The dissertation was aimed at reducing the frequency and severity of premenstrual syndrome (PMS) in women with endometriosis by developing differentiated measures of PMS treatment on the basis of studying the mechanisms of its development.
The frequency of PMS and endometriosis comorbidity was determined by retrospective analysis of 1,196 medical records. For the prospective examination, 103 women with a combination of PMS and endometriosis were selected. Determination of clinical and social features of PMS in conditions of endometriosis was performed by comparing dataes with age-matched control groups 1 (33 women with PMS) and 2 (35 women with endometriosis). Subsequently, women of the comorbidity group were divided into 4 subgroups according to the prescribed treatment: a group of patients receiving dydrogesterone with non-pharmacological measures (1A), a group of patients receiving dydrogesterone and a preparation containing magnesium glutamate hydrobromide, γ-aminobutyric acid, γ-amino-β - hydroxybutyric acid, vitamin B6 (MGG-GABA-GABOM-vit.B6) with non-drug measures - (1B), a group of patients who received the drug MGG-GABA-GABOM-vit.B6 with non-drug measures - (2B), a group of patients in which n imenyalis only non-drug measures - (2A). Assessment of the effectiveness of treatment was performed after 6 months.
According to the data obtained, the combination of PMS and endometriosis was determined in 53% of diagnosed endometriosis cases. Women in this category were characterized by higher educational attainment, urban living, intellectual work, and a long history of stress. At the same time, the comorbidity group was characterized by the predominance of severe form, decompensated PMS, high-intensity pain syndrome and reduced quality of life when compared with controls. The course of PMS in endometriosis conditions was more frequently associated with hormonal imbalance as more pronounced luteal insufficiency, hyperprolactinemia in combination with hypomagnesemia.
In the dynamics of the study was found sufficient effectiveness of the use of dydrogesterone for the treatment of manifestations of PMS. The use of the drug MGG-GABA-GABOM-vit.V6 as a monoagent did not reduce the severity of all clinical symptoms, however, was accompanied by suppression of manifestations of psycho-pathological reactions.
Treatment of patients under conditions of simultaneous use of both drugs was marked by summation and mutual potentiation of their action, which resulted in complete normalization of the disorders, or pronounced clinical efficacy, which was independently associated with the duration of PMS (β = 0.159), progesterone content in the luteal phase of the menstrual cycle β = cycle 3.07), prolactin level (β = 1.46) and serum magnesium (β = -2.17).
