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Magnesium is an important cofactor for metabolic reactions involving more than 300 enzymes, regulating a series of fundamental processes, such as myocardial contraction and blood pressure control, glucose regulation, participation in neuromuscular transmission. The prevalence of magnesium deficiency in various cohorts of fertile age women comprises up to 73.8 %. In clinical studies it was demonstrated that magnesium deficiency is associated with diseases and states such as dysmenorrhea, premenstrual syndrome (PMS), polycystic ovary syndrome (POS), climacteric syndrome, osteoporosis, use of combined oral contraceptives (COCs) and menopausal hormone therapy (MHT). Magnesium supplementation in combination with basic therapy can positively affect course and outcome of such pathologies. Magnesium organic salts could be used for countering magnesium deficiency. Among such agents, magnesium citrate has some advantage used in combination with pyridoxine (vitamin B6) providing additional effects. Health care professionals should be guided by the criteria for Mg-containing preparation selection, defined by the Russian Society of Obstetricians and Gynecologists (RSOG).

A review of world literature and Ukrainian researches on the most common requests to gynecologists among military women, on the structure of pathology and treatment methods was made. Special attention is paid to the hormonal contraception, namely combined oral contraceptives (COCs) in the usual and continuous regime (avoiding the hormone-free interval) and the levonorgestrel-releasing intrauterine systems (LNG-IUDs). Cases of global practice of using COCs in extended regimen were considered, which showed that 47.2% of 1156 women chose a prolonged regimen of COCs, the main reason for this was the desire to avoid symptoms associated with menstruation. We consider this option very positive for military women, because some studies show that military women who took COCs in a continuous regimen were almost twice as favorable to their reception as those who used them in a regular mode. The positive aspects of the LNG-IUDs use in military women are presented, as a factor in the prevention of abnormal uterine bleeding, reducing the risk of iron deficiency in case of possible blood loss, and reducing the intensity of dysmenorrhea as a negative factor in the military conditions. Ways to increase compliance between a gynecologist and a military woman are also considered, using the example of global studies, which prove that insufficient awareness of patients about the possible ways and positive effects of using COCs in extended regimen reduced patients’ commitment to choosing new regimens. Conclusions. In today’s realities, the gynecological service in our country faces a number of new problems that require a strategic approach and solution. World practice and national studies prove that stress-induced hormonal disorders in military women, such as abnormal uterine bleeding, menstrual cycle disorders, dysmenorrhea, are negative factors in combat conditions, require the attention and resolution by doctors. One of the options for solving this problem can be the appointment of COCs according to the usual and extended scheme or appointment of LNG-IUDs.

Research objectives: to evaluate the effectiveness of phytotherapy in the treatment of menstrual health disorders in women of early reproductive age after a moderate and severe form of the coronavirus disease. Material and methods. 104 women of early reproductive age with menstrual health disorders that occurred 3 months later after moderate or severe COVID-19 were under observation and 34 gynecologically and somatically healthy women of the control group who did not suffer from COVID-19. Female patients with COVID-19 were randomly divided into two groups: the main group (n=53) and the comparison group (n=51). The performed examination included: study of complaints, general and gynecological anamnesis, physical and gynecological examination, ultrasound examination of pelvic organs, determination of hormonal profile. All patients with COVID-19 received a comprehensive rehabilitation program, which included diet therapy, vitamin and mineral complexes, psychotherapy. In addition to the complex rehabilitation program patients of the main group received ayurvedic phytocompositions Femicycle or Femimens for 6 months. Results. It has been established that the moderate and severe course of the coronavirus infection affects the reproductive system of early reproductive aged women and leads to menstrual health disorders, among which irregular menstruation, premenstrual syndrome and dysmenorrhea dominate. Levels of pituitary, adrenal, ovarian and thyroid serum hormones were within the reference norm in most cases, but have statistically significant deviations from similar indicators of healthy control women who did not have COVID-19. One-third of women of early reproductive age after moderate to severe COVID-19 had elevated prolactin levels. Ayurvedic phytocompositions Femicycle and Femimens in a comprehensive rehabilitation program for post-COVID menstrual health disorders led to a faster recovery of menstrual health and a full hormonal recovery. Conclusions. Ayurvedic phytocompositions Femicycle and Femimens are effective and safe naturopathic drugs for restoring menstrual health in women of early reproductive age after experiencing moderate to severe COVID-19.

Connective tissue dysplasia is congenital anomaly manifesting as different organ's and system's alterations: locomotor, skin, visceral dysfunctions. This article presents literature review covering such topical issues as female reproductive system features affected by mesenchymal pathology (undifferentiated forms of connective tissue dysplasia) and its medicamentous management (microelements, hormonal drugs, adaptogens). The analysis of original studies on this topic has revealed that connective tissue dysplasia has significant effect on female reproductive function development and can be complicated by various menstrual dysfunctions (hypomenorrhea syndrome, oligomenorrhea, opsomenorrhea, uterine bleedings, and secondary amenorrhea) as well as by endocrine changes (anti-Mullerian hormone deficiency, hypoprolactinaemia, hypoestrogenemia, etc.). Gestation and delivery features in patients with connective tissue dysplasia (preeclampsia, premature birth, and fetal abnormalities) were also revealed.

