Endothelial Function and Hemostasis System in Women with Early Menopause
Introduction. Menopause and its underlying reduction in estrogen concentrations is an independent risk factor for atherosclerosis and other cardiovascular diseases. The purpose of the study is to study the state of endothelial regulation and hemostasis in women with different ages of menopause. Materials and methods. 74 menopausal patients aged less than 40 years old - the main group, 70 women with menopause in the 45-50 age group (comparison group) and 70 women aged 35- 40 years with menstrual function (control group). All patients were studied by studying vascular stimulation of the brachial artery under the influence of hyperemia and analyzed the state of endothelial regulation. The activity of coagulation factors (fibrinogen and plasma factor VII) and fibrinolysis (tissue plasminogen activator - tPA and plasma plasminogen activator inhibitor - PAI-1) have been studied to evaluate the hemostasis system. Results and discussion. It has been shown that patients with early menopause exhibit endothelial dysfunction phenomena, namely, a decrease in the growth of the diameter of the brachial artery after decompression, as well as a decrease in the plasma concentration of plasminogen activator in plasminogen with an inadequate increase in plasma plasminogen activator inhibitor. These factors can play an important role in the pathogenesis of atherosclerosis and other diseases of the cardiovascular system, the risk of which increases significantly in early menopause. Conclusion. In patients with early menopause, signs of disturbed endothelial regulation of vascular tone are marked, which distinguishes them from patients with termination of menstrual function after 45 years and women with a preserved menstrual function. In women with early menopause, within 12-18 months of the last menstruation, there is a decrease in the activity of the fibrinolytic linkage of the hemostasis system - a decrease in the concentration of tissue plasminogen activator and an increase in the plasma plasminogen activator plasma inhibitor.