Glands Of Women Research Articles

Ecological aspects of studying the thyroid function of the thyroid gland in women of reproductive age living in a region with iodine deficiency (Akhtynsky district, Republic of Dagestan, Russia)

Aim. To present epidemiological aspects of the study of thyroid function of the thyroid gland.The article presents the results of a clinical and laboratory examination and epidemiological aspects of studying the thyroid function of the thyroid gland in 120 women of reproductive age living in an area with iodine deficiency (Akhtynsky district, Republic of Dagestan – located at an altitude of 1.675 metres above sea level). The women were examined for thyroid diseases and for the presence of intrauterine infections: TORCH toxoplasmosis, ornithosis, rubella, cytomegalo‐ and herpesviruses.All the examined patients had thyroid diseases (the women are registered with an endocrinologist at an Endocrinological Dispensary). All women underwent correction of iodine deficiency in the form of iodine prophylaxis by taking medications containing a daily iodine requirement of up to 250 mcg to normalize thyroid function.Intrauterine infections (IUI) were found in 76 women (69 %. of the patients examined). Intrauterine infections of women registered in the women's clinic of the district hospital were also treated.

Воспаление парауретральных протоков и желез у женщин: проблема с 350-летней историей.

Introduction. Inflammation of the Skene glands is one of the common causes of persistent dysuria and recurrent lower urinary tract infections. Lack of awareness about this pathology can lead to diagnostic errors and inadequate treatment. This pathology is not sufficiently covered in the literature, which was the reason for preparing this lecture. Results. The lecture review covers the history of studying the anatomy of the paraurethral glands in women, the first attempts to diagnose and treat various diseases. The issues of homology of the paraurethral ducts and glands in women with the prostate gland in men are considered, the anatomy, morphology and immunohistochemical properties of the Skene glands are described, as well as modern ideas about their function. The historical background, nomenclature and classification are presented. The role of inflammation in these structures as a cause of persistent dysuria and a source of persistent lower urinary tract infections has been demonstrated. The need to standardize the methodology for examining patients with skineitis and the search for a specialized instrument for an adequate examination of the female urethra is substantiated. An analysis of the effectiveness of electrical resection of Skene's glands was carried out. Conclusions. One of the main factors behind unsatisfactory treatment results for lower urinary tract infections is inflammation of the paraurethral ducts and glands. Their insufficient visualization and assessment are the reasons for frequent relapses of the disease and repeated surgical interventions.

Hyposalivation but not Sjögren's syndrome associated with microbial dysbiosis in women.

Saliva modulates the environment of the oral biofilm through pH buffer, microbial attachment to host surfaces, and nutritional source. The ecology of stress occurs when a physical factor adversely impacts an ecosystem or its biotic components. Therefore, reduced salivary flow can affect oral-host balance. The leading causes of hyposalivation include disease-associated Sjögren's syndrome (SS) and menopausal women as aging-associated. However, little is known about the oral microbiome integrated with sex hormones in hyposalivation. This study aimed to characterize the hyposalivation microbiome caused by aging or disease affecting the salivary glands in women. We included 50 women older than 40 years of age in any menopausal phase. We collected stimulated saliva from 25 women diagnosed with SS (SS) and 25 without SS (non-SS). The bacterial profile of the patients was obtained by 16S rRNA sequencing. Bioinformatics analysis used machine learning to analyze the cohort's signs, symptoms, and bacterial profile. Salivary estradiol as a sex hormone variation level was determined. We obtained that 79% of the SS group, and 52% of the non-SS group had hyposalivation. We found a negatively correlated Prevotella-age and Rothia-estradiol in the SS group. Highlight, we found that the cause of the hyposalivation in the study did not explain differences in microbial diversity comparing non-SS and SS groups. Therefore, microbial communities found in hyposalivation but not related to systemic conditions suggest that changes in the oral environment might underpin host-microbial balance. The salivary microbiome was similar in women with and without SS. However, hyposalivation showed two distinctive clusters associated with the bacterial population profiles. Our study suggests that local ecological disturbances could drive the change in the microbiome.

