Menopausal transition: ambiguous definitions, diagnostic markers, and treatment strategies
DOI: 10.32364/2618-8430-2025-8-2-3
O.Ya. Leshchenko
Scientific Center for Family Health and Human Reproduction, Irkutsk, Russian Federation
Premenopause (or menopausal transition preceding menopause) is characterized by gradual depletion of ovarian follicular reserve, altered response to gonadotropin hormones, significant fluctuations of hormone levels, and irregular menstruation. Typically, a clinician is faced with a number of issues and difficulties regarding diagnosis and therapy in such patients. Aim: to discuss primary pathophysiological processes associated with the menopausal transition, as well as a place of non-hormonal treatment of comorbidities at this stage. A systematic search for guidelines, approaches, and consensus statements regarding premenopause, perimenopause, or menopausal transition published after 2014 was conducted. To identify information gaps, an additional search for randomized studies was performed in the peer-reviewed literature. The review highlights several algorithms to facilitate clinical evaluation and treatment in premenopausal women. The paper discusses reasons for seeking medical help; necessary information to be collected; issues that may affect joint decision-making, and algorithms to determine menopause status, as well as to prescribe hormonal / alternative therapy during perimenopause. Non-hormonal treatment options to mitigate symptoms of menopausal transition have been identified.
Keywords: menopause, menopausal transition, perimenopause, premenopause, hormones, epidemiology, vasomotor symptoms (VMS), menopausal hormone therapy, alternative therapy, phytotherapy, phytoestrogens, Vitex agnus-castus (VAC), Cimicifuga racemosa (CR).
For citation: Leshchenko O.Ya. Menopausal transition: ambiguous definitions, diagnostic markers, and treatment strategies. Russian Journal of Woman and Child Health. 2025;8(2):106–113 (in Russ.). DOI: 10.32364/2618-8430-2025-8-2-3
ABOUT THE AUTHOR:
Olga Ya. Leshchenko — Dr. Sc. (Med.), Chief Scientific Officer at the Department of Scientific Technologies, Scientific Center for Family Health and Human Reproduction; 16, Timiryazev str., Irkutsk, 664003, Russian Federation; ORCID iD 0000-0002-5335-1248
Contact information: Olga Ya. Leshchenko, e-mail: loyairk@mail.ru
Financial Disclosure: the author has no a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 12.03.2025.
Revised 04.04.2025.
Accepted 29.04.2025.
References
1. Santoro N., Roeca C., Peters B.A., Neal-Perry G. The Menopause Transition: Signs, Symptoms, and Management Options. J Clin Endocrinol Metab. 2021;106(1):1–15. DOI: 10.1210/clinem/dgaa764
2. Harlow S.D., Gass M., Hall J.E. et al. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Climacteric. 2012;15(2):105–114. DOI: 10.3109/13697137.2011.650656
3. Юренева С.В., Сыркашева А.Г., Перминова С.Г. и др. Ведение женщин в переходном периоде и в ранней постменопаузе: учебное пособие. М.: Издательство; 2022.Yureneva S.V., Syrkasheva A.G., Perminova S.G. et al. Management of women in transition and early postmenopause. The training manual. M.: Publishing house; 2022 (in Russ.).