Introduction and purpose of the study: Endometriosis is a prevalent condition that affects women in their reproductive years. Diagnosing the condition and determining its manifestations can be complex and uncertain, as they vary among individuals. The symptoms of endometriosis have a detrimental impact on the overall quality of life for patients, leading to decreased well-being, limitations in physical activity, and impaired social functioning. The available treatments for endometriosis are determined based on the primary symptom (chronic pelvic pain or infertility) and are primarily focused on surgical interventions, hormonal therapies, and analgesic medications. These treatments often come with numerous side effects and rarely offer long-term relief. In this review, we provide a comprehensive overview of the current knowledge regarding endometrosis, including its pathophysiology, diagnostic methods, and the existing treatment options. Materials and methods: The analysis relied on examining materials obtained from both the "PubMed" database and books. The search was performed using the keywords: "endometrosis diagnosis", "endometrosis therapy", "dysmenorrhea", "combined oral contraceptive", "laparoscopy". Summary: Endometriosis poses a significant health concern due to its correlation with compromised daily functioning and infertility. Appropriate diagnostic and therapeutic management of endometriosis contributes to a significant improvement in the wellbeing of patients, including a reduction in pain and improved ability to function both physically and socially. Conservative treatment consists of hormonal therapy, which regulates the menstrual cycle, reduces the severity of pain symptoms and inhibits the development of endometrial foci outside the uterus. In situations of advanced endometriosis, pharmacological treatments may not be sufficient and surgical therapy is required.

Primary dysmenorrhea is the most common, though often underdiagnosed, gynecological disorder of women of reproductive age. The disease presents with painful abdominal cramps associated with menstrual bleeding in the absence of pelvic abnormalities. Symptoms are caused primarily by increased levels of prostaglandins produced by the endometrium, which provides hypercontraction of the uterine muscles, ischemia, and pain. Dysmenorrhea is usually treated pharmacologically with non-steroidal anti-inflammatory drugs or hormonal contraception. In particularly severe cases, surgical treatment is also possible. Nonetheless, an increasing amount of studies on non-pharmacological treatments have been published recently. Methods like Transcutaneous Electrical Nerve Stimulation (TENS), acupuncture, continuous topical heat, or exercise and yoga seem to be effective in reducing the symptoms of primary dysmenorrhea. All have an anti-inflammatory effect by lowering prostaglandin levels, but they also contribute to reducing symptoms through other mechanisms. TENS elevates the pain threshold and, together with acupuncture, causes the release of endogenous opioids. Heat, yoga, and acupuncture also lead to increased blood flow in the uterus, reducing hypoxia. Their additional advantage is the low cost and ease of self-use, except for acupuncture, depending on the patient's needs. Side effects of non-pharmacological treatments are usually mild and rarely reported.

Introduction: Primary dysmenorrhea (PD) is a pelvic pain during menstruation in the absence of any pelvic pathologies. This disease mainly affects young women in reproductive age. In addition to pain, patients may experience many other symptoms including: gastrointestinal symptoms, sleep disorders. This contributes to reduction in their mental and physical quality of life. Purpose: the purpose of this review is to draw attention to a problem that affects a large number of society, is often underestimated and largely affects the quality of women's life, as well as to present the latest discoveries and reports on this issue. Material and methods: the scientific literature published in the years 2017-2022 was reviewed in the PubMed scientific database using the following keywords: primary dysmenorrhea, dysmenorrhea. Results: Increased prostaglanding levels, abnormalities in the reward system, oxidative stress, ischemia, and eotaxin may contribute to the development of pain in PD. These findings could open up new diagnostic or therapeutic targets. The first choice in the treatment of PD are NSAIDs, which are taken regularly for many years, so they must be as safe and effective as possible. Research suggests that thiaprofenic acid and ibuprofen are suitable. For alternative treatments TENS, heat, and acupuncture can be effective. Propolis, ginger, valeric acid, hops and exercise are also promising. Conclusions: PD is a varied disease that affects a large number of women. It leads to a reduction in the quality of life, hence it is necessary to conduct further research on a diverse, large group of respondents, in many centers, with the use of systematized pain scales, and lasting for a certain period of time.

Primary dysmenorrhea is defined as pain in the pelvic area that occurs for no specific reason during menstrual cycle. Dysmenorrhea occurs in 50% to 90% of adolescent girls and women of reproductive age which makes it one of the most common causes of pelvic pain in women. The mechanism of this condition is overproduction of prostaglandins by the endometrium, causing uterine hypercontractility, thereby leading to uterine muscle ischemia, hypoxia and pain. Dysmenorrhea significantly reduces the quality of women life, often making it impossible to perform daily activities and, in addition, it may cause a mental stress that makes both professional and school life difficult. Despite this, females often consider these symptoms as a normal part of their menstrual cycle, which makes this disease underrated and untreated. Dysmenorrhea can be treated in a various ways such as non-pharmacological, pharmacological and surgical. However, women with a typical history of primary dysmenorrhea can commence empirical therapy without any additional tests. Hormonal contraception and nonsteroidal antiinflammatory drugs have proved to be effective in this treatment. However, if conventional treatment is contraindicated, alternative treatments such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure may be used. Surgical treatment is possible, but it is used rarely and only in severe cases of treatment-resistant dysmenorrhea. However, it should be emphasized how important it is to exclude secondary causes of dysmenorrhea.

