Contraception is a unique tool that helps not only to avoid unwanted pregnancy and its termination, but also to get additional health benefits. However, the prevalence of the use of contraceptives as a whole and the resource itself, in terms of additional benefits, hormonal contraception, is far from the actual needs. The presented review substantiates the algorithm for the individual selection of a hormonal drug depending on the clinical portrait of a woman in order to solve the problem of reliable and safe protection from pregnancy with preventive and therapeutic effects.

Compliance with the use of combined hormonal contraceptive drugs containing drospirenone is presented. The use of such drugs enhances the use of hormonal contraception. The distinctive features of the drugs are considered: reliable contraception, reduced severity of side effects, additional positive preventive and curative effects.

The review of the literature presents data on the possible risks of using combined hormonal contraception and the possibilities of prescribing purely progestogenic contraception as an alternative to the use of combined means. Progestogen contraceptives include a group of agents with different routes of administration, doses and characteristics of progestins, which have a number of differences in the ratio of benefits and risks, availability, reversibility and other properties of contraception. Particular attention is paid to purely progestogenic tablets containing desogestrel, as a means equivalent in effectiveness to combination contraceptives, but safer. Safety issues are considered in the context of the use of breastfeeding women, as well as from the standpoint of the risk of arterial and venous thrombosis. The issues of non-contraceptive positive effects of purely progestogenic contraceptives are covered.

The aim of the study. To determine the clinical, hormonal and psychological characteristics in women with stress-related menstrual disorders. Subjects and methods. 82 women of reproductive age where stress was defined as the cause of menstrual dysfunction and 20 women of the same age with a regular menstrual cycle were examined. The hormonal and psychological status (Beck depression inventory, state-trait anxiety inventory, social readjustment rating scale, sleep quality assessment, the quality of life questionnaire, questionnaire of vegetative state) was examined. Results. Oligomenorrhoea in the structure of stress-induced impairment was 79.3 %, amenorrhea - 14.6 %, abnormal uterine bleeding - 3.7 % and premenstrual syndrome - 2.4 %. The level of cortisol was significantly higher (p = 0.01) in patients of the main group, whereas the level of androstenedione was significantly lower (p = 0.03). indexes DHEA-S/ cortisol, estradiol/cortisol are significantly lower in the women with menstrual disorders. A high level of stress was associated with an increase in prolactin levels. in women with stress-related menstrual disorders was dominated anxiety. Conclusion. The reaction of the reproductive system to stress is expressed mainly in menstrual irregularities arising from the development of anxiety, prolonged activation of the pituitary-adrenal axis and increased secretion of prolactin.

The effect of androgen on women s health has not been fully elucidated. Circulating levels of testosterone and dehydroepiandrosterone sulfate (DHEA-S) gradually decrease with age in postmenopausal women, although transient increases have been observed during the menopausal transition. High testosterone level has been suggested to be associated with increased risk of cardiovascular disease, increased triglyceride, insulin resistance and increase in the risk of developing breast cancer in postmenopausal women. Female androgen insufficiency, which is characterized by the presence of reduced androgen level in circulation, leads to an impairment in sexual drive, reduced libido, depressed mood, and signs and symptoms of limited androgen exposure such as decreased muscle mass, reduced bone density and decreased sense of well-being.

Data on risks of development of oncological diseases of bodies of reproductive system in women during menopausal transition and in a postmenopause are submitted at treatment of menopausal frustration by the preparations intended for menopausal hormonal therapy, the containing various doses of estrogen and progestogen used in the cyclic or continuous mode.

The article highlights the pathogenetic mechanisms of endothelial dysfunction formation and its role in the occurrence of gestational complications. The main tasks of the pregravid preparation of patients with diseases associated with endothelial dysfunction are considered. The relevance of early detection of risk factors for gestational complications caused by endothelial dysfunction is emphasized, and methods for its indirect assessment are described. A list of measures aimed at preventing the clinical implementation of endothelial dysfunction is given, and the possibilities of its therapeutic correction are described.