4. Singh M. Early age of natural menopause in India, a biological marker for early preventive health programs. Climacteric. 2012;15(6):581–586. DOI: 10.3109/13697137.2011.643514
5. Schoenaker D.A., Jackson C.A., Rowlands J.V. et al. Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents. Int J Epidemiol. 2014;43(5):1542–1562. DOI: 10.1093/ije/dyu094
6. Nappi R.E., Hillard T. Expanding knowledge across medical specialties in menopause research and practice: why it is so important for women's health. Climacteric. 2025;28(1):1–3. DOI: 10.1080/13697137.2024.2437292
7. Crandall C.J., Mehta J.M., Manson J.E. Management of Menopausal Symptoms: A Review. JAMA. 2023;329(5):405–420. DOI: 10.1001/jama.2022.24140
8. Qiu C., Chen H., Wen J. et al. Associations between age at menarche and menopause with cardiovascular disease, diabetes, and osteoporosis in Chinese women. J Clin Endocrinol Metab. 2013;98(4):1612–1621. DOI: 10.1210/jc.2012-2919
9. Gold E.B., Crawford S.L., Avis N.E. et al. Factors related to age at natural menopause: longitudinal analyses from SWAN. Am J Epidemiol. 2013;178(1):70–83. DOI: 10.1093/aje/kws421
10. Panay N., Ang S.B., Cheshire R. et al.; International Menopause Society Board. Menopause and MHT in 2024: addressing the key controversies — an International Menopause Society White Paper. Climacteric. 2024;27(5):441–457. DOI: 10.1080/13697137.2024.2394950
11. Paramsothy P., Harlow S.D., Nan B. et al. Duration of the menopausal transition is longer in women with young age at onset: the multiethnic Study of Women's Health Across the Nation. Menopause. 2017;24(2):142–149. DOI: 10.1097/GME.0000000000000736
12. Davis S.R., Taylor S., Hemachandra C. et al. The 2023 Practitioner's Toolkit for Managing Menopause. Climacteric. 2023;26(6):517–536. DOI: 10.1080/13697137.2023.2258783
13. Nappi R.E., Panay N., Davis S.R. In search of a well-balanced narrative of the menopause momentum. Climacteric. 2024;27(3):223–225. DOI: 10.1080/13697137.2024.2339129
14. Jane F.M., Davis S.R. A practitioner's toolkit for managing the menopause. Climacteric. 2014;17(5):564–579. DOI: 10.3109/13697137.2014.929651
15. Appiah D., Nwabuo C.C., Ebong I.A. et al. Trends in age at natural menopause and reproductive life span among US women, 1959–2018. JAMA. 2021;325(13):1328–1330. DOI: 10.1001/jama.2021.0278
16. Gottschalk M.S., Eskild A., Hofvind S. et al. Temporal trends in age at menarche and age at menopause: a population study of 312 656 women in Norway. Hum Reprod. 2020;35(2):464–471. DOI: 10.1093/humrep/dez288
17. Kucherov A., Buyuk E. Ovarian and Hypothalamic Aging. In: Bukulmez O., eds. Diminished Ovarian Reserve and Assisted Reproductive Technologies. Springer, Cham. DOI: 10.1007/978-3-030-23235-1_2.
18. van Look P.F., Lothian H., Hunter W.M. et al. Hypothalamic-pituitary-ovarian function in perimenopausal women. Clin Endocrinol (Oxf). 1977;7(1):13–31. DOI: 10.1111/j.1365-2265.1977.tb02936.x
19. Andrews R., Lacey A., Bache K. et al. The role of menopausal symptoms on future health and longevity: a systematic scoping review of longitudinal evidence. Maturitas. 2024;190:108130. DOI: 10.1016/j.maturitas.2024.108130
20. Fang Y., Liu F., Zhang X. et al. Mapping global prevalence of menopausal symptoms among middle-aged women: a systematic review and meta-analysis. BMC Public Health. 2024;24(1):1767. DOI: 10.1186/s12889-024-19280-5
21. Lensen S., Bell R.J., Carpenter J.S. et al. A core outcome set for genitourinary symptoms associated with menopause: the COMMA (Core Outcomes in Menopause) global initiative. Menopause. 2021;28(8):859–866. DOI: 10.1097/GME.0000000000001788
22. Santoro N.A., Brown J.R., Adel T.O. et al. Characterization of reproductive hormonal dynamics in the perimenopause. J Clin Endocrinol Metab. 1996;81(4):1495–1501. DOI: 10.1210/jcem.81.4.8636357