Migraine is often concurrent with endometriosis; however, the mechanisms of comorbidity of these conditions are inadequately studied. Pain is considered as the most significant clinical symptom and maladaptive manifestation of both migraine and endometriosis. Studying the relationship between the clinical manifestations of pain syndrome in patients with endometriosis and migraine is important, since it will contribute to the understanding of the mechanisms of comorbidity of these diseases.Objective: to analyze the features of pain syndrome in patients with migraine and genital endometriosis to clarify the neurogenic mechanisms of their comorbid relationship.Patients and methods. A total of 125 patients who had gone to a gynecologist for endometriosis were examined for the presence of migraine. In accordance with the inclusion criteria, 79 patients (mean age, 34.68±7.11 years) with genital endometriosis confirmed by diagnostic laparoscopy participated in the further study. Two age-matched groups were formed: a study group consisted of 38 patients with endometriosis and concomitant migraine; a comparison group included 41 patients with endometriosis without migraine. All the patients underwent clinical neurological examination, questionnaire survey, pelvic ultrasound, assessment of the severity of pelvic pain according to the pelvic pain index, and determination of the level of central sensitization (CS) using the CS Inventory.Results and discussion. 42% out of the 125 patients who had visited their gynecologist for endometriosis suffered from concomitant migraine, which confirms the comorbidity of these diseases. Chronic pelvic pain (CPP), dysmenorrhea, dyspareunia, and dyschesia were more common in patients with endometriosis and migraine; there were more patients with asymptomatic endometriosis in the comparison group. The patients of the two groups did not differ in the presentation of different forms of endometriosis, which favors the leading role of central mechanisms in the pathogenesis of pain syndrome in comorbidity of these diseases.In addition, there was a statistically significant increase in the presentation of CPP and dysmenorrhea in patients with chronic migraine compared to those with episodic migraine and to those without migraine. Significantly higher levels of CS according to CSI and pelvic pain index were found in patients with chronic migraine and endometriosis, which suggests that CS plays a key role in the comorbidity of these diseases.Conclusion. The phenomenon of CS is one of the mechanisms of comorbidity of migraine and endometriosis, contributes to both the worsening of various painful manifestations of endometriosis and the increase in migraine attacks, thereby causing obvious maladaptation in patients. The role of CS in the comorbidity of migraine and endometriosis opens up possibilities for the elaboration of a comprehensive interdisciplinary approach to treating these diseases.

Aim: to assess the effectiveness of using dienogest in combination with postoperative interventions in patients with endometriosis.Materials and methods. There were enrolled 102 patients with signs of external endometriosis underwent examination and surgical treatment, subdivided into 2 groups: 67 – main group (after surgical treatment, received dienogest 2 mg/day for 6 months), 35 – comparison group received no hormone therapy in the postoperative period. Surgical treatment included removal of endometrioid ovarian cysts, endometriosis foci on the pelvic peritoneum and sacral uterine ligaments. Course of the early postoperative period (up to 1 month after the intervention) as well as the long-term dynamics of the disease manifestations (3, 6, 12 and 15 months later) were assessed.Results. Dienogest was administered after surgical treatment due to endometriosis that reduced the severity of dyspareunia and intensity of chronic pelvic pain by 3.5- and 2-fold, respectively. The probability of achieving control over uterine bleeding 6 month after the onset of treatment due to endometriosis manifested with metrorrhagia showed that combination treatment (consisting of dienogest) was 3.19-fold higher compared to surgical treatment alone (OR = 3.19; 95 % CI = 1.70–11,0; p < 0,05). Recovery of normal menstrual cycle in 63 (94.0%) women of the main group was established 1.5–2 months after completing of hormonal treatment, while in the comparison group pain and dysmenorrhea relapsed in some patients at the 6-month follow-up. Decreased libido as a side effect in patients who treated with dienogest was observed in 2 (3.0 %) women.Conclusion. Dienogest was highly effective in the combination treatment of patients with verified endometriosis that resulted in reduced severity of pain and metrorrhagia. The drug was featured by low level of side effects. Thus, a combination treatment of endometriosis containing dienogest at a dose of 2 mg/day applied during postoperative period allows to reduce the severity of the disease clinical manifestations and improve treatment outcome.

By definition, contraception is the prevention of pregnancy and infection from diseases by mechanical, chemical and other contraceptives and methods. According to World Health Organization (WHO) statistics, up to 40% of women of reproductive age still believe that their needs for family planning services are not met during counseling. When recommending contraception, it is important to consider: the characteristics of the potential consumer, the underlying risk of the disease, possible undesirable drug reactions of various drugs, the cost, availability and preferences of the woman herself. Women are often forced to abandon the use of a contraceptive method in connection with adverse events, for example, when using combined oral contraceptives (COCs), they may feel worse (headaches, mood lability, weight gain, swelling, decreased libido) in a hormone-free interval, especially with the reception mode 21/7. Lack of contraception can lead to an increased risk of an unwanted pregnancy. According to statistics in the Russian Federation in 2018, the absolute number of abortions amounted to 567 183, which, according to the UN classification, corresponds to the average level (level of abortion rate per 1000 women of childbearing age). According to clinical practice, there is a relationship between deterioration of well-being and the duration of the hormone-free interval. At the moment, in our country there is the only COC, which has a hormone-free interval of 2 days, containing bioidentical estrogen estradiol valerate and dienogest. According to the Cochrane Library, COCs with a short hormone-free interval are most effective in relation to the clinical manifestations of the estrogen withdrawal syndrome. WHO calls on clinicians to raise womens awareness of modern methods of contraception.

The key characteristics of migraine are its considerable predominance in reproductive-aged women. Studying the role of gender characteristics in the pathogenesis and clinical manifestations of migraine, as well as the patterns of changes in the level of female sex hormones depending on the menstrual cycle allow menstrual-related migraine to be considered as an independent subtype of the disease with the presence of characteristic clinical symptoms. The role of comorbidity in the development of menstrual-related migraine remains one of the little studied aspects of this problem.The review presents an update on the patterns of the course of migraine in repriductive-aged women, the effects of hormonal drugs on migraine, and gynecological comorbidity.

Introduction. Adenomyosis has a significantly negative impact on women’s quality of life, causing abnormal uterine bleeding, dysmenorrhea, and chronic pelvic pain and low quality of life. There are no single theory of pathogenesis, unique prognosis and diagnostic markers for adenomyosis. The definitive treatment for adenomyosis is hysterectomy but is not appropriate for patients who wish to preserve their fertility. In this article presents data about etiology, classification, pathogenesis, clinical manifestation and surgical techniques for the treatment of adenomyosis published in medical–scientific databases.Materials and methods. The review includes data from foreign and Russian articles published in the Pubmed journals on this topic.Results. There are a lot of surgical approaches for adenomyosis; however, there is no any universal approach and management guideline for these patients.Conclusion. Adenomyosis – if multifactorial disease. There is no single pathogenesis theory. The clinical picture of adenomyosis varies from asymptomatic to severe pain. The management of adenomyosis is complex and should guide personally for each patient. All techniques and options should be considered and discussed with the patient.

