Women Of Fertile Age Research Articles

Psychometric analysis and linguistic adaptation of the Persian version of Contraceptive Self-Efficacy Scale (CSES-P)

BackgroundThis study was aimed to test adaptability of the Contraceptive Self-Efficacy Scale (CSES) for use on Persian-speaking women of reproductive age.MethodA preliminary draft of the Contraceptive Self Efficacy Scale (CSES) was prepared according to the standard translation/back translation procedures and an expert panel appraised its content and face validities. The approved draft was tested on 400 randomly selected women of reproductive age (15–49 years) at the 29th Bahman Hospital of in Tabriz, the capital city of East Azerbaijan province, North West of Iran from May to August 2018. The exploratory and confirmatory factor analysis (EFA, CFA) was carried out to verify the implicit factor structure of the CSES for use on Persian-speaking women of fertile age. The Cronbach’s α and Interclass Correlation coefficients were estimated for internal consistency and accuracy assessment of the instrument.ResultsThis translated scale indicated good internal consistency (0.9) and reliability (0.9). A four-factor solution best fitted the study data and the estimated fit indices were in the acceptable range (chi square/ degree of freedom = 2.956, the Root Mean Square Error of Approximation = 0.070, Confirmatory Fit Index = 0.667, The Tucker-Lewis Index = 0.599).ConclusionThe CSES-P can be considered as a potentially valid and reliable tool to assess contraceptive self-efficacy among Persian-speaking women. The CSES-P is a general instrument to measure overall contraceptive self-efficacy of the Iranian reproductive age women and it would also be fascinating to work on method specific self-efficacy tools in future.

The Cellular Respiration of Endometrial Biopsies from Patients with Various Forms of Endometriosis.

Endometriosis is one of the leading pathologies of the reproductive system of women of fertile age, which shows changes in cell metabolism in the lesions. We conducted a study of the cellular respiration according to the polarography and the mRNA content of the main metabolic proteins using qRT-PCR of intraoperative endometrial biopsies from patients in the control group and with different localizations of endometriosis (adenomyosis, endometrioma, pelvic peritoneum). In biopsy samples of patients with endometriomas and pelvic peritoneum endometriotic lesions, the rate of oxygen absorption was significantly reduced, and, moreover, in the extragenital case, there was a shift to succinate utilization. The mRNA content of the cytochrome c, cytochrome c oxidase, and ATP synthase was also reduced, but hexokinase HK2 as well as pyruvate kinase were significantly higher than in the control. These oxidative phosphorylation and gene expression profiles suggest the Warburg effect and a shift in metabolism toward glycolysis. For adenomyosis, on the contrary, cellular respiration was significantly higher than in the control group due to the terminal region of the respiratory chain, ATP synthase, and its mRNA was increased as well. These data allow us to suggest that the therapeutic strategies of endometriosis based on modulation energy metabolism should take lesion localization into account.

An unusual case of bowel obstruction secondary to endometriosis

Introduction: Endometriosis is a common disease of women of childbearing age. It can affect the intestines in a portion of patients, although it is generally asymptomatic. Case Report: Here we present an unusual case of a large bowel obstruction due to intestinal endometriosis. Conclusion: In the absence of signs or risk factors for colorectal malignancy, endometriosis should be considered in the differential diagnosis for large bowel obstructions occurring in women of fertile age.

Влияние заболеваемости женщин в период беременности, родов и послеродовой период на показатели использования коечного фонда отделений патологии беременности.