23. Ortmann O., Beckermann M.J., Inwald E.C. et al. Peri- and postmenopause-diagnosis and interventions interdisciplinary S3 guideline of the association of the scientific medical societies in Germany (AWMF 015/062): short version. Arch Gynecol Obstet. 2020;302(3):763–777. DOI: 10.1007/s00404-020-05682-4
24. Davis S.R., Baber R., Panay N. et al. Global consensus position statement on the use of testosterone therapy for women. Climacteric. 2019;22(5):429–434. DOI: 10.1080/13697137.2019.1637079
25. Ng E., Sztal-Mazer S., Davis S.R. Functional hypothalamic amenorrhoea: a diagnosis of exclusion. Med J Aust. 2022;216(2):73–76. DOI: 10.5694/mja2.51376
26. Anderson D.J., Chung H.F., Seib C.A. et al. Obesity, smoking, and risk of vasomotor menopausal symptoms: a pooled analysis of eight cohort studies. Am J Obstet Gynecol. 2020;222(5):478.e1-478.e17. DOI: 10.1016/j.ajog.2019.10.103
27. Orbe I., Daniel Paz D., Pejenaute L. et al. Medicinal Herbs: Its Therapeutic Use in Obstetrics and Gynaecology. In: Bizzarri M., eds. Approaching Complex Diseases. Human Perspectives in Health Sciences and Technology, vol 2. Springer, Cham; 2020. DOI: 10.1007/978-3-030-32857-3_18
28. Lloyd K.B., Hornsby L.B. Complementary and alternative medications for women's health issues. Nutr Clin Pract. 2009;24(5):589–608. DOI: 10.1177/0884533609343001
29. Souto E.B., Durazzo A., Nazhand A. et al. Vitex agnus-castus L.: Main Features and Nutraceutical Perspectives. Forests. 2020;11(7):761. DOI: 10.3390/f11070761
30. Лещенко О.Я. Мастодиния. Современные данные о причинах, течении, диагностике и подходах к коррекции. Гинекология. 2023;25(3):282–289. DOI: 10.26442/20795696.2023.3.202341Leschenko O.Yа. Mastodynia: Current data on the causes, course, diagnosis, and treatment approaches. A review. Gynecology. 2023;25(3):282–289 (in Russ.). DOI: 10.26442/20795696.2023.3.202341
31. Лещенко О.Я. Гиперпролактинемия в период постменопаузы: версии и контраверсии. Терапевтический архив. 2021;93(10):1234–1239. DOI: 10.26442/00403660.2021.10.201073Leshchenko O.Yа. Hyperprolactinemia in the postmenopause: versions and contraversions. Terapevticheskii arkhiv. 2021;93(10):1234–1239 (in Russ.). DOI: 10.26442/00403660.2021.10.201073
32. Naseri R., Farnia V., Yazdchi K. et al. Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study. Korean J Fam Med. 2019;40(6):362–367. DOI: 10.4082/kjfm.18.0067
33. Yavarikia P., Shahnazi M., Hadavand Mirzaie S. et al. Comparing the effect of mefenamic Acid and vitex agnus on intrauterine device induced bleeding. J Caring Sci. 2013;2(3):245–254. DOI: 10.5681/jcs.2013.030
34. Ma L., Lin S., Chen R., Wang X. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Gynecol Endocrinol. 2010;26(8):612–616. DOI: 10.3109/09513591003632126
35. Molaie M., Darvishi B., Jafari Azar Z. et al. Effects of a combination of Nigella sativa and Vitex agnus-castus with citalopram on healthy menopausal women with hot flashes: results from a subpopulation analysis. Gynecol Endocrinol. 2019;35(1):58–61. DOI: 10.1080/09513590.2018.1499086
36. van Die M.D., Bone K.M., Burger H.G. et al. Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis. J Altern Complement Med. 2009;15(9):1045–1048. DOI: 10.1089/acm.2008.0539
37. Abbaspoor Z., Hajikhani N.A., Afshari P. Effect of Vitex agnus-castus on menopausal early symptoms in postmenopausal women: a randomized, double blind, placebo-controlled study. Br J Med Res. 2011;1:132–140. DOI: 10.9734/BJMMR/2011/163
38. Ahangarpour A., Najimi S.A., Farbood Y. Effects of Vitex agnus-castus fruit on sex hormones and antioxidant indices in a d-galactose-induced aging female mouse model. J Chin Med Assoc. 2016;79(11):589–596. DOI: 10.1016/j.jcma.2016.05.006
39. Seidlova-Wuttke D., Wuttke W. The premenstrual syndrome, premenstrual mastodynia, fibrocystic mastopathy and infertility have often common roots: effects of extracts of chasteberry (Vitex agnus castus) as a solution. Clinical Phytoscience. 2017;3:1–1.
