antigen 19-9, and carcinoembryonic antigen), and serum lactate dehydrogenase values were not significantly different between patients with benign tumors and those with malignant tumors. On the other hand, the incidence to have abnormal signal on MRI was significantly higher in patients with malignant tumors than in patients with benign tumors. CONCLUSION: In our hospital, the incidence of malignant tumors in women with uterine corporeal mesenchymal tumors was much higher in postmenopausal patients than in premenopausal patients. Because it is generally not easy to diagnose uterine sarcomas before surgery, surgery should be positively considered when uterine sarcomas cannot be ruled out for patients in the postmenopausal period.

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Endometrial cancer is the most common gynecologic cancer. Transvaginal ultrasonography (TV USG) is considered to be the first-line diagnostic method for the evaluation of endometrial cancer. 213 asymptomatic postmenopausal patients (192 benign, 21 patients malignant endometrial findings after endometrial sampling) who underwent evaluation with gray-scale TV USG at maximum 48h before endometrial sampling were included. Except for hypertension (P=0.004) and endometrial thickness (P=0.003), there was no significant difference in the demographic data, endometrial fluid and endometrial cystic areas detected on TV USG between the groups. A cut-off value of 8.35mm for endometrial thickness yielded 98.05% positive predictive value with 95% CI. If the endometrial thickness is ≥8.35mm at TV USG performing endometrial curettage will be reasonable not to wait until 11mm and endometrial sampling is not required if TV USG shows fluid and cystic areas in the endometrial cavity.

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INTRODUCTION AND HYPOTHESIS: Genitourinary syndrome of menopause is a major health concern in postmenopausal women. This study was aimed at comparing the effect of a vitamin E vaginal suppository with that of conjugated estrogen vaginal cream on sexual function in postmenopausal women with genitourinary syndrome of menopause. METHODS: This survey was carried out on 52 postmenopausal women aged 40-65 years who had been referred to gynecology clinics in Mashhad city, during 2013-2014. Keeping ß = 0.1, the power was calculated to be 90%. The patients were randomly divided into two groups: vitamin E vaginal suppository and conjugated estrogen vaginal cream. Participants used the medications for 12 weeks. They were visited at the 4th, 8th, and 12th weeks. Validated Abbreviated Sexual Function Questionnaire (ASFQ), as the primary outcome measure, and a demographic information questionnaire, were used to collect data at each visit. Data were analyzed using SPSS and p < 0.05 was considered statistically significant. RESULTS: Mean overall scores of the ASFQ were increased significantly in both groups during the course of the study, compared with baseline (p < 0.001). However, the mean ASFQ scores of the two treatments did not differ significantly. CONCLUSION: Improved scores of ASFQ after the 12th week showed that the treatment was successful in both groups. Therefore, a vitamin E vaginal suppository may be an alternative to vaginal estrogen in relieving the symptoms of vaginal atrophy in postmenopausal women, especially those not able to use hormone therapy or have low compliance.

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Hyperprolactinemia is not a common finding in postmenopausal women. Prolactinomas detected after menopause are usually macroadenomas. Due to atypical clinical features they may remain unrecognized for a long period of time. Interestingly the growth potential of prolactinomas remains after menopause. Most tumors are invasive and present with high prolactin levels. They respond to medical treatment with dopamine agonists in terms of prolactin normalization, tumor shrinkage, and improvement in pituitary function. Treatment with dopamine agonists is usually long term. Reducing doses of cabergoline to the lowest that keeps prolactin levels normal prior to withdrawal is proposed to patients with macroprolactinomas who normalize prolactin after > 5 years of treatment and who do not have cavernous sinus invasion. Cabergoline can achieve a high percentage of remission maintenance in the first years after withdrawal. However, the percentage of relapse-free patients 5 years after withdrawal is significantly lower. Besides recurrent hyper-prolactinemia in a subgroup of macroprolactinomas after a long-interval tumor regrowth may be detected. Menopause cannot ensure remission of the tumor so long-term surveillance is suggested. In patients with microadenomas data on long-term remission rates (normalization of prolactin and disappearance of the tumor) after suspension of treatment with dopamine agonists are highly variable. The current strategy for microprolactinomas is not to treat hyperprolactinemia in menopause if it recurrs after discontinuation of dopamine agonists. This is based on: (1) reports that elevated prolactin levels may normalize in some women after menopause, (2) the fact that the association between prolactin levels and breast cancer is inconsistent in postmenopausal women, (3) the lack of clinical evidence that normalization of prolactin levels in postmenopausal women improves bone mineral density or reduces the risk of fracture, and (4) the fact that, concerning the metabolic syndrome, no data are available on metabolic parameters after suspension of treatment with dopamine agonists. For a change in strategy, i.e., for the potential benefits from treatment of hyperprolactinemia in the postmenopausal period with dopamine agonists concerning weight loss, improved insulin sensitivity, decreased fracture risk, and improved sexuality, more evidence is needed.

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In order to study the role of the marital status and place of residence, as the social determinants of the development of vertebral pain syndrome and related disorders of life activity, the results of a survey of 148 postmenopausal women aged 50-69 years were analyzed. Respondents were divided into groups depending on their marital status (living in a family with husbands and other relatives, only with husbands or alone) and places of residence (in rural or urban areas). The results of this study suggest that family status and place of residence in women of older age groups do not directly influence on the back pain, however they contribute to impairment of vital functions associated with back pain, in particular, psychological state, general activity, working capacity, and also stipulate a higher frequency of requests for medical care and hospitalizations. In single women the level of disruption of daily activity is significantly higher, although the incidence of disability in doing household chores is significantly lower than in married women. Single women reliably seek medical help more often and are hospitalized throught back pain. It was also found the significant correlations between the place of residence and the frequency of health problems related to back pain, psychological and mood disorders, general activity, relationships with others, daily disability in work, impaired ability to move and the frequency of medical help seeking throught back pain. In conclusion, ite should be taken into account in planning of treatment and rehabilitation of women of older age groups with back pain.

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We have analyzed the vertebral pain syndrome (VPS) rate in 2 844 women aged 40-89 years, divided into groups according to the period of life (reproductive, perimenopausal and postmenopausal (PMP)) and evaluated the relationship between VPS frequency and indices of bone mineral density (BMD). It was found that the frequency of VPS during different physiological periods of woman life ranges from 84,1 to 94,4 %, with significant increase when the PMP period is more than 20 years compared with women in reproductive and early postmenopausal periods. The significant increase of the VPS frequency in thoracic and lumbar spines starts from 1-3 years of PMP and is retained at higher level for all subsequent periods of PMP. In postmenopausal women, a significant increase of the relative risk of VPS in the thoracic (in 1,3-1,4 times) and the lumbar (1,2-1,3 times) spines was found. In patients with osteoporosis with duration of PMP for 1-3 years, the frequency of VPS in thoracic spine was significantly higher than the indices in women with osteopenia, while patients with duration of PMP of 7-9 years had significantly higher frequency comparing to groups with osteopenia and norms. In patients without vertebral fractures and osteoporosis VPS frequency in the thoracic spine was significantly higher during periods of 4-6 and 7-9 years of PMP compared with women in reproductive period and compared with the women with normal BMD indices. The revealed features of the VPS should be considered while planning therapeutic interventions in women of older age groups.

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