Features of achieving compensation of hypothyroisis in pregnant women

BACKGROUND: Hypofunction of the thyroid gland in women at the pre-pregnancy stage and during pregnancy is associated with a high risk of congenital hypothyroidism in children, as a result of which irreversible changes in the nervous system are formed. Despite the mandatory intake of potassium iodide preparations, pregnant women often develop gestational hypothyroidism, which requires the appointment of levothyroxine. Many women have episodic hypofunction of the thyroid gland before pregnancy, associated with various factors. Diagnosed hypothyroidism requires hormonal correction. The recommended dose of levothyroxine calculated by the patient’s weight is not always adequate to achieve TSH targets. In addition, there are pharmacological factors. Levothyroxine sodium preparations differ in bioavailability. The stability of drugs is affected by external factors and the composition of fillers from different manufacturers of drugs.AIM: To assess the dependence of TSH reduction on the method of taking levothyroxine in a population of pregnant women.MATERIALS AND METHODS: Statistical analysis and prospective study was carried out from 2019 to 2021. On the basis of the «Perinatal Center», Tyumen, women’s consultative and diagnostic department. Pregnant women with diagnosed primary subclinical and manifest hypothyroidism in the first trimester of pregnancy (n=76) were selected for cohort observation. All pregnant women were prescribed L-thyroxine Berlin-hemi. Other levothyroxine preparations were not used in order to exclude distortion of the results of the study.RESULTS: Pregnant women with hypothyroidism were divided into two groups according to the method of taking L-thyroxine: oral (n=54) and sublingual (n=22). A month later, TSH normalization was observed in 41 pregnant women in the oral group (76%) and in 22 pregnant women in the sublingual group (100%). Women who did not achieve hypothyroidism compensation were recommended sublingual administration without increasing the dose of L-thyroxine, provided that TSH was no higher than 4.0 mcME / ml. A TSH study a month later showed that all pregnant women achieved compensation. CONCLUSION: Based on the conducted research, it is shown that the more rational administration of levothyroxine sodium preparations is sublingual, since there is a slightly alkaline reaction in the oral cavity, which does not have a destructive effect, like gastric juice.

Metabolic-associated fatty liver disease (NAFLD) as a cancer risk factor

The purpose of this review was to update information on the prevalence and relationship of cancer development of various localizations with non-alcoholic, metabolic-associated fatty liver disease (NAFLD/MAFLD). Discussion: The second most common cause of death among patients with NAFLD are malignant neoplasms both in the gastrointestinal tract (liver, colon, esophagus, stomach and pancreas) and in other organs (kidneys, prostate gland in men and mammary gland in women). Obesity and other metabolic disorders are associated with an increase in morbidity or mortality from various types of cancer. Due to the high prevalence of NAFLD among patients with metabolic syndrome, type 2 diabetes mellitus, an extrapolation of this development is assumed among patients with NAFLD. Metabolic disorders, imbalance of the intestinal microflora are considered as possible pathogenetic mechanisms for increasing the risk of cancer among patients suffering from NAFLD. Conclusion: in addition to the risk of developing hepatocellular carcinoma as a natural course of the disease, convincing evidence is accumulating for the role of NAFLD as an independent risk factor for the development and progression of cancer, especially in the gastrointestinal tract.

Analysis of malignant neoplasms morbidity of the female genital organs and mammary glands in Chernihiv region

