Shurpyak S. Rehabilitation of reproductive health of women with dyshormonal changes in reproductive organs and comorbid pathology.

The dissertation presents a new solution to the scientific problem of combined dyshormonal proliferative diseases of the reproductive system in women with comorbid states (vitamin D deficiency, thyroid gland dysfunction, obesity, chronic endometritis), new pathogenesis links were established, which consist of a combination of dyshormonal disorders (an imbalance of gonadotrophin secretion, transient hyperprolactinemia, desynchronization of sexual steroid synthesis, LFD with change in estrogen/progesterone ratio) the development of hyperplasia amid falling VDR receptor expression, DS expression of estrogen and progesterone receptors, proliferative disorders ratio and apoptotic processes at the tissue level of hormone-dependent tissues of the reproductive organs.The effectiveness of the proposed differentiated therapy for normalization of the menstrual cycle was 97.2% at 73.3% in the comparison group, with a reduction of pain syndrome - 94.7% and 60.6%, cyclic mastodynia - 93.9% and 43.9%, reduction of vegetative-vascular and nonspecific symptoms - 94.8±3.9% and 24.3±16.7% respectively. The use of differentiated pharmacotherapy allowed reducing the incidence of relapses of clinical manifestations of combined proliferative dyshormonal pathology for 12 months of follow-up from 14.5% to 4.1% and achieving the desired pregnancy without stimulation of ovulation and the use of ART in 64.1% of patients compared to 30, 6% in normal practice.