Diseases (conditions) associated with excess production of androgens in the female body or an increase in the sensitivity of hormone-dependent organs to them are united by the concept of ‘hyperandrogenic syndrome’. Its variants range from isolated skin lesions and its derivatives to systemic diseases accompanied by a high risk of menstrual irregularities, infertility, metabolic disorders, cardiovascular pathology, and carcinogenesis. The management of patients with hyperandrogenism is carried out by gynecologists, endocrinologists, dermatologists, general practitioners, but in real life, interaction between representatives of certain medical specialties, unfortunately, is rarely observed. As a result, the treatment of patients with hyperandrogenism is sinning with polypharmacy, inappropriate prescribing and ignoring the current needs of women. The situation is aggravated by the fact that there are practically no drugs annotated for the treatment of external manifestations of hyperandrogenism, and the number of drugs that can have a multifaceted effect is small. One of the strategies that can reduce the drug load and solve several problems at once to compensate for androgen-dependent dermopathies and maintain health in patients with hyperandrogenism is the appointment of combined hormonal contraception. The determining factors in the choice of a hormonal contraceptive for women with hyperandrogenism should be the presence of the antiandrogenic effect of the progestin in the composition of the drug and the safety of long-term use of the drug.

Micronutrient deficiency in the diet of a pregnant woman can negatively affect not only the course and outcome of childbirth, but lead to long-term changes in the metabolism, structure and function of fetal organs. The results of numerous studies confirm the influence of nutrition on adaptation reserves, the ability to learn and the predisposition to the development of diseases in offspring. Fetal programming can influence the course of ontogenesis, the processes of development, maturation and aging of the body. The nature of intrauterine nutrition affects the health and the risk of subsequent diseases not only in children, but also in adults in the long term. For the prevention of unfavorable fetal programming, timely examination of pregnant women is necessary to detect the presence of nutritional disorders. To correct micronutrient deficiency in pregnant women, an integrated approach is used, including diet therapy using appropriate vitamin and mineral complexes. in the prevention and complex therapy of somatic diseases.

Purpose of the study. Evaluation of the effectiveness and safety of COC-DRSP in the control of psychosomatic symptoms in women with stressdependent menstrual irregularities.

Materials and methods. The observational study involved 28 women aged 18 to 39 years with somatoform anxiety disorder and menstrual irregularities resulting from stressful events and did not have a tendency to improve in the process of therapeutic lifestyle modification and the use of means to improve adaptation. In order to prevent pregnancy and control the menstrual cycle, the patients were prescribed a combined oral contraceptive containing drospirenone (DRSP-COC) in the «24 + 4» regimen. Prior to the study, 3 and 6 months after initiation of therapy, psychosomatic symptoms of anxiety disorder were assessed.

Results. Reception of DRSP-COC (Dimia) led to a significant decrease in the frequency and severity of psychosomatic symptoms after three cycles of therapy with the preservation of the effect with continued administration.

Conclusion. DRSP-COC is effective in relieving psychosomatic symptoms in women with stress-related menstrual irregularities.

Aim of study. Using specific clinical examples to analyze the therapeutic and diagnostic approaches in patients with dyshormonal breast diseases (DBD).

Material and methods. Based on the data of the anamnesis, clinical and laboratory examination (ultrasound of the mammary glands and thyroid gland, the results of hormonal examination, MRI of the brain and pituitary gland with contrast enhancement), as well as data from the literature, two clinical cases of DBD were analyzed in detail.

Results. The presented clinical data indicate that hyperprolactinemia is the main marker of hormonal distress in patients with DBD, and MRI of the brain reveals structural changes that lead to an increase in prolactin levels. With moderate hyperprolactinemia, the administration of herbal dopaminomimetics leads to a decrease in the symptoms of DBD and allows to correct the concomitant hormonal pathology.

Conclusions. It is advisable to include MRI of the brain in the scope of examination of patients with DBD, as well as to apply a differentiated approach to the management of patients. One can start therapy with herbal preparations that have a complex positive effect on the female reproductive system, Mastodynon® or Cyclodynon®.

