OBJECTIVE OF THE STUDY
To determine the effect of ozone therapy on lipid peroxidation (LPO) and antioxidant defence system (ADS) in patients with genitourinary menopausal syndrome (GMPS).
MATERIAL AND METHODS
Eighty patients aged 48 to 54 years (mean age 50.5±2.8 years) with postmenopausal duration of 2.6±1.5 years, 60 of whom had genitourinary menopause syndrome, were examined. All patients with GMPS received suppositories with oestriol (0.5 mg), one daily for the first 4 weeks of follow-up and then two injections a week, while Group 1 of 30 patients also received combined ozone therapy, including vaginal applications of ozonated olive oil №10 and rectal insufflations of an ozone-oxygen mixture with a concentration of ozone of 2000 μg/L №10. A further 30 patients (Group 2) received only applications of ozonized olive oil along with suppositories with oestriol. Group 3 (control) included 20 women without signs of GMPS. The effect of different variants of treatment on the lipid peroxidation process was assessed by biochemiluminometry, using Imax, S, tg2ά indices. The levels of LPO products — diene conjugates and Schiff bases were also studied. ADS was evaluated by analyzing the activity of antioxidant enzymes — catalase and superoxide dismutase. These studies were performed before the treatment and 1 month after its completion. Clinical follow-up was carried out for 6 months.
RESULTS
Clinically, combined local ozone therapy showed the maximal effect, which was manifested in relief of complaints and increase in the vaginal health index. It was also found that the initial values of the studied parameters of LPO-ADP differed from the normal values — there was an increase in lipoperoxidation and a reduced level of antioxidant enzymes. Under the influence of combined ozone therapy Imax decreased 1.4 times, S decreased 1.46 times, tg 2 ά — 1.53 times, the blood diene conjugates content decreased 1.9 times, Schifr bases — 2 times. At the same time, catalase activity increased by 34% and superoxide dismutase activity increased by 27.8%. Conventional treatment didn’t produce such an effect.
CONCLUSION
On the basis of a comparative analysis of the efficacy of using only vaginal ozone therapy and a combined technique involving both treatment of the vaginal walls with ozonated olive oil and rectal insufflation of the ozone-oxygen mixture, we can state a greater pathogenetic validity of the combined local ozone therapy due to the effect of stimulation of the activity of antioxidant enzymes catalase and superoxide dismutase, which has the effect of suppressing the synthesis of free radicals, reducing the intensity of lipid peroxidation. Consequently, combined ozone therapy may be an important adjunct to local menopausal hormonal therapy for such a socially significant disease as GUMC.