Malignant neoplasms of genital organs and mammary glands in women adversely affect the economic condition and demographic situation in most of the countries of the world, since a significant proportion of women affected by these diseases at working and reproductive age.The objective: to study and analyze the five-year dynamics of the incidence of for malignant neoplasms of the female genital organs and mammary glands in Chernihiv region.Materials and methods. The official data of sectoral statistical reporting for the period 2017–2021 of administrative territories of Chernihiv region and Ukraine were used. The medical statistical method and the method of structural and logical analysis were applied.Results. The analysis of the incidence for malignant neoplasms of the female genital organs and mammary glands in women in the Chernihiv region demonstrated that in the dynamics of the years 2017–2021, the incidence rate per 10 thousand female population as a whole tended to increase from 75.3 to 79.4 (in 1.05 times). At the same time, the incidence rate of malignant neoplasms of the mammary glands increased from 67.2 to 72.0 in (in 1.07 times); the frequency of cervical malignant neoplasms increased from 14.7 to 18.0 (in 1.22 times); the incidence rate of ovarian malignancies increased from 19.8 to 21.2 (1.07 times). In 2021, all the mentioned indicators in the region had higher values than in Ukraine as a whole. In the regional administrative territories these indicators had significant differences.Conclusions. High incidence rates for malignant neoplasms of the female genital organs and mammary glands in women in Chernihiv region for 2017–2021 were revealed, that requires optimization of preventive activities of the health care system at the regional level.

Гормональний гомеостаз у жінок репродуктивного віку з аденоміозом

The problem of adenomyosis is particularly relevant for patients of reproductive age, as it is accompanied by the significant disturbances of menstrual and generative functions. The article presents the results of studying the condition of the hypothalamic-pituitary-ovarian system in women of reproductive age with adenomyosis.The objective: to study the state of the hypothalamic-pituitary-ovarian system in women of reproductive age with benign endometrial and myometrial pathology.Materials and methods. The main group included 120 women of reproductive age with benign endometrial and myometrial pathology (adenomyosis, endometrial hyperplasia and combined pathology), and the control group included 40 healthy women without gynecological pathology. The functional state of the hypothalamic-pituitary-ovarian system was evaluated by the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2) and progesterone (P) in blood serum in different phases of the menstrual cycle.Results. In women with adenomyosis, endometrial hyperplasia and combined pathology, there is hyperproduction of gonadotropic hormones with an increase of their secretion level compared to a group of healthy women: the average concentration of FSH, regardless of the phase of the menstrual cycle, increased by 1.9 times (p<0.05), LH – 2.2 times, PRL – 2 times, which indicates the presence of hyperprolactinemia. Both in the I and II phases of the menstrual cycle, the occurrence of additional FSH and LH peaks from basal hormone secretion was determined in patients of the main group, which reached the level of hormone concentration in the ovulatory peak. In the patients of the main group, hyperestrogenemia during the entire menstrual cycle and hypoprogesteronemia were detected. The expression of hormonal shifts depended on gynecological pathology (adenomyosis, endometrial hyperplasia and combined pathology) and the functional state of the woman.Conclusions. The indicators of gonadotropic and prolactin-stimulating activity of the pituitary gland in women with benign uterine pathology confirm the participation of FSH, LH and prolactin in the complex processes of regulation of the reproductive system.

Hormonal homeostasis in women of reproductive age with adenomyosis

The problem of adenomyosis is particularly relevant for patients of reproductive age, as it is accompanied by the significant disturbances of menstrual and generative functions. The article presents the results of studying the condition of the hypothalamic-pituitary-ovarian system in women of reproductive age with adenomyosis.The objective: to study the state of the hypothalamic-pituitary-ovarian system in women of reproductive age with benign endometrial and myometrial pathology.Materials and methods. The main group included 120 women of reproductive age with benign endometrial and myometrial pathology (adenomyosis, endometrial hyperplasia and combined pathology), and the control group included 40 healthy women without gynecological pathology. The functional state of the hypothalamic-pituitary-ovarian system was evaluated by the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2) and progesterone (P) in blood serum in different phases of the menstrual cycle.Results. In women with adenomyosis, endometrial hyperplasia and combined pathology, there is hyperproduction of gonadotropic hormones with an increase of their secretion level compared to a group of healthy women: the average concentration of FSH, regardless of the phase of the menstrual cycle, increased by 1.9 times (p<0.05), LH – 2.2 times, PRL – 2 times, which indicates the presence of hyperprolactinemia. Both in the I and II phases of the menstrual cycle, the occurrence of additional FSH and LH peaks from basal hormone secretion was determined in patients of the main group, which reached the level of hormone concentration in the ovulatory peak. In the patients of the main group, hyperestrogenemia during the entire menstrual cycle and hypoprogesteronemia were detected. The expression of hormonal shifts depended on gynecological pathology (adenomyosis, endometrial hyperplasia and combined pathology) and the functional state of the woman.Conclusions. The indicators of gonadotropic and prolactin-stimulating activity of the pituitary gland in women with benign uterine pathology confirm the participation of FSH, LH and prolactin in the complex processes of regulation of the reproductive system.