P u r p o s e : assessment of the impact of morbidity in women during pregnancy, childbirth and the postpartum period on the utilization of bed capacity in pregnancy pathology departments. Materials and methods. Based on official statistics, a comparative statistical analysis of the incidence rates of women of fertile age with the XV class of diseases ICD‑10 «Pregnancy, childbirth and the postpartum period» and indicators of the use of bed capacity in pregnancy pathology departments of St. Petersburg with indicators for the Russian Federation and the Northwestern Federal District in dynamics for 2017 was carried out. 2022. To assess the relationship between indicators, the nonparametric Spearman rank correlation method was used. Statistical data processing was carried out using the MS Office‑2016 and StatSoft-Statistica 10.0 software packages. Results. In 2017–2022, there were significant differences in the level and dynamics of the incidence of class XV diseases in women of fertile age in the metropolis and from the indicators for the Russian Federation and the Northwestern Federal District. With multidirectional dynamics of these indicators, almost the entire study period, the incidence rate of women in St. Petersburg was lower than the national and district averages, and over six years the incidence rate decreased by 30.8%. The work of pregnancy pathology beds, the average length of stay of patients on them in the metropolis were higher than the Russian and regional averages, and the turnover of beds was higher. It was revealed that in Russia and the Northwestern Federal District, the morbidity of pregnant women, women in labor and postpartum had virtually no effect on the average occupancy of a pregnancy pathology bed per year and its average downtime, and in the metropolis, with a decrease in morbidity rates, bed occupancy moderately decreased and its downtime increased. At the same time, the impact of the incidence of class XV diseases in women on the average length of stay of patients in pregnancy pathology beds in the country as a whole and in the Northwestern Federal District was more significant than in the metropolis. At the same time, the impact of morbidity among pregnant women, women in labor and postpartum in the city on the turnover of beds in this profile was less significant than on the indicators in the federal district. It was found that the decrease in morbidity had a moderately pronounced effect on reducing the length of stay of women in the city’s pregnancy pathology departments and increasing the turnover of beds. Conclusion. There are differences in the level and dynamics of morbidity indicators for pregnant women, parturients and postpartum women and indicators of the use of obstetric beds for the pathology of pregnancy in the metropolis from these indicators in Russia and the Northwestern Federal District. The incidence of women during this period has a moderate impact on the average bed occupancy per year, the average length of stay on a bed, bed turnover and the average bed idle time. The impact of a decrease in morbidity on the use of pregnancy pathology beds in the metropolis differed from Russia and the Northwestern Federal District, which was expressed in the strength and significance of the connection.

The fertility timing gap: the intended and real timing of childbirth.

The fertility gap, which indicates the difference between the planned and actual number of children born, can be explained by the shift in parenthood to older ages and is associated with the non-attainment of one's intended reproductive plans. This paper focuses on the gap in the timing of entry into parenthood, i.e. between the planned and actual age at the birth of the first child. The study is based on data from the Women 2016 survey which re-interviewed women of fertile age from the second wave of the Czech Generations & Gender Survey conducted in 2008. At the population level, the fertility timing gap differs across generations. While for Czech women born between 1966 and 1971 the planned age exceeded the actual observed age by one year, the realisation of fertility occurred two years later than planned for the youngest generation (1983-1990) included in the study. At the individual level, the later-than-planned realisation of fertility was found to be related primarily to partner-related factors.

Polymorphism of xenobiotic biotransformation enzyme genes and their role in early pregnancy loss

Considering the progressive decrease in the number of women of fertile age, as well as children and adolescents, the primary medical and social task at the present stage is to preserve the reproductive health and life of women, preserving every desired pregnancy. The concept of demographic policy of the Russian Federation for the period until 2025 defines the global national goals, i.e. to increase the total fertility rate by 1.5 times, to reduce maternal and infant mortality by at least 2 times, and to improve the reproductive health of women, children and adolescents. Today every fifth desirable pregnancy ends in early loss, and the rate of miscarriage does not tend to decrease and, in fact, increases every year. Carriage of susceptibility or candidate genes can alter the course of biochemical processes in women and cause early pregnancy losses. According to the literature, the cytochrome P-450 gene (CYP1A1, CYP1B1), xenobiotic detoxification genes (GSTT1, GSTM1, GSTP1) and many others are recognized as candidate genes (genetic markers) associated with reproductive losses. Adverse pregnancy outcome is usually multifactorial; in turn, the combination of polymorphic variants of different candidate genes can increase the risk of early losses. A detailed study of the role of candidate genes with clarity and confirmation of the interest of candidate genes in the development of pregnancy loss is undeniable. In this regard, the interest of many researchers in studying the polymorphism of genes of the xenobiotic biotransformation enzyme system as one of the causal factors of pregnancy failure is understandable. The study of this group of genes is of particular relevance in regions with developed industry and high anthropogenic load. The article is devoted to the analysis of the existing data of foreign and domestic literature sources concerning the relationship between polymorphism of xenobiotic biotransformation system genes and reproductive losses.