Рurpose of the study was to evaluate the influence of Isthmocele (IC) hysteroscopic repair on symptoms (abnormal uterine bleeding, dysmenorrhea) in premenopausal patients with residual myometrium thickness more than 2.4 mm and to assess myometrial thickness 3, 6 and 12 month post surgery. Materials and methods. It was a prospective case series of symptoms evaluation and myometrium thickness following hysteroscopic IC repair in premenopausal women not willing to conceive. Diagnosis of IC was based on 2D transvaginal ultrasound and symptom evaluation. Symptom frequency and residual myometrium thickness by ultrasound were evaluated before hysteroscopic repair and after 3, 6 and 12 months after it in patients with IC as single possible cause of symptoms. Results. In the period from January 2017 to January 2018 there were 32 cases of symptomatic IC in premenopausal women. 8 (25%) of them had coexisting uterine pathology that could cause AUB, these women were not included in hysteroscopic treatment efficacy analysis. Thus 24 patients with residual myometrium thickness of more than 2.4mm and not willing to conceive underwent hysteroscopic repaire of IC. Three months after surgery, most patients reported a complete relief of symptoms: abnormal uterine bleeding reduced from 33.3% (8 patients) to 4.2% (1 patient); intermenstrual bleeding form 75% (18 patients) to 12.5% (3 patients); dysmenorrhea – from 91.7% (22 patients) to 29.2 (7 patients). This effect was even more prominent after 6 and 12 months. Average residual myometrium thickness values changed in the following way: 3.6 ± 0.9 before surgery; 4.9 ± 1.2 mm after 3 months; 5.9 ± 1.0 mm after 6 month and 6.5 ± 1.1 mm after 12 months. Conclusion. Hysteroscopic repair of IC is a technically feasible, safe and highly effective procedure for symptoms (abnormal uterine bleeding, pelvic pain, dysmenorrhea) in women with other uterine pathology excluded and not willing to conceive. Efficacy and specific features technical performance and medical treatment in cases with coexisting adenomyosis and other uterine pathology are to be defined in future studies as such cases are frequent.

Menstrual rhythm disorders and symptoms associated with the menstrual cycle are one of the main reasons for women to make an appointment with a gynecologist. After the endocrinopathies and organic substrates of menstrual irregularities are excluded, the doctor is faced with the difficult task to treat conditions that reflect the functional dysfunction of the body and its adaptation to high stress load. It is beyond argument that hormone therapy is the main resource of a gynecologist, but it is not always acceptable and does not solve all the problems of normalizing psychoneuroendocrine status. The dependence of functional disorders on environmental stress factors allows a doctor to use lifestyle correction, including rational nutrition and adding various micronutrients, in a program to improve the quality of life, eliminate psychoemotional symptoms and symptoms of autonomic dysfunction. In turn, the restoration of the adaptive reserve of the body becomes key to the recovery of menstrual function.

Nowadays, there exist a large number of methods that allow to prevent unintended pregnancy. One of the most common technique in Poland is hormonal contraception in the form of contraceptive pills. This method is effective, easy to use, and more importantly it does not cause permanent sterility. Moreover, hormonal contraception comes with plenty of additional health benefits that are not related to contraception alone, such as: reduction of menstrual pain, regular cycles and lack of menorrhagia. Due to the beneficial effect on the body, hormonal contraception is used in the treatment of certain diseases, such as acne and endometriosis. Reduction of numerous existing symptoms leads to an improvement in the quality of women’s lives.

The World Health Organization estimates dysmenorrhea as the most important cause of a chronic pelvic pain. Its prevalence among adolescents and young women ranges from 40 % to 90 %, and varies, depending on age, country of residence and population density of the area. Primary dysmenorrhea is responsible for reducing the quality of life, absenteeism in the workplace or at school, refusing to participate in community and sporting events, changing of pain perception and sleep disturbance. There is evidence of its relationship with an early menarche, a family history, a length of the menstrual cycle, bad habits, poor sleep hygiene, an unbalanced diet, sedentary lifestyle and obesity. Characteristic features of a personality contribute in a certain way, making women prone to neuroticism and pain catastrophizing to be more at risk of developing dysmenorrhea. Irritable bowel syndrome, musculoskeletal pain and interstitial cystitis often accompany dysmenorrhea and respond to its treatment positively. Despite the proven validity of nonsteroidal anti­inflammatory drugs treatment there are resistant forms of menstrual pain, those make a search for alternative therapy relevant.

The article provides a modern view on features of different stages of a woman’s life. It presents information on pathogenetic basis and effectiveness of modern phytotherapy with a use of certified agents for a treatment of main pathological conditions associated with different stages of a woman’s life when the hypothalamic-pituitary-ovarian system’s function is formed, actively functions and then undergoes a gradual involution. The features of the use of herbal remedies in pathological conditions of the reproductive system (premenstrual syndrome, hyperprolactinemia, menopausal syndrome, mastalgia, etc.) are described. The article is illustrated with figures and tables for better understanding by clinicians. It emphasis on the features of herbal therapy, its high acceptability, safety and efficacy in the age aspect.