40. Кулагина Н.В. Лечение масталгии на фоне диффузной мастопатии у пациенток в периоде менопаузального перехода. Акушерство и гинекология. 2016;11:136–42. DOI: 10.18565/aig.2016.11.136-42Kulagina N.V. Treatment of mastalgia on the background of diffuse mastopathy in patients during menopausal transition. Obstetrics and gynecology. 2016;11:136–142 (in Russ.). DOI: 10.18565/aig.2016.11.136-42
41. Ooi S.L., Watts S., McClean R., Pak S.C. Vitex Agnus-Castus for the Treatment of Cyclic Mastalgia: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt). 2020;29(2):262–278. DOI: 10.1089/jwh.2019.7770
42. Drewe J., Boonen G., Culmsee C. Treat more than heat-New therapeutic implications of Cimicifuga racemosa through AMPK-dependent metabolic effects. Phytomedicine. 2022;100:154060. DOI: 10.1016/j.phymed.2022.154060
43. Бурчаков Д.И., Сметник А.А. Ранний контроль вазомоторных симптомов и некоторых метаболических изменений в перименопаузе.Women's Clinic. 2022;4:6–14.Burchakov D.I., Smetnik A.A. Early control of vasomotor symptoms and some metabolic changes in perimenopause. Women's Clinic. 2022;4:6–14 (in Russ.).
44. Leach M.J., Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012;2012(9):CD007244. DOI: 10.1002/14651858.CD007244.pub2
45. Балан В.Е., Бурчаков Д.И. Цимицифуга кистевидная (Cimicifuga Racemosa): ботаника, фармакология и место в современной клинической практике. Women's Clinic. 2022;1:21–29.Balan V.E., Burchakov D.I. Cimicifuga Racemosa: botany, pharmacology and their place in modern clinical practice. Women's Clinic. 2022;1:21–29 (in Russ.).
46. Mohapatra S., Iqubal A., Ansari M.J. et al. Benefits of Black Cohosh (Cimicifuga racemosa) for Women Health: An Up-Close and In-Depth Review. Pharmaceuticals (Basel). 2022;15(3):278. DOI: 10.3390/ph15030278
47. Alamoudi O., Bakrshoom F.Y. Vitex agnus castus and Some Female Disorders: A Review. Agricultural Reviews. 2021;42(2):209–214. DOI: 10.18805/ag.R-170
2. Harlow S.D., Gass M., Hall J.E. et al. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Climacteric. 2012;15(2):105–114. DOI: 10.3109/13697137.2011.650656
3. Юренева С.В., Сыркашева А.Г., Перминова С.Г. и др. Ведение женщин в переходном периоде и в ранней постменопаузе: учебное пособие. М.: Издательство; 2022.Yureneva S.V., Syrkasheva A.G., Perminova S.G. et al. Management of women in transition and early postmenopause. The training manual. M.: Publishing house; 2022 (in Russ.).
