Peculiarities of the course of benign uterine disease in women of childbearing age with metabolic syndrome

Abstract

The aim of the research: to identify the peculiarities of the course of benign uterine disease in women of childbearing age with metabolic syndrome for further improvement in diagnostics, treatment and prevention of the medical condition mentioned above.Materials and methods. In the first stage a retrospective chart review was conducted for 382 patients with benign uterine disease. 130 women with benign uterine disease with metabolic syndrome and without metabolic syndrome were studied prospectively, 50 somatically healthy women with normal menstrual and reproductive function were included in the control group. Anamnesis, character of the past inflammatory diseases of the reproductive organs, abdominal surgeries, duration of the infertility period were studied, data of socioeconomic status, somatic, gynecologic, obstetric, infection history were studied thoroughly. All women underwent full clinical and laboratory check-up. Special attention was paid to past surgeries. All examined women underwent anthropometric measuring (body height, body weight, waist circumference, hip circumference), BMI (body mass index) was used to evaluate body weight, blood pressure. Metabolic syndrome (MS) was determined by the following “combined” criteria – criteria of WHO 1999 (impaired glucose tolerance) and criteria IDF (2009) taking into account the age-related levels of lipids and arterial blood pressure (AP) according to the results of the population study.Results and discussion. Analyzing the data of the clinical characteristics of the women examined it’s necessary to draw a conclusion, that the patients of the main group in whole didn’t differ from the women in the control group. Therefore, further we examined the women of both main and control groups using special laboratory and instrumental methods and taking into consideration the representativeness of these groups. The analysis of smoking habit (table 6) revealed the prevalence of the smoking women (40.3% and 39.7 % compared to 18.0 %). High figure of smoking women among those with impaired menstrual function and uterine leiomyoma can be indicative of negative influence of smoking on synthesis of hormones by ovaries. Analysis of incidence of unfavorable ecological conditions among the examined women showed that one third of the them lived in areas of environmental pollution. The collected data revealed clinical evidence of estrogen dominance prevailing in patients of the main group. Thus, for the great majority of the patients symptoms such as headache 29 (40.3%) and 43 (55.1%) compared to 3 (6.0%) in healthy women of the corresponding age, (p < 0.05), frequent mood swings (70.8%, 76.9% in the 1st and 2nd groups correspondingly compared to 4.0% in healthy women, p < 0.05), fatigue (73.6%, 70.5% and 8.0% in healthy women, p < 0.05).Conclusions. Having analyzed the anamnestic data, it was revealed that in women of the main group, inflammation of fallopian tubes and ovaries was observed more frequently, abortions in anamnesis was more prevalent, especially one abortion, the number of delivered pregnancies was far lower (3.2 times) in women of the main group compared to those of the control group, which is understandable as the main group consisted of women with infertility, for a part of whom this infertility was secondary. Despite the young age of the patients (median age 33), extragenital pathology was prevalent in more than half of the women in the control group, in 76.7% of women with metabolic syndrome and benign uterine disease. The nature of extragenital pathology did not differ significantly. The proportion of women who were satisfied with their self-realization was significantly lower in women with metabolic syndrome and benign uterine disease. Analysis of the incidence of adverse environmental conditions showed that a third of the women surveyed lived in areas of environmental pollution. Women with the metabolic syndrome and benign uterine disease the duration of menstrual cycle is longer, with normal volume of blood loss. All women with symptoms of benign uterine disease generally have relative estrogen dominance, which is commonly characterized with mammalgia and mastalgia.