Nachotova T. The secondary amenorrhoea of adolescent girls (clinical and hormone-metabolic aspects, pathogenesis, diagnostic and treatment).

The dissertation research is devoted to the solvation of the the actual scientific issue - the increase of effectiveness of treatment of adolescent girls with the secondary amenorrhea by the way of the elaboration of the system of medical and preventive measures to preserve their reproductive potential on the basis of study of clinical peculiarities, pathogenetic procedures of maturity, the role of genetic, hormonal and metabolic factors in the formation of this menstrual function disorders. In the research, on the basis of the conducted integrated investigation the key procedures in the formation of the secondary amenorrhea of adolescent girls, which determine clinical implications and nature in the course of this violation of menstrual function, are defined. The secondary amenorrhea that emerged after the regular menstrual cycle occurs against a background of loss of correlation in the hypophysis-ovaries system and that results in the fall of the oestrogen saturation of the organism against a background of energy resources deficiency. The secondary amenorrhea that emerged after other menstrual function disorders occurs as a result of changes of directivity of correlations in the hypophysis-ovaries and insulin-ovaries systems with the hyperandrogyny formation. It is shown that it is the particular features of determination of uterus dimensions on hormones content, IGF-1 and the condition of the organ blood supplying that is one of the important links of pathogenetic procedures of occurrence of secondary amenorrhea of adolescent girls. Treatment complexes directed to eliminate hormonal disorders and normalization of uterus and ovaries blood supplying are suggested. Clinical, anamnestic and hormonal indices are chosen, and prognostic tables for the calculation of efficiency of non-hormonal treatment of the secondary amenorrhea are developed to be used on different levels of medical care rendering.