CLINICO-PHARMACOLOGICAL ASPECTS OF OVARIAN-MENSTRUAL CYCLE SUPPORT. Review

Abstract

Relevance. It is known that 12.5% of women suffer from infertility. Correction of menstrual disorders is an important way to maintain a woman's reproductive health.
 Objective is to consider current data on the physiology, etiopathogenesis and pharmacotherapy of women with ovarian-menstrual disorders.
 Methods. Analysis of the data presented in PubMed, by keywords "ovarian-menstrual cycle", "pharmacological support".
 Results. Modern data on physiology, humoral regulation of the ovarian-menstrual cycle are presented. The role of positive and negative feedback between estradiol and progesterone levels and the activity of anterior pituitary gonadotropic hormones and insulin regulatory pathways is emphasized. The main changes of the central nervous system and behavioral features depending on the phase of the menstrual cycle are described. The directions of pharmacological support and stimulation of ovulation are described. The mechanisms of action and indications for the use of oral hypoglycemic and gonadotropic drugs, the benefits and place of each in the maintenance and stimulation of the ovarian-menstrual cycle are presented. Metformin is effective in clomiphene-resistant women and may be combined with clomiphene, particularly in the treatment of polycystic ovary syndrome (PCOS). Sitagliptin improves ovulation in PCOS, is more effective in combination with metformin. Gonadotropins stimulate the ovaries, promoting the production and maturation of eggs, progesterone prepares the inner layer of the uterus to fix the embryo and helps to bear fruit. They are mainly used in women with PCOS in whom other drugs are ineffective.Some results of pharmacogenetic researches, efficiency, in particular, use of follicle-stimulating hormone depending on genetic polymorphisms of its receptor are noted.
 Conclusions. In modern conditions, the use of pharmacological agents is an important area of support and stimulation of the ovarian-menstrual cycle to improve female reproductive function.