Analysis of the manifestation frequency of different variants of calcifications in the mammary glands in women of mature and old age according to screening mammography data

The relevance of the problem of early diagnosis of pathological changes in the mammary glands (MG) of women of different ages is due to the fact that in the world rankings of neoplasms localization, both benign and malignant, the MG occupies a leading position today. According to multiple information sources, more than 80% of women of reproductive age are diagnosed with various MG diseases. For the purpose of early detection of pathological changes developing in MG today, mammography is widely used, which allows easy visualization of calcifications, MG and obtaining their complete characteristics.The purpose of our study was to determine the frequency of detection and to study the age-related dynamics of different types of calcifications in the mammary glands of mature and elderly women according to the mammography results.Material and methods. In the course of the research, a randomized sample of archival anonymized mammograms of 100 women (50 mature and 50 elderly) who underwent screening or preventive examination was processed. Examinations were performed on the Fujifilm Amulet Innovality device (Japan) in direct (SS) and medial-lateral oblique (MLO) projections. Calcifications were assessed by shape, number, and size.Research results. It was determined that in a randomized sample of examined women, only 34% of adults and 28% of elderly people did not have calcifications in the mammary glands. In 24% of adults and 48% of elderly people, calcifications were detected in the mammary glands bilaterally, in another 42% of adults and 24% of elderly people - in only one of the the mammary glands. Among women of mature age, the largest specific share in the examined sample belongs to persons without calcifications in the mammary glands; among the elderly, the largest share is women with calcifications in both mammary glands. According to the results of the conducted research in a randomized sample of mature and elderly women, the following was found: isolated scattered punctate calcifications (35% of the examined); single punctate/round calcifications (23% of the examined); annular calcifications (11% of the examined); multiple calcifications (19% of the examined); calcifications larger than 1 mm (14% of the examined); calcified vessels (4% of the examined).Conclusions. Digital mammography is a highly informative method of examining the mammary glands, which allows us to visualize calcifications and differentiate them by size, shape and number. According to the results of the analysis of a randomized examination sample of 100 mature and elderly women, various variants of calcifications were found as single, diffuse, punctate; single punctate/round; annular; multiple; greater than 1 mm; as well as calcified vessels. With age, the frequency of mammary gland calcifications increases.

Clinical characteristics of women with endometrial hyperplasia on the background of thyroid dysfunction

The objective: to define the specificities of clinical characteristics in women of reproductive age with endometrial hyperplasia associated with hypothyroidism.Materials and methods. There were 180 women with endometrial hyperplasia under our supervision. In 120 women, the pathology of endometrium was associated with newly diagnosed hypothyroidism. The patients with the thyroid dysfunctions were divided into the following groups: asymptomatic persons – 48 cases; symptomatic ones – 45 women; compensated patients with mild symptoms – 27 individuals. The control group consisted of 60 patients with endometrial hyperplasia without thyroid pathology.The data of the somatic and gynecological anamnesis, the concentration of sex hormones and thyroid hormones, the results of histological examination of the endometrium were analyzed in all the women.Results. The following data were found: the age of women with hyperprolactinemia without thyroid pathology is younger than the age of those with hyperprolactinemia and thyroid pathology; hypothyroidism in women with endometrial hyperplasia is contingent on frequently growing body weight, but not obesity; the most common concomitant pathology in women with endometrial hyperplasia and hypothyroidism was mastopathy which was diagnosed almost in every third patient. The frequency of such endocrine pathologies as polycystic ovary syndrome and hyperprolactinemia in women with endometrial hyperplasia has almost increased twice in the presence of hypothyrosis. In case of endometrial hyperplasia and hypothyrosis there was a significant decrease of estradiol concentration with a preserved level of gonadotropic hormones (luteinizing hormone and follicle-stimulating hormone), and the lowest values were defined in women with symptomatic hypothyroidism. Chronic endometritis, the detection rate of which does not depend on thyroid dysfunction, was diagnosed in 61.5 % patients with endometrial hyperplasia.Conclusions. Thyroid dysfunction is involved in the mechanisms of development of hyperplastic processes of the endometrium, which is the basis for screening the functional state of the thyroid gland in women with endometrial pathology.

