Introduction. Postmenopausal women in a state of oestrogen deficiency often experience pelvic prolapse with underlying genitourinary menopausal syndrome, when the progression of atrophic processes in the vaginal mucosa comes to the forefront.Aim. To evaluate the results of the use of topical hormonal therapy in the perioperative period to improve the vaginal epithelial surface appearance in postmenopausal women who need surgical treatment of pelvic prolapse.Materials and methods. A comparative prospective randomized clinical trial included 60 postmenopausal patients aged 60 to 69 years with a postmenopausal period of 10 to 20 years, suffering from POP-Q stage II–IV pelvic prolapse (ICS, 1996). All patients were recommended surgical treatment using vaginal approach. The treatment group (Group 1) included 30 patients who received topical hormonal therapy with an estriol drug (Ovestin cream, 1 mg/g) within 1 month before reconstructive plastic surgery. The comparison group (Group 2) included 30 patients who did not receive hormonal treatment in the perioperative period.Results. No complications were observed in the treatment group after reconstructive plastic surgery in the early and late postoperative periods. In the comparison group, natural urination was not achieved in 9 of 30 (35.0%) women on Day 2 after surgery, in 4 of 30 (13.3%) patients on Day 3. Also in that group, 4 of 30 (13.3%) patients experienced infectious and inflammatory complications in the postoperative period, the mucous membrane healing in 5/30 (16.6%) patients took a long time, over 1 month.Conclusions. The use of topical hormonal therapy with an estriol drug in the perioperative period in patients who require surgical treatment of pelvic prolapse results in the relief of vulvovaginal atrophy symptoms and adequate regeneration of the vaginal mucosa, which helps reduce the likelihood of complications in both early and late postoperative periods.

As a result of the age-related decline in reproductive function, during the perimenopausal and postmenopausal periods female patients experience an estrogen deficiency state. Due to this state, symptoms of estrogen deficiency, which are combined into the concept of “climacteric syndrome”, begin to manifest. Climacteric syndrome is a complex of vegetative-vascular, mental, and metabolic-endocrine disorders that develop in women not only due to decrease in estrogen synthesis, but also the general ageing of the body. Clinical manifestations of the climacteric syndrome have a certain priority of development. With a decrease of the hormonal function of the ovaries, vasomotor disorders step forward. They represent all forms of autonomic regulation disorders, such as hot flashes, arterial pressure and pulse liability, respiratory disorders, hyperhydrosis, chills, and many others. In this article, the greatest emphasis is placed on the issue of vasomotor disorders, in particular hot flashes, in women of the perimenopausal and postmenopausal periods. Attention is paid to the medical and social component of the issue discussed. Given the fact that today the life expectancy of people, including women, is significantly increasing in the developed countries, a large number of females are faced with the issue of menopausal syndrome. The clinical manifestations of menopause not only have an extremely negative impact on the women’s quality of life, but also lay the groundwork for the development of more severe somatic disorders. The article also considers in detail the frequency of hot flashes, and the pathogenetic mechanisms of their development. The “gold standard” for the treatment of patients suffering from vasomotor disorders is particularly detailed. Today, the menopausal hormone therapy is recognized as the most effective therapeutic approach, which, subject to a personalized approach to patients and the absence of contraindications to its prescription, demonstrates high protective capabilities.