Melnykov S. Diagnosis, treatment and prophylasy of sexual dysfunction in different female age groups

Dissertation is devoted to the problem of improving the methodological approaches in diagnosis, treatment and prevention of sexual dysfunction in women with gynecological disorders in the reproductive and menopausal age.For the first time the frequency and spectrum of sexual dysfunction in women of reproductive and menopausal age were ranged and it was defined that sexual disorders are formed in large part of women against the background of gynecological disorders (in the reproductive period it is observed in 46.1 % of women, in menopause - in 72.6 %) and they are correlated with gynecological (52.5 %) and somatic (25.4 %) diseases.It was determined the peculiarities of anatomical ultrasonographic and Doppler functional parameters in clitoris tissues in women of fertile age which change on the early stages of sexual dysfunction and should be considered in their diagnosis. The obtained results allowed to review the ways of the choice of methods of hormonal contraception directly by oral contraceptives and hormonal intrauterine contraception accordingly to perspectives to achieve sexual harmony of couples, and also it was proved the negative influence on the women's sexual health of such methods to prevent unwanted pregnancy as interrupted coitus and condoms for men.The complex approach in the study the information of modern diagnostic criteria of sexual dysfunctions allowed to develop "Algorithm for evaluation of sexual health of women in the family planning", which enables the choice of the most appropriate contraceptive method and facilitates the identification of sexual dysadaptation of couples.The violation of the functional reaction (vasocongestion and vasodilatation) of urogenital tract vessels is one of the pathogenic mechanisms of dyspareunia development against the background of urogenital disorders in women of menopausal age with hypoestrogenia (estradiol levels below 50 pg / ml), what we confirmed at determination of the nitric oxide metabolites levels in the vaginal secretion, clitoris vascular Doppler indices and vaginal pH-metry content in the dynamics observation.