Endometrial gland specific progestagen-associated endometrial protein and cilia gene splicing changes in recurrent pregnancy loss.

Endometrial glands are essential for fertility, consisting of ciliated and secretory cells that facilitate a suitable uterine environment for embryo implantation. This study sought to determine whether an endometrial gland-specific transcriptome and splicing profile are altered in women with recurrent pregnancy loss. Our data provide a comprehensive catalogue of cilia and progestagen-associated endometrial protein (PAEP) gene isoforms and relative exon usage in endometrial glands. We report a previously unannotated endometrial gland cilia transcript GALNT11 and its susceptibility to exon skipping. Key endometrial receptivity gene transcripts are also reported to change in endometrial glands of women with recurrent pregnancy loss. The endometrial gland cilia and PAEP targets identified in this study could be used to identify a perturbed endometrium, isolate causes of recurrent pregnancy loss and develop targeted therapies in personalised medicine.Lay summarySuccessful embryo implantation is a trade-off between the lining of the womb which receives an implanting embryo, termed the endometrium, and a good quality embryo. For days 21–24 of the menstrual cycle, the endometrium undergoes changes into a receptive state in which it can receive an implanting embryo. Inappropriate endometrial receptivity is thought to underlie recurrent pregnancy loss. Improving pregnancy success in women with recurrent pregnancy loss requires an increased understanding of the endometrium at the molecular level. Genes contain the instructions for the cell and which genes are turned on or off determine how well it can do its role. We sought to determine a gene expression pattern of human endometrial glands in women with recurrent pregnancy loss (n = 5) vs a control group (n = 5). We identify target genes altered in women with recurrent pregnancy loss. Endometrial gland markers could be used to identify inappropriate endometrial receptivity.

Clinical characteristics of women with endometrial hyperplasia on the background of thyroid dysfunction

The objective: to define the specificities of clinical characteristics in women of reproductive age with endometrial hyperplasia associated with hypothyroidism.Materials and methods. There were 180 women with endometrial hyperplasia under our supervision. In 120 women, the pathology of endometrium was associated with newly diagnosed hypothyroidism. The patients with the thyroid dysfunctions were divided into the following groups: asymptomatic persons – 48 cases; symptomatic ones – 45 women; compensated patients with mild symptoms – 27 individuals. The control group consisted of 60 patients with endometrial hyperplasia without thyroid pathology.The data of the somatic and gynecological anamnesis, the concentration of sex hormones and thyroid hormones, the results of histological examination of the endometrium were analyzed in all the women.Results. The following data were found: the age of women with hyperprolactinemia without thyroid pathology is younger than the age of those with hyperprolactinemia and thyroid pathology; hypothyroidism in women with endometrial hyperplasia is contingent on frequently growing body weight, but not obesity; the most common concomitant pathology in women with endometrial hyperplasia and hypothyroidism was mastopathy which was diagnosed almost in every third patient. The frequency of such endocrine pathologies as polycystic ovary syndrome and hyperprolactinemia in women with endometrial hyperplasia has almost increased twice in the presence of hypothyrosis. In case of endometrial hyperplasia and hypothyrosis there was a significant decrease of estradiol concentration with a preserved level of gonadotropic hormones (luteinizing hormone and follicle-stimulating hormone), and the lowest values were defined in women with symptomatic hypothyroidism. Chronic endometritis, the detection rate of which does not depend on thyroid dysfunction, was diagnosed in 61.5 % patients with endometrial hyperplasia.Conclusions. Thyroid dysfunction is involved in the mechanisms of development of hyperplastic processes of the endometrium, which is the basis for screening the functional state of the thyroid gland in women with endometrial pathology.