Pelvic pain is one of the common causes for visiting a doctor, which can be the main symptom of gynecological diseases and an independent pathological condition. Acute pelvic pain is most often caused by an infection that affects the organs of a woman’s reproductive system. Non-infectious causes of pain are also associated with inflammation, and estrogens support pain and inflammation in women, which increases the risk of chronic pelvic pain (CPP). The urgency of the pelvic pain problem is considered not only in connection with an adequate diagnosis of its causes, but also from the perspective of managing the pain symptoms themselves. The anaesthesia strategy significantly improves the quality of life and prevents the development of chronic inflammatory diseases and CPP syndrome. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in pain therapy, and their effect consists in reducing the synthesis of prostaglandins and is pathogenetically substantiated both in the complex treatment of acute pelvic infections and in the treatment of idiopathic menstrual pain. The article presents clinical observations of the use of NSAIDs with the specified purpose.

The purpose of the described research was to study the effectiveness of the use of micronized progesterone in the treatment of premenstrual syndrome. 68 women of reproductive age from 18 to 40 years old (mean age 31.2 ± 5.3 years) with premenstrual syndrome of mild and moderate severity were studied. The women were randomized into two groups: the treatment group (n = 35) and the control group (n = 33). The study groups were comparable in age and forms of premenstrual syndrome. Patients of treatment group received therapy with Proginorm OVO, 200 mg per day from 16 to 25 days of the menstrual cycle for three cycles. The drug Proginorm OVO was chosen taking into account its properties, which are similar to the properties of natural endogenous progesterone in the presence of progestogenic, antiestrogenic and light antiandrogenic and aldosterone effects. The women of control group did not receive drugs. To alleviate the condition, for patients of both groups were recommended non-drug measures: optimization of work and rest, balanced nutrition, active lifestyle with moderate physical exertion. Authors concluded that the use of micronized progesterone is appropriate and effective in treating the main manifestations of premenstrual syndrome, especially with regard to pain, changes in behavior and symptoms of fluid retention in the body. In this case, the period of premenstrual syndrome manifestations treatment is advisable to continue up to 6 months, preventing the rapid recovery of symptoms after cessation of therapy.

Dysmenorrhea is one of the most spread diseases in gynecological practice. The pathology rate is about 45–95 % of menstruated women. Aim of the research was to determine clinical and social aspects of women with dysmenorrhea. Materials and methods. The study involved 155 women with diagnosis dysmenorrhea who formed the basic group. 55 persons had primary form of disease (the I group), 100 patients – secondary one (the II group). Control group included 30 women without pathology. Intensity of pain was determined by Visual Analogue Scale, quality of life – 36-Item Short Form Health Survey. For statistical analysis we used program Stаtistica 6.0. Results. We did not find any association between employment, body mass index and development of dysmenorrhea. The number of persons with reduced physical activity was 1.86 times more in the group with dysmenorrhea (61.94 %) than among healthy individuals (33.33 %; χ2 = 7.28, P = 0.007; OR = 3.84, CI = 1.67–8.83, P = 0.002). Gynecological pathology in anamnesis had only 46.67 % of controls and 74.19 % of basic group patients (χ2 = 7.77, P = 0.005; OR = 3.29, CI = 1.47–7.33, P = 0.004). High rate of gynecological diseases among patients with dysmenorrhea was due to great frequency of this pathology in the women of the II group. Almost the same rate of primagravida and multigravida was also among persons in the observed groups. Duration of pain syndrome usually was 1–2 days in the I group women. Persons of the II group indicated prolonged pain syndrome during menses lasting 2–4 days. Besides this, chronic pelvic pain (χ2 = 19.42, P < 0.001 compared to the I group), dyspareunia and dyschezia (χ2 = 5.95, P = 0.03 compared to the I group), pain, which was not connected with menstrual cycle (χ2 = 16.95, P < 0.001 compared to the I group) were typical for patients of the II group. Most women of both groups indicated moderate intensity of pain (67.27 % persons in the I group and 73.00 % in the II). Algomenorrhea, premenstrual syndrome, heavy menstrual bleeding were mostly diagnosed in the persons with secondary dysmenorrhea. All the scores of 36-Item Short Form Health Survey were significantly decreased in basic group patients compared to controls. Index of “Bodily pain” was less by 25.56 % in persons with dysmenorrhea compared with healthy individuals (P < 0.001). Score “Vitality” was the lowest among other indices of psychological component – by 27.27 % (P < 0.001) compared to controls. We determined decrease of “Social Functioning” and “Role-Emotional Functioning” in women with secondary dysmenorrhea more than in patients with primary one (P = 0.049). Conclusions. Among social factors that can lead to dysmenorrhea we found association of reduced physical activity with the development of pathology (OR = 3.84, CI = 1.67–8.83, P = 0.002). Chronic pelvic pain, dyspareunia, pain which is not related to menstrual cycle, are more common symptoms associated with secondary dysmenorrhea compared to primary one (P < 0.05). But there is no difference in intensity of pain between women with primary and secondary forms of pathology. Decreased quality of life is typical for women with dysmenorrhea.

The article provides a summary of the evaluation of efficacy of folate-containing oral contraceptive (Yaz® plus) containing gestagen with antiandrogenic and antimineralocorticoid effect, which, neutralizes the symptoms of primary dysmenorrhea in addition to preventing unwanted pregnancies, and also has registered indications for the treatment of acne.

Purpose of the study. Perform a brief review of the published works devoted to the evaluation of the effectiveness and safety of drotaverine hydrochloride in the treatment of abdominal cramping caused by primary dysmenorrhea, and an analysis of the use of obtained data in the clinical obstetrician-gynecologist practice.Materials and methods. The authors performed PubMed searches to find foreign and domestic articles using the keywords “dysmenorrhea”, “spasmolytic therapy”, “drotaverine”, “spasm”, “pain”. The analysis of the clinical studies showed the effectiveness of spasmolytic therapy of primary dysmenorrhea with drotaverin hydrochloride.Conclusion. Drotaverine hydrochloride can be recommended as an effective and safe first-choice drug to treat primary dysmenorrhea.

