Introduction. The treatment of climacteric syndrome involves the menopausal hormone therapy. However, there are some contraindications to MGT. Because the alternative methods of correction of CS are needed. First of all, these are phytopreparations. Objective. To evaluate the efficacy and safety of various doses of the phytopreparation 7-hydroxymatairesinol (7HMR) in the treatment of climacteric syndrome of moderate severity. Material and methods. The randomized placebo-controlled study involved 60 women with a CS of moderate severity. Patients were divided into three groups: I group consisted of 20 patients who received the preparation of 7-hydroxymatairesinol J capsule J once a day; II group - 20 patients, who received the preparation of 7-hydroxymatairesinol 2 capsules once a day; III group - 20 patients, who received placebo one capsules once a day. Results. Analysis of the intensity of the hot flushes showed that after three months of therapy the frequency of the hot flushes decreased in all group: the group I (7-hydroxymatairesinol J capsule once a day) by 45 %; the group II (7-hydroxymatairesinol 2 capsules once a day) by 65 %; in the placebo group by 25 %. It is worth noting, the II group the frequency of the hot flushes decreased by 20 % more than in the I group. After evaluating the dynamics of psychoemotional symptoms in women with CS, we found positive dynamics after 3 months of treatment in group I of patients by 70 %, in the group II by 80 %, and in the placebo group all the symptoms decreased only by 20 %. Conclusions. The study showed that Lignarius was effective in relief of the hot flashes in both groups (45 and 65 % respectively). In the II group the efficiency was 20 % higher than in the group I, and significantly exceeded efficiency of placebo, where its was only 25 %. Lignarius also showed efficiency in relief of psychoemotional symptoms: in the I group it was 70 %, in the group II - 80 %, and in the placebo group - only 20 %. Discussion of the results. The study showed, the efficacy of Lignarius significantly differed from placebo in patients with the CS of moderate severity, and in the II group the efficacy was higher than in the I group. There are not data of hepatotoxicity and estrogenic effect of the 7-hydroxymatairesinol. We consider, the phytopreparation Lignarius may be used in the therapy for CS. It is an effective and safe phytopreparation.

Combined oral contraception is now not only a means of preventing unwanted pregnancy, but also a method of prevention and therapy of a number of diseases. In Russia, women do not often resort to the use of hormonal contraceptives, as residents of Europe, North and South America. The reasons for the insufficient distribution of hormonal contraceptives in our country are insufficient awareness of the useful properties of contraception, along with an exaggerated view of the negative consequences of taking hormones, as well as a lack of time for medical personnel to provide adequate counseling and individual drug selection. Overcoming the problem is possible with the maximum simplification and optimization of the choice of hormonal contraceptive for each specific woman, depending on her health status, reproductive status and age.

At present, early pregnancy plays an important role. Two-thirds of miscarriages occur at the beginning of pregnancy. One of the causes of spontaneous miscarriages is hormonal dysfunction, namely progesterone deficiency. In this regard, we followed the course of pregnancy first trimester in women with signs of threatened miscarriage and revealed that the efficacy of tableted drugs progesterone (antiseptic) in the group of women receiving treatment in the day hospital condition is higher compared to female patients receiving inpatient treatment and injection of 1 % oil solution of progesterone.

One of the main causes of habitual miscarriage, preeclampsia, fetal development retardation, hypertensive complications of pregnancy is a violation of microcirculation and increased intravascular coagulation. In turn, microcirculatory disorders are the result of several pathogenetic mechanisms, among which great importance is given to endothelial dysfunction. The review discusses the physiological aspects of increasing blood coagulation during pregnancy and questions of the pathogenesis of complications of gestation from the standpoint of endothelial dysfunction and increased coagulability of the blood. Illuminates diseases and conditions, the risk of which is associated with endothelial dysfunction. Methods of pharmacotherapy aimed at the prevention and treatment of gestational complications are considered. Particular attention is paid to the drug sulodexide - anticoagulant, a representative of the glycosaminoglycan family, which has a unique profile of a predominantly positive effect on endothelial function.

