Purpose of the study: to examine the morphological and immunohistochemical features of the endometrium in postmenopausal women with uterine bleeding, depending on body weight and metabolic syndrome.Materials and methods. The study included 114 women with postmenopausal uterine bleeding. Women were divided into 3 groups. Group I included 41 patients with overweight and obesity class I–II, group II – 43 women with metabolic syndrome, group III (control) consisted of 30 patients with normal body weight. Hysteroscopy with morphological analysis of biopsied material was performed for all patients of groups I and III and 41 patients of group II. Pathohistological and immunohistochemical analysis were used to diagnose endometrial pathology. The level of cell proliferation in the endometrium was assessed by immunohistochemical analysis using monoclonal antibodies for Ki-67 expression; antiapoptotic activity was determined by the Bcl-2 and COX-2 expression.Results. Endometrial pathology was diagnosed in 94.74% of women. Endometrial polyps in the structure of the identified pathologyprevailed in group I and control group III (82.93% and 83.33%, respectively), while endometrial polyps were detected in 25.59% of women in the group II. Endometrial hyperplasia was diagnosed in the vast majority (69.76%) in group II, hyperplasia without atypia was detected in 51.16% and endometrial hyperplasia with atypia in 18.60%.Conclusions. Endometrial hyperplasia value was higher in postmenopausal women with metabolic syndrome compared to patients with normal weight, overweight and obesity. There was an increase of Ki-67, Bcl-2 and COX-2 expression in the endometrial glands in women with metabolic syndrome in comparison to patients with normal weight and obesity, for which only increased Bcl-2 expression in the stroma was observed. This confirms the existing data on the predominance of the apoptosis inhibition over proliferation in the formation of endometrial diseases in the postmenopausal period and confirms the combination of hyperproliferative processes and apoptosis inhibition if there is metabolic syndrome.
The aim of the research: to evaluate the clinical efficacy and prevention of relapses of inflammatory and degenerative processes of the vagina in patients in perimenopausal period with the drug Femheal. Materials and methods. The study included 40 women aged from 49 to 56 years in perimenopausal period with clinical and laboratory confirmation of nonspecific vulvovaginitis and degenerative processes of the vagina: held pH meter before the appointment of therapy Femheal, 7 days and 3 months after the application Femheal. According to the severity of menopausal disorders to treatment included menopausal hormonal therapy, lipid-lowering and antihypertensive drugs. Results. The use of complex therapy with the use Femheal helps to restore the vaginal microbiota, which is accompanied by disappearance of clinical manifestations nonspecific vulvovaginal (feeling pain in the abdomen, in the genitals, itching, burning, swelling, discomfort and disperion), by normalization of pH. This therapy was effective in the prevention of recurrence, and with an integrated approach to reproductive aging - improving the quality of life. Conclusion. Practicing obstetrician-gynecologists, introducing the pathogenesis of chronic nonspecific vulvovaginal and related violations, especially in a situation when the pathological condition has completely pathognomonic clinical and laboratory evidence, should exclude bacterial vaginosis, sexually transmitted infections, timely identification of changes in the vaginal environment through pH test. Given the high efficiency Femheal in our study and documented in international publications relative to the positive evaluation reattain of action of the drug in the complex treatment of nonspecific vulvovaginitis and prevention of their recurrence, recommended his application for restoration of the vaginal biotope. Key words: nonspecific vulvovaginitis, perimenopausal period, Femheal.
In recent decades, there has been a fairly active debate on the role of genetic predisposition, average factors, adverse effects of reproductive toxins, infections, special behaviour that includes harmful habits for human diseases and not to implement their reproductive plans. Environmental disasters, the Covid-19 pandemic, the incorporation of the modern human and industrial waste, forest fires, excessive radiation following the national tragedy of Chernobyl has become global, not only the age of dependent diseases, but the disorders of the main functional systems of the female and male organism that result in reproductive function, reduce the quality of life and duration. Unfavourable medium effects, disturb the process of interacting with the genotype of the organism in shaping the phenotype. This information is needed by doctors to develop periconceptology, which is the task of this clinical lecture.
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