The article considers the causes for the development and modern methods of managing dysmenorrhea. The conservative therapy includes the use of combined hormonal contraceptives, physiotherapy procedures, vitamins and symptomatic drugs. The authors stress the significance of Nimesil® in the first-line therapy of primary dysmenorrhea of the syndrome along with the combined hormonal contraceptives and symptomatic agents. The use of this drug is characterized by rapid onset of effect, strong analgesic effect and good tolerability.

Robert's uterus (asymmetric septate uterus) is a rare and unique Mullerian duct anomaly, first reported by Robert H. in 1970. This malformation shows two uterine hemicavities, one being blind, causing hematometra, and the other cavity is communicating to a single cervix. The main symptom of the young women affected by this pathology is the cyclic pelvic pain during menstruation, in spite of normal menstrual flow. This article represents a rare case report of the Robert's uterus in a 14-year-old girl, who was hospitalized for diagnostic assessment and treatment of a congenital uterine anomaly. We present magnetic resonance imaging (MRI) and ultrasound (US) findings in a case of asymmetric septate uterus.

The article describes the clinical case of the nodular form of adenomyosis, first detected in a patient at the age of 16 years after another appeal to a gynecologist in connection with pronounced prolonged dysmenorrhea with ultrasound of a small pelvis. After the diagnosis of “Nodular form of adenomyosis”, the patient received 6 injections of triptorelin acetate 3.62 mg, resulting in an adenomyosis node decreased in size from 72 x 68 mm to 31 x 29 mm. Taking into account the developed side effects (aches in bones, hot flushes, weakness, tachycardia), therapy with triptorelin was discontinued. Clinical efficacy persisted for 6 months, after which painful menstruation resumed. Two years later, the patient was urgently transferred to the gynecological department of the Kyiv City Clinical Hospital No. 9 with severe manifestations of dysmenorrhea. With ultrasound of the pelvic organs, an endometrioid node in the uterus measuring 50 x 46 mm was found. The patient was recommended receiving Visanne (dienogest) in a dose of 2 mg, which she took 1 year and 10 months, being under constant supervision of the clinic’s specialists. The unauthorized break in treatment, which the patient explained with good health, provoked the resumption of painful symptoms. Visanne was continued for 2 years, as a result of which the endometrioid node decreased to 21.0 x 16.7 mm. In April 2017, in connection with the patient’s marriage and the desire to become pregnant, the reception of the dienogest was canceled. It is proposed to take a plant complex of antiproliferative action containing indole-3-carbinol 200 mg and green tea extract 82 mg. After 8 months, the patient was diagnosed with a pregnancy at 4 weeks, against which the adenomyosis node decreased to 18.1 x 11.1 mm. The results of the first two ultrasound screenings of the fetus in the gestation period of 13 and 18 weeks are described. There were no deviations in fetal development, and the endometriosis focus in the uterus was not clearly visualized at the first screening. The importance of the problem of secondary dysmenorrhea on the background of endometriosis, the establishment of a timely diagnosis and the choice of the right treatment tactics on which the future reproductive health of a teenage girl directly depends.

The article presents the pathogenesis aspects of dysmenorrhea based on the role of prostaglandin hyperproduction in the development of the disease. The presence of severe painful cramps in dysmenorrhea resulting in a temporary decline in labour productivity contributes to not only on a significant decrease in the patients’ quality of life, but also to economic costs. In this regard, seeking a solution to the dysmenorrhea therapy problem acquires not only medical, but also social significance. The use of nonsteroidal anti-inflammatory drugs (nimesulide) as a pathogenetically validated therapy for dysmenorrhea proves their efficiency and is a feasible option for therapy.

The article summarizes the results of numerous randomized studies and structured the approach to the tactics of managing patients with primary dysmenorrhea. The starting therapy is the administration of non-steroidal anti-inflammatory drugs and/or estrogen-progestational drugs. In the absence of the effect of therapy for 3 months, it is advisable to switch to a drug of another group or a combination of drugs. Failure to achieve the desired therapeutic result within 6 months is the basis for clarifying the diagnosis. The article is illustrated by the clinical case of a patient with primary dysmenorrhea.

This publication is devoted to the most common problem in women of reproductive age - dysmenorrhea. Unfortunately, the underestimation of the importance of dysmenorrhea often occurs on the part of both patients and doctors. Meanwhile, dysmenorrhea causes not only a decrease in the quality of life, but also a number of serious disorders, including the risk of developing endometriosis, adenomyosis and even tumorous diseases. With such articles as prevention and prevention of diseases.

The article is devoted to the subject of topical interest to women of reproductive age. Affecting not only the health of women, but also various aspects of their life, dysmenorrhea is a medical and social problem. The use of nonsteroidal anti-inflammatory agents in this condition is an effective means of pathogenetic therapy that significantly improves the quality of life of women.

Menstrual irregularities are an eternal female problem, in the treatment of which ever new aspects are opening. One of the most common problems is pain in the abdomen during menstruation. This form of menstrual disorder requires special attention, since, according to different authors, menstrual cramps of various severity are registered by 30 to 75% of women. However, about 10% of women, along with sharp pain, speak about deterioration of the general condition to the extent of temporary disability. Moreover, it is known that pain affects the emotional sphere, mental and general condition of the woman, and as a consequence, the relations within the family, thus making it a relevant healthcare and social problem (Smetnik V.P., Tumilovich L.P., 1998).