Early mechanical stimulation of the nipple-areola receptors complex promotes the mammary milk ejection function in women delivered by cesarean section

Mechanical stimulation and milk ejection from mammary gland in women delivered by caesarean section since 1 day post partum by the breastpump with vacuum and compression stimuli promotes milk ejection function. On the third day postpartum the stimulated mothers had significantly more milk flow reflex peaks than those who were not subjected to stimulation during the 10 min milk ejection session.

Стан щитоподібної та молочних залоз у жінок із вторинною неплідністю та ранніми репродуктивними втратами в анамнезі

У статті викладені результати вивчення стану щитоподібної та молочних залоз у жінок (n = 203) із вторинною неплідністю та ранніми репродуктивними втратами в анамнезі (вагітні жінки із загрозою переривання вагітності, вагітність у яких закінчилась мимовільним викиднем в ранні терміни, жінки з викиднем, позаматковою (трубною) вагітністю) за результатами сонографічного обстеження молочних та щитоподібної залоз на етапах обстеження та лікування. Проведені дослідження свідчать, що жінки з порушеною репродуктивною функцією на тлі ранніх репродуктивних втрат становлять групу з високою частотою тиреоїдної патології та значним ризиком виникнення дисгормональних змін у молочних залозах, що потребує проведення активних скринінгових сономамографічних обстежень для виявлення даної патології. Подальший підбір лікувальних схем та визначення лікувальної тактики після різноманітних репродуктивних втрат повинні проводитися при зіставленні очікуваного результату терапії та ступеня ризику можливих ускладнень із боку молочних залоз з урахуванням сонографічно верифікованої патології.

Striae of pregnancy

Striae may form on the skin due to a number of factors: rapid weight gain, muscle hypertrophy, endocrinopathies, breast enlargement, as a side effect of long-term topical use of strong corticosteroids. However, in some rare circumstances, striae can develop as a complication due to the use of tissue expanders. This cosmetic defect develops most often on the skin of the thighs, abdomen, mammary glands in women and the shoulders in men. Striae of pregnancy are a common cosmetic skin defect. The development of striae is associated with stretching and rupture of connective tissue in susceptible individuals against the background of influence of genetic and hormonal factors. The appearance of striae gravidarum does not have a significant effect on the health of patients, however, a cosmetic defect caused by the appearance of striae can generate psychoemotional (psychoemotional) stress and lead to a decrease in quality of life. The striae development occurs in certain stages. The initial period of striae development – red (immature) striae – is characterized by the absence of changes in the epidermis and signs of inflammation in the dermis. The appearance of white (mature) striae is accompanied by the architectural distortion of elastic fibre net and changes in the viscoelastic properties of the affected skin, which becomes much less elastic. The correction of striae requires topical treatment that help moisturize and soften the skin, stimulate the processes of collagen production, as well as physiotherapy techniques. However, many of them have contraindications for use during pregnancy. The article discusses the issues of the use of cosmetic products that can be used during pregnancy.