Предупреждение врачебных нарушений при ведении беременных женщин с выявленной ИППП: экспертное мнение медицинского юриста и дерматовенеролога (междисциплинарная дискуссия)

The urgency of the medical malpractice problem is due to the fact that the presence of sexually transmitted infections (STIs) in women of fertile age is a common cause of reproductive loss. The authors discuss what an obstetrician-gynecologist should pay attention to at the stage of preconception period and during pregnancy in patients with an identified STI. The article also raises the following important interdisciplinary discussion issues: which specialist should treat the pregnant woman with identified STI and her sexual partner? Should only an obstetrician- gynecologist be involved in the treatment process? At what point does subjectively conscientious medical treatment become inappropriate? It remains relevant and necessary to have correct and unambiguous formulations in clinical recommendations on the pregnancy management with identified STIs (namely, chlamydia, gonorrhea and trichomoniasis) and on the professional interaction of obstetrician-gynecologists with dermatovenerologists in such cases. Besides, it is necessary to develop a legal and structural algorithm for the prevention of medical malpractices to prevent the legal liability of both a medical organization and a specific attending obstetrician-gynecologist in the pregnancy management with STIs. KEYWORDS: sexually transmitted diseases, pregnant women, obstetrician-gynecologist, dermatovenerologist, clinical recommendations, gonorrhea, chlamydia, trichomoniasis. FOR CITATION: Khryanin A.A., Radchenko M.V. Prevention of medical malpractices in the pregnancy management with STIs: expert opinion of a medical lawyer and a dermatovenerologist (interdisciplinary discussion). Russian Journal of Woman and Child Health. 2024;7(3):259– 265 (in Russ.). DOI: 10.32364/2618-8430-2024-7-3-7.

Численность населения региона с точки зрения его репродуктивно-демографического потенциала.

As a result of the study, the transformation of the age structure of the population of the Kostroma region was noted, which leads to a negative change in the demographic burden – the proportion of the working-age population decreases with an increase in the proportion of the population older than the working-age population, there is a significant decrease in the number of women of fertile age in urban and rural areas, while the number of women aged 15–24 years has significantly decreased. In recent years, the total fertility rate has decreased, there has been an increase in the average age of the mother at birth, the birth rate is decreasing under the age of 20 and at the age of 20–24, it is increasing in the group of 30–34-year-olds and older. Despite the decrease in the mortality rate, the indicators of the Kostroma region exceed the national average. Life expectancy has a pronounced upward trend, but remains lower than the average for the Russian Federation and the Central Federal District. The identified trends determine the demographic situation in the region, which requires operational decisions on the development and implementation of scientifically based special family-oriented programs aimed through interdepartmental interaction at stabilizing regional reproductive and demographic indicators.

Взаимосвязь воспроизводства населения с репродуктивным здоровьем женщин фертильного возраста в Красноярском крае.