Background. For many women, the monthly suffering induced by menstrual “cramps” is severe enough to profoundly disrupt their quality of life. In the case of primary dysmenorrhea, a condition related to premenstrual syndrome (PMS), intense uterine contractions are thought to trigger moderate to intense pain despite the absence of an underlying infection or other medically-identifiable disease states. The associated uterine hyper-contractility is reminiscent of labor, and associated pain is likely to be mediated by the release of prostaglandins, leukotrienes and the infiltration of leukocytes that normally accompany the breakdown of the endometrial lining. Standardized extracts of Vitex agnus-castus berries (VAC extracts of chaste tree, or chaste berries) are clinically effective in treating the symptoms of PMS, yet the mechanisms of how the chemically complex mixture acts are largely unknown. Methods. Using an in vivo dysmenorrhea model rats were treated with 10 mg/kg estradiol-benzoate i.p. once daily for 12 days and with 2.1, 10.3 or 20.7 mg/kg VAC dry extract p.o. once daily for 7 days prior to induction of convulsions. Uterine contractions where induced with 2 IU/kg oxytocin i.p., followed by monitoring of abdominal convulsions and signs of pain on the last day of the experiment. Moreover, in vitro methods were applied that are described in the methods section. Results. Here, we show that the VAC herbal dry extract BNO 1095 (commercially available as Cyclodynon®) targets the uterine myometrial tissue and inflammatory signaling molecules of associated migratory/inflammatory cells. Specifically, BNO 1095 dose-dependently inhibited oxytocin-induced uterine contractions in a rat dysmenorrhea model in vivo and drug-induced contractions in isolated human and rat uterine tissue in vitro. Furthermore, BNO 1095 showed a promising anti-inflammatory capacity by potently inhibiting 5-lipoxygenase activity and leukotriene production and by reducing the production of reactive oxygen species and inflammatory cytokines in vitro. Conclusion. These results provide evidence that BNO 1095 effectively treats menstruation-related complaints including primary dysmenorrhea.

The article deals with modern theories of the pathogenesis of dysmenorrhea. A special place is given to prostaglandin, an anti-prostaglandin theory. As a therapy for dysmenorrhea, the group of prostaglandin-synthetase inhibitors is considered in detail. The article presents the results of our own study of the clinical efficacy of ketoprofen lysine salt in 50 patients diagnosed with primary dysmenorrhea.

According to various researchers, primary dysmenorrhea affects between 20% and 91% of women. Combined oral contraceptives (COCs) are the first choice drugs in young women with primary dysmenorrhea. They have high efficiency, therapeutic and protective effects. In order to assess the acceptability of a drug containing ethinylestradiol and chloromadinone acetate in women with symptoms of dysmenorrhea, 75 women aged 75 years were monitored at V.I.Kulakov Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. at the age of 18 to 40 years. The average age was 23.4±4.1 years. The average duration of the menstrual cycle is 27.4±1.3 years. The duration of dysmenorrhea averaged 6.3 years. All patients were prescribed the drug Belara in the classical mode (21+7). 54 (72%) patients noted the disappearance of symptoms already on the 3rd cycle of drug use and another 15-20% of patients in 12 months. Subjective evaluation, obtained with the help of visual analogue scale, showed that after 3, 6 and 12 months of using the drug Belara, 72, 80 and 92% of patients were respectively satisfied or very satisfied with the effect of therapy. Analysis of individual BP parameters before and during contraception testified to the lack of influence of this drug on these parameters. Analysis of the dynamics of biochemical parameters, lipid spectrum of blood and some parameters of hemostasis did not reveal clinically and statistically significant changes that go beyond the limits of normative values. Analyzed are also the side effects that arose on the background of using the drug Belara, which were observed mainly in the first 2 months use of COCs. Six patients noted meager intermenstrual bleeding, 3 women reported nausea, tension and heaviness in the mammary glands - 5 (6.7%), one woman complained of insignificant dizziness during 1 course of treatment. Allergic reactions were not identified. All the side effects disappeared on their own and did not require additional therapy. Contraceptive effectiveness of the drug Belara was 100%. Thus, literature data and our experience have shown that a combined oral contraceptive containing 2 mg of chloromadinone acetate and 0.03 mg of ethinyl estradiol (Belara) is a highly effective, safe and pathogenetically valid drug in the therapy of dysmenorrhea. With long-term use it does not have a negative effect on the cardiovascular system, parameters of hemostasis and metabolic metabolic rates. All women were from 18 to 39 years old with dysmenorrhea of varying severity.

Endometriosis is a pathological process which is characterized by growth and development of tissue resembling the endometrium by its structure and function, while localizing beyond its normal site within the mucous membrane of uterine body. Endometriosis is one of the most topical issues of modern medicine. Regarding mechanisms of endometriosis occurrence, there are various, sometimes mutually exclusive points of view. Thus, over 10 theories of endometriosis origin are known, though none of those can comprehensively explain the multiplicity of manifestation and localization of endometriosis. The lead clinical manifestations of endometriosis are pain syndrome (dysmenorrhea, dyspareunia, dyschezia, etc.) and infertility. One of the main endometriosis treatment methods is surgery, particularly the low-invasive surgery. Surgical methods of treatment are often extra radical for young females and leads to castration syndrome in patients of reproductive and pre-menopausal age, and may well be of low efficacy regardless of surgical tactics. The main principle of medicinal therapy using any hormonal agent is the suppression of estradiol secretion by ovaries. The basis for hormonal therapy is formed by application of progestagens, anti-gestagens and gonadoliberin agonists

We studied the use of the drug Menalgin in 52 patients aged 13 to 28 years in the treatment of primary dysmenorrhea in women without organic pathology of the pelvic organs. The drug showed high analgesic efficacy and reduction of the need for other pain medications. The positive effect on psycho-emotional status and health of patients was also noted.

The review tells about disorders which cause uterine bleeding clinically manifested in heavy menstrual bleeding combined with dysmenorrhea and changes in the central nervous system. The key pathogenetic cause of bleeding associated with endometrial dysfunction is inflammation. Hormonal therapy, being the first-choice treatment, provides a comprehensive effect on the interrelated mechanisms, demonstrates high efficacy and allows for preservation of the uterus.

