Аim – to work out the algorithm of prophylaxis of leiomyoma (LM) relapses and rehabilitation of women of reproductive age with metabolic syndrome (MS) in postoperative period. Materials and methods. In research group 130 women with LM and MS (research group) or without MS (comparison group) were involved. The control group consisted of 50 somatically healthy women with normal menstrual and reproductive functions. МS was set on according the following "combined" criteria – criteria of WHO 1999 (impaired glucose tolerance) and criteria of IDF (2009) taking into account the age-related levels of lipids and arterial blood pressure. In venous blood plasma we determined total testosterone, DHEA-S, estradiol, progesterone, FSH, LH, prolactin, using solid-phase ELISA on the "Cobas e 411" and reagents of DRG Diagnostics, Germany. The content of total cholesterol, triglycerides and high-density lipoproteins (HDLP) was determined by a colorimetry method using the "DiaSys" sets (Germany). Before operative interventions the histological and immunohistochemical research was conducted after the aspiration biopsy or separate diagnostic scraping of uterus. Endoscopic surgery was provided in research and comparison group using "Karl Storz" equipment (Germany) on the generally accepted methodology. Results and discussion. The volume of operative intervention and operative access was determined depending on the previous results of endometrial biopsy, sizes and localization of nodules. During the study of the hormonal homoeostasis we revealed increase of estradiol (research group – 429.4±31.2 and comparison group – 320.4±25.3 vs 228.3±24.1 nmol/l in control; р 0.05), but the decline of this index was determined in women of research group and comparison group on the 21-th day of cycle. In addition, pays attention on itself increase of androgens in women with LM and MS as compared to other groups of patients. Revealed increase of LDLP (1.2 times), triglycerides (1.7 times), total cholesterol (1.4 times) and decreased HDLP (1.4 times) reflect negatively on the reproductive function. The immunohistochemical research showed that in the case of MS there was a positive reaction on androgen receptors in leiomyoma cells, particularly in the vessel wall myocytes. We offered our patients the moderate hypocaloric diet and the individually worked out program of fitness. Metformin was added to traditional therapy. The treatment complex lasted from 3 to 6 months. As a result, we observed the decrease of body weight by 10.5±1.8 kg on average, that corresponded 11.4%. Waist circumference decreased in all patients and in average of group consisted 10.2±3.2 сm; hip circumference decreased by 6.6±4.2 сm suggesting the visceral fat lost. We established statistically significant decrease of LDLP cholesterol that undoubtedly is the additional positive result of provided therapy. Efficiency of the offered diagnostic and curative complex for women with LM and MS was estimated by absence of relapses of LM and by incidence of pregnancies. So at the first year of supervision there were no relapses of LM in ІА subgroup (aromatase inhibitor added to traditional treatment), indeed in ІІA subgroup (traditional treatment only) relapses occurred in 6 patients (20%). The pregnancy occurred in 6 (20.0±2.1%) women of ІІА subgroup, and frequency calculated for one cycle of stimulation consisted 16.7%. The stimulation of ovulation using the aromatase inhibitor 2.5 mg/d was more effective: the pregnancy occurred in 11 (36.6±2.4%) women of ІА subgroup, accordingly frequency calculated for one cycle of stimulation – 30.0 %, that 1.8 times more effective due to offered method of treatment. Conclusions. Comorbidity of benign diseases of uterus and MS in women of reproductive age takes place on a background of significant estradiol increase. Immunohistochemical feature of this comorbidity is expression of androgenic receptors in the separate stromal cells of endometrium and cellular myomas. Improvement in diagnostic and treatment algorithm (using aromatase inhibitor for stimulation of ovulation) resulted in prophylaxis of LM relapses and increase of pregnancies as compared to traditional treatment. We offer the algorithm of management of women of reproductive age with benign diseases of uterus and MS: I stage: complex clinical and laboratory assessment; ІІ stage: correction of revealed hormonal and metabolic violations at MS; ІІI stage: add the aromatase inhibitor to the standard treatment for restoration of reproductive function.