Relevance. Problems of population reproduction and reproductive health of women of fertile age [1] attract much attention from both domestic and foreign researchers. Important demographic indicators that characterize population reproduction are fertility and mortality, the level of which significantly affects the population size, natural growth and determines the demographic situation not only of the territories, but also of the country as a whole [2]. Purpose of the study: to analyze literary sources and compare with official statistical data of the Krasnoyarsk Territory, both for the region with low population density, and separately for the western medical district of the Krasnoyarsk Territory, fertility rates, women’s reproductive health, the frequency of abortions and the number of births. Material and methods. For an objective assessment, information was taken from Rosstat for the Krasnoyarsk Territory and data from dashboards of the situation center of the Krasnoyarsk Territory, data from the state report on the state of public health and health care activities in the Krasnoyarsk Territory in 2022, a retrospective analysis of medical documentation and state statistics materials was carried out with copying data. Results of the study. Over the past three years, negative changes have emerged in the demographic development of the Russian Federation, expressed in a decrease in the number of births and an increase in the number of deaths. Total fertility rate in Russia in 2020. amounted to – 9.8‰, in 2021. – 9.6‰, in 2022 – 8.9‰. In the Krasnoyarsk Territory in 2020. – 10.1‰, 2021 – 10.0‰, 2022 – 9.9‰ [3]. The indicator both for the country as a whole and for the Krasnoyarsk Territory did not reach the following values: 1980. – 15.9‰ and 1990 – 13.4‰. In the western medical district of the Krasnoyarsk Territory, the birth rate in 2020–12.4‰, in 2021–12.2‰ and in 2022 amounted to 12.0‰. The average age of women giving birth in Russia is 26 years in 2022, in the Krasnoyarsk Territory in 2022 it was 29.2 years and in the western medical district of the region – 29.5 years. The share of premature births among women who completed pregnancy increased over 5 years by 11.2% and in 2022 amounted to 5.8% in the Krasnoyarsk Territory as a whole, and in the western medical district of the region 5.4%. Population reproduction is largely related to women’s reproductive health. Conclusions. The relationship between population reproduction and the reproductive health of women of fertile age in the Krasnoyarsk Territory has been established, based on a study of literature data and statistical data for a region with low population density.

Reproductive Changes in the Population of the Republic of Croatia

Knowledge of demographic trends is the basis for policy making, both economic, social, health, etc., as well as population policy. The Republic of Croatia has been facing demographic problems for many years, mainly an increase in the elderly population with a simultaneous decrease in the reproductive base and the number of young people. Croatia is one of the countries in the post-transition stage of population characteristics, characterized by the transition of the total fertility rate from a low positive rate to a level that no longer ensures the renewal of generations, and the mortality rate, which is determined by increasing life expectancy. In the Republic of Croatia, fertility is measured by the periodic total fertility rate, which indicates the average expected number of live births that a woman of fertile age (15 to 49 years) would give birth to. The total fertility rate of 2.1 children is often cited in the literature and among the public as the numerical level of generational change, while the Republic of Croatia has recorded a total fertility rate below this level for decades, i.e., 1.48 (2020). Another important characteristic of the post-transition period is late childbearing. The age limit for marriage and readiness to have a first child is increasing. The average age of a mother at the birth of her first child increased from 23.5 years (1960) to 29 years (2020), which significantly shortens a woman's reproductive time. Due to numerous factors, the number of live births has decreased from 95,560 children in 1960 to 35,845 children in 2020, a decrease of 59,715 live births. The subject of this work is a study of the reproductive determinants of population development in the Republic of Croatia, focusing on the determination of the factors influencing fertility and the quantitative presentation of demographic indicators. The aim of this work is to find the cause of declining fertility. Therefore, this work analyzes the factors that influence fertility. Due to the resulting birth deficit, it is necessary to take measures to promote births. Therefore, in the concluding remarks, recommendations are given for improving the demographic situation in the Republic of Croatia in the context of promoting births and increasing fertility. Keywords: reproductive changes, fertility, Republic of Croatia, total fertility rate

Folate - a scoping review for Nordic Nutrition Recommendations 2023.