The article focuses on the identification of causal relationships between dysmenorrhea, endometrioid and tumor processes. Studies have shown that dysmenorrhea, apart from a decline in the quality of life, can be the cause of development of a number of serious health disturbances, including endometriosis, adenomyosis and even tumoral diseases. Non-steroidal anti-inflammatory drugs are not only the effective means of therapy for dysmenorrhea patients, but also a pathogenetically reasonable approach to prevent the outbreak of the disease.

The range and sales analysis of pharmaceuticals for the dysmenorrhea treatment on the market of Russian Federation was carried out. Various groups of medicaments can be used for the dysmenorrhea therapy. Vast majority of medicines is prescribed and can not be used for self-treatment. The most commonly used medicines have quite extensive list of the registered therapeutic indications that complicates the analysis of sales whereas not only patients with dysmenorrhea provide the market requirements. Despite there is a broad assortment, just a few medicines lead in the sales market and have a stabile demand. Federal and local market structures of the dysmenorrhea treatment are slightly different (by the example of the Voronezh region). Pentalgine (in value) and Citramon (in volume) have the greatest sales among analgetics. Among antispasmodic the leader of sales is No-spa.

spasmodic abdominal pain is a common complaint. Dysmenorrhea is one of the most important problems not only from medical, but also social point of view. Drotaverine hydrochloride is a potent smooth muscle spasmolytic agent. Objective: To evaluate the effectiveness of drotaverine in the daily practice management of spasmodic abdominal pain due to gastrointestinal, biliary, urological tract conditions and dysmenorrhea. Material and Methods: a multicenter, prospective, cross-sectional and longitudinal product registry (3 visits), non-interventional on the therapeutic strategy was conducted in Mexico, Kazakhstan, and Russia. Each investigator contributed at the 2 sequences: one cross-sectional, assessing physicians' interest for and knowledge of spasmodic abdominal pain management [Prescription Registry, PR] and longitudinal registry [LREG]: data on 25 consecutive eligible patients with spasmodic pain were recorded in the PR, and 5-day (+3) follow-up on the first 5 consecutive eligible patients receiving NOSPA ® . Pain was evaluated asking patients to rate the worst abdominal pain over the past 12 hours (11-point Numerical Pain Rating Scale, NPRS) and a Visual Analogue Scale (VAS) to evaluate the drotaverine onset of action. Only spontaneous adverse events reports were collected. Results: 208 physicians participated and included 5507 patients. 75% of them received drotaverine. Treatment was mostly prescribed in monotherapy (72%). From these patients, 1116 were included in the Longitudinal Registry (881 in the PP population) with a mean age of 34.2 ± 12.5 years. 86 % were females. Most suffered from dysmenorrhea (53%). They received drotaverine for 5.7±4 days. 89% were responders. Compared to the first evaluation, a statistical difference was observed in patients suffering from dysmenorrhea (p

Treatment of dysmenorrhea is a very important question. Dysmenorrhea is a cyclic pathological process, manifested by pain in the lower abdomen in the days of menstruation and is accompanied by emotional-mental, vegetative, vegetative-vascular and metabolic endocrine symptoms. Dysmenorrhea is divided into primary, in which you cannot identify pathological changes in the genital organs, and secondary, associated with gynecological diseases (most often inflammatory diseases of the genital organs and endometriosis). Drugs that are used for dysmenorrhea treatment are often characterized by the presence of side effects, inconvenience for the patient or the high cost. Aim. To analyze drugs use for the treatment of dysmenorrhea. Metods and results. There were 66 patients with dysmenorrhea under our supervision. Patients were divided into two groups of 33 women. Patients with dysmenorrhea of the first group have been treated within 6 months receiving the drug Lutein. The second group of women got synthetic progestins. Conclusion. There is evidence that Lutein is an optimal choice because of its efficiency, an affordable price, a comfortable mode of use and rare side effects.

N the structure of girls-teenagers gynecological pathology menstrual disorders constitute 61-63%. One of the most important and common reasons for breach of the establishment of the menstrual cycle is the presence of focus of infection. On the bases of research results authors were able to substantiate effectiveness of complex approach to a treatment with herbal remedies Tonsilgon H and Ciclodinon, what contributes to the achievement of stable remission of chronic tonsillitis, normalization of menstrual function, the elimination simptoms of dysmenorrhea.

The study included 120 women aged 24 to 44 years attending Vivea gynecology department and wanting to use an intrauterine levonorgestrel-releasing system (LNG-BMC) as a contraception method.After a preliminary examination and exclusion of contraindications for this method of contraception LNG-BMC is inserted into the first 7 days of men-strual bleeding.The results indicate a high contraceptive efficacy of the LNG-BMC, a therapeutic effect in dysmenorrhea, premenstrual syndrome, menorrhagia, anemia.

Сontraceptives containing chlormadinone acetate as the progestin component other than a contraceptive effect, ensure the stability of the menstrual cycle when giperpolimenoree and dysmenorrhea, and also have a pronounced therapeutic effect in androgen-dependent dermatopatiyah and manifestations of premenstrual syndrome.

The article concerns somatic and reproductive health issues (menstrual cycle and functioning of mammary glands). The data has been received from of the total examination and questionnaires of female adolescents. The study has revealed 96% of orthopedic disorders and 72% of endocrine disorders. The investigation has found out that 97% of girls have had menstrual disorders. Dysmenorrhea has been observed in 84% of patients. The study demonstrated that 57% of girls had the cyclic (premenstrual) and 20% girls had the persistent mastalgia. The dysplasia of mammary glands was diagnosed in 92% of patients. The hypodynamia, smoking and pessimism are more typical for female adolescents