Peculiarities of Sexual Health of Women of Reproductive Age Depending on the Types of Localization of Paraurethral Glands

Sexual health is a state of physical, emotional, mental and social well-being associated with sexuality. The complexity of the female sexual reaction lies in its dependence on many physiological, psychological and sociocultural factors. The objective: a comprehensive analysis of erogenous zones in women of reproductive age, taking into account the types of localization of the paraurethral glands, assessment of their sexual function and the causes of its disorders. Materials and methods. A comprehensive study to confirm the existence of female paraurethral glands and their functional activity, performed at the Institute of Urology of the National Academy of Medical Sciences of Ukraine (Department of Reconstructive Urology and Advanced Technologies), took 94 relatively healthy women of reproductive age, who as a result of a comprehensive examination paraurethral glands of different types of localization (anterior, posterior, diffuse). Analytical-synthetic, comparative analyzes were used. Average values with their standard error were calculated; in cases of comparison of statistical values, Student’s test was used. Results. The relationship between the localization of the paraurethral glands in women of reproductive age and the peculiarity of the manifestation of sexual relations has been traced. Differences in the number and severity of the reaction of erogenous zones among this category were revealed. Sexual dysfunctions in 24 (25.5%) of 94 women were predominantly in the posterior type of localization of the glands (50% versus 37.5% and 12.5% in the anterior and diffuse types, respectively). Among the reasons for dissatisfaction with sexual relations, women most often indicated satisfaction (36.2%), then – reaching orgasm (22.4%) every fifth noted the absence (decrease) of sexual arousal and 13.7% – a decrease in desire; dyspareunia was observed in 8.6% of cases, was inconsistent and manifested itself with individual partners. These features were mostly manifested in cases with the posterior type of localization of the paraurethral glands of different reproductive ages. Conclusion. The results obtained made it possible to reveal the features of the sexual life in women, depending on the type of localization of their paraurethral glands.

Peculiarities of ultrasound diagnostics of paraurethral glands in women of fertile age

Aim. Evaluation of ultrasound diagnostics of paraurethral glands considering their types of location in women of fertile age. Materials and methods. A gynaecological, sexological and ultrasound study of 94 women in the age from 24 to 42 (average age 31.01 ± 6.60) was carried out. Determination of paraurethral glands during ultrasound study was conducted in the format of grey scale (B-mode) using the Doppler colour flow mapping and evaluation of Doppler indices of paraurethral glands both before and after sexual stimu­lation. To optimize the paraurethral glands visual view at the beginning of examination urinary bladder was catheterized and a balloon, filled with gel, was inserted into vagina. Results. The front type of paraurethral glands location was found in the accumulation of glandular tissues in regard to the distal part of urethra in 67 (71.2 %) of the examined, back type – in the area of back urethra in 19 (20.2 %), diffuse type – along urethra in 7 (7.5 %) and absence – in 1 (1.1 %). Paraurethral glands were visualized in the form of clear isoechogenic oval formation with the following dimensions: length – 2.20 ± 0.60 cm, width – 1.52 ± 0.40 cm, thickness – 1.30 ± 0.30 cm, and volume – 4.75 ± 0.50 cm3. The diameter of vessels in the paraurethral glands area was between 0.17 cm and 0.21 cm in calm state and 0.39–0.41 cm – during stimulation. Maximum systolic speed of blood flow (Vps) in calm was 8.9–11.1 cm/sec, while in sexual stimulation it was 13.9–14.1 cm/sec, resistance index (IR) – 0.60–0.62 and 0.63–0.68, respectively, pulsation index (IP) – 1.22–1.44 and 1.61–1.72, respectively. Conclusions. The ultrasound study of vessels of paraurethral glands, when Doppler method is used according to the suggested methodology, gives the opportunity not only to identify its anatomical structure, but also to determine its types. In CDC the increase of diameter of vessels and the optimization of vessels image in the area of paraurethral glands in case of sexual stimulation were marked.