Folate is an essential micronutrient for normal development and metabolic function, and folate deficiency is associated with an increased risk of cancer, cardiovascular disease, mental dysfuntion and negative pregnancy outcomes. When estimating folate requirements, one must consider different bioavailability and functionality between synthetic folic acid and dietary folate, together with increased needs of folate in women of fertile age, pregnant and lactating women, preterm and small for gestational age weight infants and individuals who are homozygote for the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism. In order to achieve an adequate metabolic status based on the metabolic marker total homocysteine, and not merely the absence of clinical signs of folate deficiency, the recommended intake of folate differs according to age, pregnancy and lactation. According to the World Health Organization, a decision limit for folate deficiency in adults is serum folate level below 10 nmol/L, and in women of fertile age a red blood cell folate level below 906 nmol/L in order to prevent neural tube defects. Qualified systematic reviews along with identified relevant literature have been used for this scoping review prepared for the Nordic Nutrition Recommendations 2023.

Assessment of Clinical, Biochemical and Hormonal Aspects of Women of Fertile Age with Polycystic Ovary Syndrome

Assessment of patient management tactics and the effectiveness of polycystic ovary syndrome (PCOS) therapy, taking into account modern international recommendations. Inadequate assessment of the menstrual cycle without taking into account modern characteristics of the normal menstrual cycle leads to overdiagnosis and, as a result, the appointment of unnecessary therapy. The incidence of PCOS among women of young fertile age with menstrual disorders was 49.5%. Clinical hyperandrogenism of varying severity was detected in all patients with PCOS. The use of microdosed COCs containing drospirenone in the treatment of PCOS in 93% of cases reduces the severity of clinical hyperandrogenism, normalizes the menstrual cycle and improves anxiety indicators by 16.5%

Визуализация представлений о душе в украшениях национальных костюмов саха (якутов) и тувинцев

Introduction. The cultural heritages of the Sakha (Yakut) and the Tuvan are distinguished by a similarity of basic worldview ideas pertaining to the structure of the Universe, multi-storeyedness of each of the Three Worlds, the pantheon of deities, etc. Goals. The article aims to interpret semantics of ethnic jewelry as a visual narrative articulating the ideas of individual soul in traditional Sakha and Tuvan cultures. To facilitate this, the paper shall summarize the available descriptions of these ideas from ethnographic material, identify some facts confirming jewelry used to serve as markers of soul, consider semantics of traditional jewelry signs. The study hypothesizes as follows: when it comes to soul visualizations, folklore sources manifest repeated indications localizing one of the three souls (aorta, blood, belt, etc.) ― hence, the other two must also have some certain locations and related beliefs, too. Methods. With due regard of the dynamics in religious and aesthetic preferences, the employed interdisciplinary and comparative historical approaches comprise the structural/functional, interpretative, and axiological methods. The method of mosaic reconstruction proves as instrumental in revealing jewelry symbolism. Results. The paper confirms adornments (jewelry pieces) act as means to visualize some valuable worldviews, ideas of human soul and its whereabouts, prestige and behavioral norms. The former are defined as utmost identity signs for an inhabitant of the Middle World that serve as markers and protective amulets for each of the three human souls, also viewed as mediators between the sacred and profane worlds, triggers in ritual communication, and social status indicators. Conclusions. Being a universal form, circle (silver disk, bead, infinity knot, and button) denotes the place and function of each soul. For instance, the air one of the Sakha and the middle one of the Tuvan are placed in the head and identified with head adornments (jewelry pieces). According to Sakha beliefs, the maternal soul is localized in the mediastinum (pulse and blood ― heart and liver), while Tuvans place soul one into the navel. Yakut women of fertile age tend to mark this soul with solar breast jewelry, with no identified symbolic parallels in the Tuvan costume. Yakuts believe the third earthly soul be indicated with a belt buckle and dwell in the navel, while the Tuvan tradition says the good soul dwells in the belt. So, the Yakut have retained somewhat more archaic version of the symbolic corpus. And the differences are largely determined by the late influence of Manchu-Chinese culture and Buddhism on worldviews of southern Tuvans.