The problem of endometrial polyps in women of reproductive age is one of the urgent problems of modern gynecology. The detection rate of PE according to the data of domestic and foreign scientists reaches 25–35%, and therefore they occupy a leading place in the structure of intrauterine pathology.

The aim. To study the levels of specific autoantibodies (to double-stranded DNA; to TrM‑03 antigens and collagen) and to assess their prognostic value for the risk of PE formation and recurrence in patients of reproductive age.

Materials and methods. Examination of 86 patients aged 18 to 45 years (average age was 34.1 ± 6.3 years), admitted for hysteroscopy, hysteroresection of PE. Study of the relative content of specific autoantibodies to double-stranded DNA; to TrM‑03 antigens and collagen in blood serum was carried out by the method of enzyme-linked immunosorbent assay using specialized reagent kits (ELI-P-Complex).

Results. In the course of this study, it was found that in the overwhelming majority of cases (65.1%) PEs were manifested by various types of AMC. All patients with PE were diagnosed with a significant decrease in the level of autoantibodies to double-stranded DNA, which is a marker of apoptosis processes, as well as a statistically significant decrease in the levels of autoantibodies to platelet antigens TrM‑03. The profile of deviations in the level of autoantibodies to TrM‑03 from the reference range in the area of negative values correlated with an increase in the average level of autoantibodies to collagen.

Conclusions. Determination of the levels of auto-ATs to double-stranded DNA in serum can be used as a marker for predicting the recurrent course of PE. Determination of the levels of auto-ATs to platelet antigens TrM‑03 and to collagen in blood serum can be used as markers for the development of AMC by the type of BMC or a combination of BMC and BMC in patients with endometrial polyps.

Cystitis is the most common pathology of the urinary tract in women both in our country and abroad. The high incidence of this disease in women in the population is influenced by anatomical, physiological features of the female body, violations of personal and sexual hygiene, burdened with an obstetric and gynecological (OAG) history, etc. In the current domestic and foreign recommendations for the diagnosis and treatment of cystitis in women, it is noted that in the vast majority of cases (up to 80% cases), the causative agent of cystitis is Escherichia coli, sensitive to nitrоfuran drugs.

The purpose of the work. To demonstrate the effectiveness of the use of nifuratel (Nifuratel-SZ, Northern Star Co., Russia) in women with cystitis of various age groups using clinical examples. In the first clinical example, the high effectiveness of the use of nitrоfuran was shown in a woman of active reproductive age with OAG, in the second, in a teenager with an acute inflammatory process, in the 3rd-in a postmenopausal patient with concomitant multiple organ pathology.

Conclusion. Nifuratel (Nifuratel-SZ, Northern Star Co., Russia) has proven to be a highly effective and safe drug with a wide range of antibacterial effects in patients with cystitis of different age groups.

Goal. Optimization of the effectiveness of diagnosis and prediction of the degree of risk of violation of the vaginal microbiota.

Materials and methods. 572 patients were examined with complaints of copious discharge from the genital tract and/or an unpleasant smell. All women were observed in accordance with anamnestic, clinical, and laboratory criteria.

Results and conclusions. When examining patients, the results of anamnestic, clinical and laboratory signs were evaluated according to a point system, taking into account their informative value and the probability of influencing the vaginal microbiome. Based on the data analysis, a method for predicting the degree of risk of violation of the vaginal microbiota was proposed. The method allows for a personalized therapeutic and diagnostic approach and allows predicting the risk of violation of the vaginal microbiota as early as possible.

The article is devoted to the discussion of possible mechanisms of the development of cognitive disorders, the onset and progression of neurodegenerative diseases and the level of sex hormones in women during perimenopause, a condition associated with endocrine changes caused by a decrease in the follicular mass of the ovaries, and, as a consequence, a decrease in the level of their steroid hormones (in particular, estrogen). It is known that estrogen has a neuroprotective effect, affects the mental and cognitive spheres. Reducing it in the perimenopausal period contributes to the appearance of vegetative symptoms (hot flashes, insomnia, mood changes, etc.), increases the risk of developing depressive-anxiety symptoms, cognitive disorders. In order to correct them and prevent the development of neurodegenerative diseases, it is possible to use hormone replacement therapy to prolong the neuroprotective effect of estrogens in a woman’s body.