Optimization of diagnostic hyperplastic processes in the hormone-sensitiv organs (uterus, brest) during reproductive function reabilitation

The objective: a study of the condition of the mammary glands in women with uterine leiomyoma on the background of inflammatory diseases of the genital organs. Materials and methods. At the first stage of the research, a retrospective analysis of histories of 246 women with infertility and uterine leiomyoma on the background of inflammatory diseases and pathology of mamma glands, who were treated in the department of family planning and rehabilitation of reproductive function of State Institution “Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine” named after Academician OM Lukyanova in 2015-2019 was done. In the second stage, a screening ultrasound examination to detect pathology of the breast was performed on the 6th-11th day of the menstrual cycle. Results. The severity of clinical manifestations of dyshormonal dysplasia of the breast depends on the influence of the most significant risk factors associated with mamma glands diseases: late reproductive age, number of interrupted pregnancies (abortion, miscarriage), genital diseases, age of menarche, the parameters of the menstrual cycle, disorders and duration of menstruations, duration of infertility and lactation, comorbid somatic pathology, especially liver disease, thyroid disease, frequent stress and severe heredity.Conclusions. The high frequency of combination of uterine leiomyoma and dyshormonal dysplasia of the breast in women with infertility indicates the need for timely diagnosis and adequate correction of this pathology as one of the factors in the development of mamma gland diseases and the earliest use of methods of rehabilitation of reproductive function. This will increase the effectiveness of infertility treatment and prevention of uterine and mammological pathology.

Knowledge of the patients of the Department of Obstetrics and Gynaecology about lactation and breastfeeding during the Covid-19 pandemic and before the pandemic – a comparative study

IntroductionThe mammary gland is a paired skin gland of women, responsible for the lactation process. It is synchronized with the operation of the endocrine system. The production of breast milk takes place after childbirth through the action of the hormonal and nervous systems. Secretion is controlled by prolactin and oxytocin. Its composition includes: proteins, fats, carbohydrates, minerals and vitamins. It is rich in stem cells. The function of the gland is to secure the nutritional and energy needs of the newborn.Aim of the workThe aim of the study was to evaluate and compare the knowledge of the patients of the Department of Obstetrics and Gynaecology, WSZZ in Kielce about lactation and breastfeeding before and during the Covid-19 pandemic –a comparative study.Material and methods420 puerperae participated in the study. The first pre-COVID-19 pandemic group included 196 women, the second group during the pandemic period included 224 respondents. Among the puerperae, women aged over 30 constituted the most numerous age group.The Bioethics Committee of UJK (Jan Kochanowski University of Kielce) approved the study No. 16/2021.Statistical analysis was performed with the use of the Statistica computer program.ResultsThe patients living in the city have more knowledge about lactation and breastfeeding than the patients from rural areas.The older the patient and the greater the number of completed pregnancies and deliveries, the greater the knowledge about lactation and breastfeeding.The assessment of the involvement of medical personnel depends on the time when the patient gave birth.The period of the COVID-19 pandemic has impacted the knowledge about reducing the risk of breast cancer in women.The patients from the pandemic period are more knowledgeable about breastfeeding and lactation than patients in the pre-pandemic period.

CLINICAL COURSE OF PERIMENOPAUSAL PERIOD IN WOMEN WITH HYPERANDROGENISM SYNDROME

Hyperandrogenism is a disorder of endocrine status caused by excess production of androgens. The syndrome is a consequence of increased androgen production both in the ovaries and adrenal glands. However, such a division is very arbitrary, as increased production of androgens in the adrenal glands may increase production in the ovaries and vice versa. Androgens in women are synthesized by ovaries, adrenal glands and peripheral tissues, which also participate in metabolism.The set of androgens in both womenand men includes dehydroepiandrosterone-sulfate, dehydroepiandrosterone, androstenedione, testosterone and 5-alpha-dihydrotestosterone (5-alpha-DHT). Still, unlike men, women have a higher concentration of the first three hormones than the lasttwo. Androgen synthesis in the adrenal glands in women is regulated by adrenocorticotropic and in the ovaries by luteinizing hormone (LH) and some other intraglandular autoparacrine mechanisms. According to recent studies, in addition to the basic biological, previously commonly known effects of androgens, their new mechanisms of influence on the female body have been discovered. Keywords: hyperandrogenism, hormones, ovaries, adrenal glands, reproductive disorders