Psycho-emotional stress and its impact on the intestine before and after artificial abortion

This study explores the psycho-emotional stress and related intestinal symptoms among women of fertile age who underwent an artificial abortion, utilizing a well-defined point-based questionnaire for stress levels and the revised version of the questionnaire for healthcare professionals to evaluate intestinal symptoms. The cohort consisted of 400 participants, with stress levels categorized as low (0–30 points), medium (31–70 points), or high (71+ points) according to the Perceived Stress Scale-10 (PSS). Further, perceived helplessness and perceived self-efficacy were evaluated via negative and positive PSS items, respectively. Findings indicated that most (65.5 %) women experienced high, and 27.5 % — medium stress before an abortion. Notably, pre-abortion stress levels were generally higher compared to those after an abortion. Concurrently, the frequency of bowel symptoms declined after an abortion. A significant relationship was found between pre-abortion bowel symptoms and higher post-abortion PSS scores, and an increase in the perceived helplessness subgroup (p = 0.051, R2 = 0.156; p = 0.029, R2 = 0.138, respectively). Furthermore, higher perceived helplessness scores were linked with increased pre-abortion intestinal symptoms (p = 0.043, R2 = 0.341). The study, however, found no significant correlations between bowel symptoms and the perceived self-efficacy subgroup. These results suggest an association between pre-abortion psychological factors (lower self-efficacy and higher stress levels) and the incidence of intestinal symptoms, thus shedding light on the intersection of psychological and physical well-being in reproductive health contexts. Further research is needed to explore these mechanisms and develop effective support strategies.

Papillary thyroid microcarcinoma: impossible to operate observe – where to put a comma?

Objective. To evaluate the efficiency of diagnostics and treatment in patients with microcarcinomas of the thyroid gland at the State Medical Institution "RCOD of the Ministry of Health of the Republic of Tatarstan named after Professor. M.Z. Sigal" for 2020-22.
 Materials and methods. MIS "BARS. Healthcare – MIS" of oncological dispensary, outpatient charts and medical histories of patients operated on for thyroid microcarcinomas were used.
 Results. In the study group, all patients had papillary microcarcinoma. Women over 45 years of age prevailed. Women of fertile age accounted for 41.7%. The combination of microcarcinoma with thyroid adenomas, colloidal goiter and AIT was detected in 78.6% of patients. The organ capsule invasion occurred in 35.7% of patients, metastases to regional lymph nodes – in 19%. Thyroidectomy was performed in 66.7% of patients; 12 (28.6%) patients underwent I-131 therapy.
 Conclusions. Due to the fact that papillary microcarcinoma of the thyroid gland is often found in women of fertile age, and develops against the background of another thyroid pathology complicating diagnostics, it sprouts an organ capsule in 35.7% and gives metastases to regional lymph nodes in 19%, therefore requires a timely diagnostics and radical treatment.

The Dynamics of the Prevalence of Diseases Among Women of Fertile Age in the Charyshsky District of the Altai Region, Living Near the Fall Areas of Separable Parts of Launch Vehicles

Part of the territory of the Altai Region is involved in rocket and space activities as fall areas of separable parts of launch vehicles. This creates a number of specific problems for the ecological situation and the population living near the fall areas. Taking into account the aggravated demographic situation in Russia, this paper presents a dynamic analysis of the prevalence of diseases among women of fertile age in the Senteleksky village Council of the Charyshsky district, as a territory adjacent to the zone of rocket and space activities. The results of the medical examination of the population in 1999, 2006, 2011 and 2015 were used in the work. The most significant diseases and features of the dynamics of the prevalence of classes of diseases and individual nosologies were identified.

Transcriptomics and Spatial Proteomics for Discovery and Validation of Missing Proteins in the Human Ovary.