4. Singh M. Early age of natural menopause in India, a biological marker for early preventive health programs. Climacteric. 2012;15(6):581–586. DOI: 10.3109/13697137.2011.643514
5. Schoenaker D.A., Jackson C.A., Rowlands J.V. et al. Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents. Int J Epidemiol. 2014;43(5):1542–1562. DOI: 10.1093/ije/dyu094
6. Nappi R.E., Hillard T. Expanding knowledge across medical specialties in menopause research and practice: why it is so important for women's health. Climacteric. 2025;28(1):1–3. DOI: 10.1080/13697137.2024.2437292
7. Crandall C.J., Mehta J.M., Manson J.E. Management of Menopausal Symptoms: A Review. JAMA. 2023;329(5):405–420. DOI: 10.1001/jama.2022.24140
8. Qiu C., Chen H., Wen J. et al. Associations between age at menarche and menopause with cardiovascular disease, diabetes, and osteoporosis in Chinese women. J Clin Endocrinol Metab. 2013;98(4):1612–1621. DOI: 10.1210/jc.2012-2919
9. Gold E.B., Crawford S.L., Avis N.E. et al. Factors related to age at natural menopause: longitudinal analyses from SWAN. Am J Epidemiol. 2013;178(1):70–83. DOI: 10.1093/aje/kws421
10. Panay N., Ang S.B., Cheshire R. et al.; International Menopause Society Board. Menopause and MHT in 2024: addressing the key controversies — an International Menopause Society White Paper. Climacteric. 2024;27(5):441–457. DOI: 10.1080/13697137.2024.2394950
11. Paramsothy P., Harlow S.D., Nan B. et al. Duration of the menopausal transition is longer in women with young age at onset: the multiethnic Study of Women's Health Across the Nation. Menopause. 2017;24(2):142–149. DOI: 10.1097/GME.0000000000000736
12. Davis S.R., Taylor S., Hemachandra C. et al. The 2023 Practitioner's Toolkit for Managing Menopause. Climacteric. 2023;26(6):517–536. DOI: 10.1080/13697137.2023.2258783
13. Nappi R.E., Panay N., Davis S.R. In search of a well-balanced narrative of the menopause momentum. Climacteric. 2024;27(3):223–225. DOI: 10.1080/13697137.2024.2339129
14. Jane F.M., Davis S.R. A practitioner's toolkit for managing the menopause. Climacteric. 2014;17(5):564–579. DOI: 10.3109/13697137.2014.929651
15. Appiah D., Nwabuo C.C., Ebong I.A. et al. Trends in age at natural menopause and reproductive life span among US women, 1959–2018. JAMA. 2021;325(13):1328–1330. DOI: 10.1001/jama.2021.0278
16. Gottschalk M.S., Eskild A., Hofvind S. et al. Temporal trends in age at menarche and age at menopause: a population study of 312 656 women in Norway. Hum Reprod. 2020;35(2):464–471. DOI: 10.1093/humrep/dez288
17. Kucherov A., Buyuk E. Ovarian and Hypothalamic Aging. In: Bukulmez O., eds. Diminished Ovarian Reserve and Assisted Reproductive Technologies. Springer, Cham. DOI: 10.1007/978-3-030-23235-1_2.
