The substantiation of differentiated therapy of the combined disgormonal pathology of reproductive organs in women of reproductive age with comorbid conditions

Abstract

The objective: substantiation of the differentiated therapeutic approaches to the treatment of the combined dyshormonal pathology of the reproductive organs, taking into account the comorbidity of the patients.Materials and methods. The study involved 300 women of reproductive age (20 - 42 years, an average of 29.9±5.6 years). The examination included ultrasonographic examination of the pelvic organs, mammary glands, thyroid gland, determination of the levels of pituitary tropic hormones and ovarian steroid hormones, thyroid hormones, antibodies to thyroperoxidase, serum levels 25 (OH) D. Results. Obesity of varying degrees was observed in 31.0% of the patients examined. The prevalence of autoimmune thyroiditis in patients with a dyshormonal pathology of the reproductive system was 36.0%, and subclinical hypothyroidism was diagnosed in 21.3% of women, but among patients with autoimmune thyroiditis, the incidence of subclinical hypothyroidism was 59.3% with 3.7% of manifest hypothyroidism. Insufficiency of vitamin D was detected in 34.0% of patients with dyshormonal pathology, vitamin D deficiency in 44.3%, severe deficit in 21.7%. Сonclusions. The use of complex differentiated pharmacotherapy for treatment of combin dyshormonal pathology of reproductive organs with correction of comorbid states allows to achieve a higher efficacy in comparison with usual practice (normalization of MCs 97.2% at 73.3%, reduction of pain syndrome 94.7% at 60.6% and cyclic mastodynia – 93,9% at 43,9%, reduction of vegetative-vascular and non-specific symptoms – 94,8±3,9% at 24,3±16,7%), to reduce the frequency of relapses during 6 months of observation from 14, 5% to 4.1% (p=0.0128), to achieve the desired pregnancy without stimulants and the ART and ovulation in 64.1% of patients compared with 30.6% (p=0.0079) in case of usual practice.