Efforts to understand the complexities of human biology encompass multidimensional aspects, with proteins emerging as crucial components. However, studying the human ovary introduces unique challenges due to its complex dynamics and changes over a lifetime, varied cellular composition, and limited sample access. Here, four new RNA-seq samples of ovarian cortex spanning ages of 7 to 32 were sequenced and added to the existing data in the Human Protein Atlas (HPA) database www.proteinatlas.org, opening the doors to unique possibilities for exploration of oocyte-specific proteins. Based on transcriptomics analysis of the four new tissue samples representing both prepubertal girls and women of fertile age, we selected 20 protein candidates that lacked previous evidence at the protein level, so-called "missing proteins" (MPs). The proteins were validated using high-resolution antibody-based profiling and single-cell transcriptomics. Fourteen proteins exhibited consistent single-cell expression patterns in oocytes and granulosa cells, confirming their presence in the ovary and suggesting that these proteins play important roles in ovarian function, thus proposing that these 14 proteins should no longer be classified as MPs. This research significantly advances the understanding of MPs, unearthing fresh avenues for prospective exploration. By integrating innovative methodologies and leveraging the wealth of data in the HPA database, these insights contribute to refining our understanding of protein roles within the human ovary and opening the doors for further investigations into missing proteins and human reproduction.

Endometriosis, polycystic ovary syndrome, and the thyroid: a review.

Endometriosis and polycystic ovary syndrome (PCOS) are common gynecological disorders that constitute a significant burden of disease in women of fertile age. The disorders share a link to female reproduction and infertility; however, divergent effects on menstrual cycle, related hormones, and body composition have been proposed. Disorders of the thyroid gland including abnormal thyroid dysfunction (hyperthyroidism or hypothyroidism) and/or markers of thyroid autoimmunity similarly show a female predominance and onset in younger age groups. We reviewed the literature on the association between endometriosis, PCOS, and thyroid disease up until July 1, 2023, and identified 8 original studies on endometriosis and thyroid disease and 30 original studies on PCOS and thyroid disease. The studies were observational and heterogeneous regarding the design, sample size, and definitions of exposure and outcome; however, a tendency was seen toward an association between hyperthyroidism and endometriosis. Especially an association between endometriosis and slightly elevated levels of thyroid-stimulating hormone receptor antibodies has been found and corroborated in studies from different populations. On the other hand, the literature review turned a focus toward an association between hypothyroidism and PCOS, however, with uncertainties as to whether the association is caused by hypothyroidism per se and/or the thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies). More evidence is needed to substantiate an association between endometriosis, PCOS, and thyroid disease, and to differentiate between the role of thyroid function and thyroid autoimmunity. Furthermore, studies are warranted to extend knowledge on the different disease characteristics and underlying mechanisms.

ANALYSIS OF DEMOGRAPHIC INDICATORS IN AGRICULTURE-BASED AND RAW MATERIALS-BASED REGIONS OF THE RUSSIAN FEDERATION

In recent decades, there has been some reduction in the working age population in most regions of the Russian Federation (influenced by the “demographic pit” of the 90s of the 20th century). The decline in the population is certainly a negative factor in the socio-economic development of any territory. The present study conducted a comparative analysis of the main demographic indicators of the two regions — agriculture-based (Altai region) and raw materials-based (Khanty-Mansi autonomous region — Ugra). The choice of these constituent entities of the Russian Federation is due to their specialization, industry, agriculture, food industry, oil and gas production are the main groups of economic progress of the entire state. The analysis of demographic processes was based on the data posted in official open sources (Federal State Statistics Service).
 According to the authors, without the sufficient number of working age population, without maintaining the optimal ratio of men and women, the level of marriage, the number of women of fertile age, the development rate of the territories will decrease. Preserving the population, increasing the birth rate and life expectancy is the main task of the authorities, which is reflected in the programs of socio-economic development approved by all levels of government of the Russian Federation.

Factors affecting female sexual well-being: a 5-year follow-up of a randomised clinical trial on post-abortion contraception

IntroductionSexual well-being is associated with general well-being. Several factors, such as overweight, infertility, anxiety and sex hormones, also play a role, but the effects of hormonal contraception remain a point...