18. van Look P.F., Lothian H., Hunter W.M. et al. Hypothalamic-pituitary-ovarian function in perimenopausal women. Clin Endocrinol (Oxf). 1977;7(1):13–31. DOI: 10.1111/j.1365-2265.1977.tb02936.x
19. Andrews R., Lacey A., Bache K. et al. The role of menopausal symptoms on future health and longevity: a systematic scoping review of longitudinal evidence. Maturitas. 2024;190:108130. DOI: 10.1016/j.maturitas.2024.108130
20. Fang Y., Liu F., Zhang X. et al. Mapping global prevalence of menopausal symptoms among middle-aged women: a systematic review and meta-analysis. BMC Public Health. 2024;24(1):1767. DOI: 10.1186/s12889-024-19280-5
21. Lensen S., Bell R.J., Carpenter J.S. et al. A core outcome set for genitourinary symptoms associated with menopause: the COMMA (Core Outcomes in Menopause) global initiative. Menopause. 2021;28(8):859–866. DOI: 10.1097/GME.0000000000001788
22. Santoro N.A., Brown J.R., Adel T.O. et al. Characterization of reproductive hormonal dynamics in the perimenopause. J Clin Endocrinol Metab. 1996;81(4):1495–1501. DOI: 10.1210/jcem.81.4.8636357
23. Ortmann O., Beckermann M.J., Inwald E.C. et al. Peri- and postmenopause-diagnosis and interventions interdisciplinary S3 guideline of the association of the scientific medical societies in Germany (AWMF 015/062): short version. Arch Gynecol Obstet. 2020;302(3):763–777. DOI: 10.1007/s00404-020-05682-4
24. Davis S.R., Baber R., Panay N. et al. Global consensus position statement on the use of testosterone therapy for women. Climacteric. 2019;22(5):429–434. DOI: 10.1080/13697137.2019.1637079
25. Ng E., Sztal-Mazer S., Davis S.R. Functional hypothalamic amenorrhoea: a diagnosis of exclusion. Med J Aust. 2022;216(2):73–76. DOI: 10.5694/mja2.51376
26. Anderson D.J., Chung H.F., Seib C.A. et al. Obesity, smoking, and risk of vasomotor menopausal symptoms: a pooled analysis of eight cohort studies. Am J Obstet Gynecol. 2020;222(5):478.e1-478.e17. DOI: 10.1016/j.ajog.2019.10.103
27. Orbe I., Daniel Paz D., Pejenaute L. et al. Medicinal Herbs: Its Therapeutic Use in Obstetrics and Gynaecology. In: Bizzarri M., eds. Approaching Complex Diseases. Human Perspectives in Health Sciences and Technology, vol 2. Springer, Cham; 2020. DOI: 10.1007/978-3-030-32857-3_18
28. Lloyd K.B., Hornsby L.B. Complementary and alternative medications for women's health issues. Nutr Clin Pract. 2009;24(5):589–608. DOI: 10.1177/0884533609343001
29. Souto E.B., Durazzo A., Nazhand A. et al. Vitex agnus-castus L.: Main Features and Nutraceutical Perspectives. Forests. 2020;11(7):761. DOI: 10.3390/f11070761
30. Лещенко О.Я. Мастодиния. Современные данные о причинах, течении, диагностике и подходах к коррекции. Гинекология. 2023;25(3):282–289. DOI: 10.26442/20795696.2023.3.202341Leschenko O.Yа. Mastodynia: Current data on the causes, course, diagnosis, and treatment approaches. A review. Gynecology. 2023;25(3):282–289 (in Russ.). DOI: 10.26442/20795696.2023.3.202341
31. Лещенко О.Я. Гиперпролактинемия в период постменопаузы: версии и контраверсии. Терапевтический архив. 2021;93(10):1234–1239. DOI: 10.26442/00403660.2021.10.201073Leshchenko O.Yа. Hyperprolactinemia in the postmenopause: versions and contraversions. Terapevticheskii arkhiv. 2021;93(10):1234–1239 (in Russ.). DOI: 10.26442/00403660.2021.10.201073
32. Naseri R., Farnia V., Yazdchi K. et al. Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study. Korean J Fam Med. 2019;40(6):362–367. DOI: 10.4082/kjfm.18.0067