Vitamin A (retinoids) is a hormonal growth factor for which there are corresponding receptors (retinoid receptors) and which is fundamentally necessary for the growth and the differentiation of the cells of the placenta and the fetus. During pregnancy, the need for the vitamin A increases thus requiring a balanced approach to the dosage of the vitamin A. The molecular and the clinical effects of the physiological doses of the vitamin A during pregnancy and in the fetus depend on the availability of other vitamins and trace elements. Supplements oif the vitamin A in combinations with other essential micronutrients contribute to (1) reducing the risk of cleft lip/palate, diaphragmatic hernia, neural tube defects, hypertrophic stenosis of the pylorus and other vitamin A-dependent malformations, (2) normalization of birth weight, (3) expression of lung surfactant proteins, prevention of the bronchopulmonary dysplasia and of the chronic lung diseases (bronchiolitis, bronchitis, bronchial asthma, pneumonia) at an early age, (4) reduction in the measles mortality, (5) the child birth the best anthropometric parameters and with a high Apgar score, (6) preventing the development of allergy in children, (7) preventing anemia, (8) improving cognitive and behavioral development of children.

The urgency of the problem of chronic endometritis (CE) is due to the high prevalence of infertility, miscarriage and in vitro fertilization failure (IVF) in patients with this pathology in the absence of a sufficient effect of standard therapy. Successful restoration of the endometrial morphofunctional characteristics requires a decrease in the intensity of the inflammatory response while preserving the reparative potential of the tissue, which can be achieved with the help of immunomodulation. The purpose of this study was to study the effects of the use of sodium deoxyribonucleate (Derinat®) in the complex therapy of CE in women with reduced fertility. The study involved 136 women with verified diagnosis of CE, randomized to the group of research (n = 70) and control group (n = 66). All patients received standard therapy for CE, women in the treatment group additionally received Derinat® (solution for intramuscular administration of 15 mg/ml) according to the scheme: 5 ml (75 mg) once a day after 24-48 hours, 10 injections per course. The effects of therapy were evaluated by the dynamics of clinical symptoms of CE, the results of microbiological and ultrasound studies (US). Results. In the treatment group, there was a significant decrease in the prevalence of clinical symptoms after completion of therapy and a three-month follow-up period compared with the control group (p < 0.05). The frequency of detection of conditionally pathogenic microorganisms after the end of the treatment course decreased in the study group to 26 % and in the control group to 51.5 % (p < 0.05). Comparison of the echographic parameters of the final characteristics showed that in the group treated with Derinat®, the significantly lower percentage of observations preserved the hyperechogenicity of the endometrium and subendometrial layer, the heterogeneity of the structure, the thinning of the endometrium and the dilation of arcuate veins (p < 0.05). Conclusion. The use of Derinat® increases the effectiveness of CE therapy and may be helpful in restoring fertility in these patients.

In obstetric practice, the search for reserves to increase the effectiveness of prevention of gestational complications associated with infectious and inflammatory diseases of the urinaiy system is relevant. The purpose of this study was to assess the results of using the Canephron® N herbal medicine in pregnant women with chronic pyelonephritis. The study included 100 women, randomly divided into four groups, three of which were carried out for prophylactic use of the drug Canephron®N, and were not prescribed phytoprophylaxis in the fourth. It has been established that monotherapy with Canephron®N reduces the risk of exacerbations of chronic pyelonephritis, improves the functional state of the urinary tract, reduces the incidence of bacteriuria. Optimal results are achieved with the use of prophylactic courses of Canephron®N at the gestational period of 10-12, 22-24, and 34-36 weeks.

Objective: to provide an overview of modern methods for assessing the function and strength of the pelvic floor muscles in women available for clinical practice. The main provisions. Foreign and domestic sources found in free access Internet databases were analyzed. Visual observation, palpation, perineometry, electromyography, ultrasound and magnetic resonance imaging measure various aspects of the function and strength of the pelvic floor muscles. Perineometry allows you to accurately measure the force of contractions of the pelvic floor muscles and is an easy and affordable way. Oxford vaginal palpation technologies, biofeedback devices, and ultrasound can be important clinical tools in the practice of a physician to quantify dysfunction of the pelvic floor. Conclusion. The obtained data on methods for assessing the function and strength of the pelvic floor muscles indicate the need for perineometry in clinical practice for the timely diagnosis of pelvic floor insufficiency, which will allow choosing the right rehabilitation method for women of different age groups.