The incontinence often occurs in the postpartum period, negatively affecting women′s quality of life. In addition to medical and surgical correction of this disease, there is a method of training the muscles of the pelvic floor with the help of biofeedback. Materials and methods. The study included 42 patients with micturition disorders in the puerperium, who were treated with biofeedback in combination with electrostimulation of the pelvic floor muscles, and 5 mg of solifenacin in OAB. Results. 39 (92.9 %) patients noted health improvement. The average maximum intraurethral pressure (Pura increased from 54.6 ± 4.2 to 72.3 ± 7.6. The cough test was negative. Analysis of visual analogue scales showed an improvement from 42.44 ± 7.39 to 81.7 ± 8.29 mm (an improvement of 49 %). Conclusions. The effectiveness of the biofeedback method in combination with electrostimulation of the pelvic floor muscles and medicine therapy was 83.3 %.

The analysis of available foreign and Russian data on the prognostic and diagnostic significance of the FRAX tool in predicting the risk of bone fracture in osteopenic syndrome is carried out.

The article presents a review of the literature on the normal anatomy of the pelvic floor muscles and methods for assessing their functional state, which, to date, in the light of a multidisciplinary approach, can be used in coloproctological, gynecological and urological practices. The spectrum of the described methods starts from the simplest methods of assessing the functional state of the muscles of the pelvic floor during examination and ends with anorectal high-resolution manometry using water-perfusion catheters with the construction of a virtual model for the distribution of pressure in the anal canal.

The article discusses the differential diagnosis of intrahepatic cholestasis of pregnant women and liver diseases that complicate the course of pregnancy. As an illustration of the diagnostic difficulties, ones own clinical observations of liver dysfunction during pregnancy are presented.

The study of the effectiveness of medical rehabilitation methods, in particular manual therapy (MT) and therapeutic physical culture (physical therapy) in pregnant women with dorsopathies in the second and third trimesters of pregnancy in order to improve the quality of life, course and outcomes of pregnancy. 305 pregnant women were examined. The patients were divided into three groups: the 1st was treated by a chiropractor (n = 135), the 2nd got a course of exercise therapy (n = 35), the 3rd, control group (n = 135), did not receive treatment. The mean age was 30.92 ± 0.23 years, with p = 0.05 and P = 95 %. Primeval amounted to 43.27% (n = 132) of the total number of examined persons, repeated - 56.73 % (n = 173); primiparous - 61.96 % (n = 189), repeated 38.04 % (n = 116). In the first group, the number of sessions of manual therapy ranged from 1 to 4. So it took one session in 47 cases (34.8 %), 2 sessions - 58 (42,9%), 3 sessions - 23 (17,1 %) and 4 sessions - 7 (5,2 %) pregnant. The physical therapy course included 10 sessions. An assessment of the quality of life of pregnant women with dorsopathies was conducted using the following methords: EuroQol-5D questionnaire, the Oswestry questionnaire, the medical and social characteristics, the pain syndrome using the McGill questionnaire, the visual analogue scale (VAS), and the verbal evaluation score scale of pregnant women with this pathology. In the course of the current study, preliminary results have been obtained, which allow concluding about the effectiveness of MT in pregnant women over the methods of exercise therapy. There was an improvement in the quality of life of a pregnant woman, a decrease in pain, until its complete elimination, a decrease in the number of caesarean sections.

The evaluation of hemostasis when using compression joints. Surveyed 43 women, which was imposed hemostatic sutures on the uterus. At 44.2 % (19 women) was used for ligation of the vascular bundle, to stop bleeding with hypotension uterus. At 9.3 % cases was ligated the ovarian artery. At 4.6 % ligation of the internal iliac artery. At 9.4 % performed supravaginal amputation of the uterus, due to massive blood loss to stop hypotonic bleeding.