33. Yavarikia P., Shahnazi M., Hadavand Mirzaie S. et al. Comparing the effect of mefenamic Acid and vitex agnus on intrauterine device induced bleeding. J Caring Sci. 2013;2(3):245–254. DOI: 10.5681/jcs.2013.030
34. Ma L., Lin S., Chen R., Wang X. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Gynecol Endocrinol. 2010;26(8):612–616. DOI: 10.3109/09513591003632126
35. Molaie M., Darvishi B., Jafari Azar Z. et al. Effects of a combination of Nigella sativa and Vitex agnus-castus with citalopram on healthy menopausal women with hot flashes: results from a subpopulation analysis. Gynecol Endocrinol. 2019;35(1):58–61. DOI: 10.1080/09513590.2018.1499086
36. van Die M.D., Bone K.M., Burger H.G. et al. Effects of a combination of Hypericum perforatum and Vitex agnus-castus on PMS-like symptoms in late-perimenopausal women: findings from a subpopulation analysis. J Altern Complement Med. 2009;15(9):1045–1048. DOI: 10.1089/acm.2008.0539
37. Abbaspoor Z., Hajikhani N.A., Afshari P. Effect of Vitex agnus-castus on menopausal early symptoms in postmenopausal women: a randomized, double blind, placebo-controlled study. Br J Med Res. 2011;1:132–140. DOI: 10.9734/BJMMR/2011/163
38. Ahangarpour A., Najimi S.A., Farbood Y. Effects of Vitex agnus-castus fruit on sex hormones and antioxidant indices in a d-galactose-induced aging female mouse model. J Chin Med Assoc. 2016;79(11):589–596. DOI: 10.1016/j.jcma.2016.05.006
39. Seidlova-Wuttke D., Wuttke W. The premenstrual syndrome, premenstrual mastodynia, fibrocystic mastopathy and infertility have often common roots: effects of extracts of chasteberry (Vitex agnus castus) as a solution. Clinical Phytoscience. 2017;3:1–1.
40. Кулагина Н.В. Лечение масталгии на фоне диффузной мастопатии у пациенток в периоде менопаузального перехода. Акушерство и гинекология. 2016;11:136–42. DOI: 10.18565/aig.2016.11.136-42Kulagina N.V. Treatment of mastalgia on the background of diffuse mastopathy in patients during menopausal transition. Obstetrics and gynecology. 2016;11:136–142 (in Russ.). DOI: 10.18565/aig.2016.11.136-42
41. Ooi S.L., Watts S., McClean R., Pak S.C. Vitex Agnus-Castus for the Treatment of Cyclic Mastalgia: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt). 2020;29(2):262–278. DOI: 10.1089/jwh.2019.7770
42. Drewe J., Boonen G., Culmsee C. Treat more than heat-New therapeutic implications of Cimicifuga racemosa through AMPK-dependent metabolic effects. Phytomedicine. 2022;100:154060. DOI: 10.1016/j.phymed.2022.154060
43. Бурчаков Д.И., Сметник А.А. Ранний контроль вазомоторных симптомов и некоторых метаболических изменений в перименопаузе.Women's Clinic. 2022;4:6–14.Burchakov D.I., Smetnik A.A. Early control of vasomotor symptoms and some metabolic changes in perimenopause. Women's Clinic. 2022;4:6–14 (in Russ.).
44. Leach M.J., Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012;2012(9):CD007244. DOI: 10.1002/14651858.CD007244.pub2
45. Балан В.Е., Бурчаков Д.И. Цимицифуга кистевидная (Cimicifuga Racemosa): ботаника, фармакология и место в современной клинической практике. Women's Clinic. 2022;1:21–29.Balan V.E., Burchakov D.I. Cimicifuga Racemosa: botany, pharmacology and their place in modern clinical practice. Women's Clinic. 2022;1:21–29 (in Russ.).
46. Mohapatra S., Iqubal A., Ansari M.J. et al. Benefits of Black Cohosh (Cimicifuga racemosa) for Women Health: An Up-Close and In-Depth Review. Pharmaceuticals (Basel). 2022;15(3):278. DOI: 10.3390/ph15030278
47. Alamoudi O., Bakrshoom F.Y. Vitex agnus castus and Some Female Disorders: A Review. Agricultural Reviews. 2021;42(2):209–214. DOI: 10.18805/ag.R-170
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