The article presents the results of a study on the effectiveness of using clotrimazole 2% to treat candidal vulvovaginitis in girls. The use of a clotrimazole 2% cream treatment regimen, (100 mg), intravaginally once daily in girls with candidal vulvovaginitis is justified and highly effective. The absence of side effects while taking clotrimazole increases the commitment to this type of therapy.

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.

Aim: To assess the efficacy and safety of ulipristal acetate (UA) use in uterine myoma patients before surgical treatment. Material and methods: 78 patients of reproductive age with uterine bleeding and anemia, who underwent laparoscopic myomectomy, were included in the study. Patients were divided into two groups: the first group consisted of 43 women who received 5 mg of ulipristal acetate daily for 3 months before the operation and the second group consisted of 35 patients without ulipristal treatment. A comparative analysis was made between clinical laboratory data groups, pathomorphological changes in myoma and endometrial nodes, and long-term treatment results. Results: As a result of UA therapy uterine bleeding stopped in all patients of the first group, the size of myoma nodes decreased by 25% according to visual diagnostics data, hemoglobin content normalized without iron-containing drugs. Duration of the operation and volume of intraoperative blood loss were less in the first group of patients in comparison with such parameters in the second group. Conclusion: Use of ulipristal acetate for preoperative assessment of patients with uterine myoma of reproductive age suffering from uterine bleeding and anemia is effective and safe.

The article presents updated data on the microbial composition of breast milk in healthy women and women with lactational mastitis. The authors describe the main ways of the formation of mammary gland microbiome and its effect on the maternal and newborn health. The feasibility of using probiotic agents created on the basis of strains of lactic acid bacteria isolated from breast milk is substantiated both for the treatment of lactational mastitis and for its prevention in risk groups.

Vulvovaginal candidiasis (VVC) is one of the most common vaginal infections, representing 40% to 50% of all cases of infectious vulvovaginitis. Between 70-75% of sexually active women experience at least one episode of VVC in their lifetime, and 8-10% of adult women have recurrent VVC. The treatment of VVC remains as one of the most pressing challenges of gynecology. The share of recurrent disease event rates remains high, despite the modern medicines used to treat various forms of VVC.

Besides the contraception the modern contraceptives have non-contraceptive effects. The ability to use the vaginal ring in patients with combined pathology as gynecological as somatic is important due to the micro-dosed of ethinyl estradiol and highly selective gestagen.

Objective: To determine the benefits of COC in the 26/2 mode compared with the traditional 21/7 in reducing the frequency of side effects. Main provisions. Side effects – the main cause of women’s refusals to take COCs – occur predominantly on days of taking pills without hormones due to a drop in estradiol levels. Reduction of the hormone-free COC interval (mode 26/2) reduces the frequency of headache and pelvic pain and other symptoms. Conclusion. COC, with regimen 26/2, may be a promising option for users who experience adverse symptoms.

The urgency of the problem of vaginal infection is determined by its highest prevalence in the structure of obstetric-gynecological morbidity. Currently, the share of diseases of the lower genital tract associated with quantitative unbalance conditionally pathogenic microorganisms of bacterial and fungal origin vagina, which occur in 40-65% of pregnant women. Carried out a sufficient number of studies showing the role of vaginal microbiocenosis dysbiotic violations in the development of pathology of pregnancy, childbirth and postpartum infectious complications. It is known, that for vaginal infections and dysbiosis significantly more often increases the risk of chronic placental insufficiency, premature birth, low birth weight and postpartum endometritis, wound infection. In connection with the above, it is important to timely diagnose microflora disorders using clinical and laboratory research methods, followed by adequate etiotropic therapy. Timely and effective treatment of vaginal dysbiosis in pregnant women before delivery reduces the risk of postpartum infectious complications.

Aim of the study: To present an analysis of the literature data on the role of Lactobacillus fermentum CECT5716 in the prevention and treatment of postpartum lactation complications. Materials and methods: literature sources published in the Pubmed, Scopus database were searched. Results: according to randomized clinical studies, the use of Lactobacillus fermentum CECT5716 in the postnatal period by mothers leads to the correction of breast microbiota by reducing the number of pathogenic bacteria and increasing lactic-acid bacteria, reducing the content of inflammatory factors in breast milk. Conclusion: Lactobacillus fermentum CECT5716 is an effective and safe way to prevent and treat postpartum lactation complications.

Vaginal infections occupy an important place in the structure of obstetric-gynecological morbidity. Bacterial vaginosis, trichomoniasis and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Foreign and domestic studies indicate a high frequency of adverse obstetric and neonatal outcomes with this pathology: premature termination of pregnancy, placental insufficiency, fetal growth retardation, chorioamnionitis, postpartum suppurative inflammatory diseases and other complications. Patients with ischemic-cervical insufficiency should be assigned to the group at high risk of developing the above complications. The mixed vaginal infections detected in them require the rehabilitation of the birth canal and the elimination of possible pathogens in a short time. In this regard, timely diagnosis and rational treatment of vaginal infection will reduce the frequency of complications of pregnancy, childbirth, the postpartum period, and neonatal morbidity.

The review focuses on the clinical and epidemiological characteristics of herpes viral infection, in particular genital herpes. The current treatment options for recurrent genital herpes are presented. The main mechanisms of action of acyclic nucleosides are presented. A detailed description of valaciclovir (Valvir) is given.

Human papillomavirus infection (HPV) is one of the most common infections today. Young women have a high risk of infection with HPV. The contagiosity of the virus reaches 80%. HPV is a cause of cervical cancer. Genital warts is one of the most common clinical manifestations of HPV, the incidence is 120–150 per 100,000 population. The aim of the study was to assess the degree of incidence of vulvar and vaginal warts, according to the official statistical forms and clinical practice. The statistical forms do not give an accurate account of the incidence of HPV due to the characteristics of reporting. According to clinical observation, signs of HPV were detected in 23,3% of female students, who underwent periodic medical examinations, and in 10,1% of patients, who addressed complaints to the gynecologist. Inosine pranobex is the most studied systemic immunomodulator used to eliminate HPV. The non-intervention open-site single-center study showed that the effectiveness of monotherapy acounted for 66,9%, which categorized inosine pranobex as a first-line drug.

Vulvovaginal candidiasis today is one of the most pressing problems in the field of women’s health. However, the prevalence of Candida with formed drug resistance to fluconazole significantly complicates the treatment of this disease. Thus, the evaluation of the safety and efficacy of other antimycotic drugs becomes an important task in the fight against recurrent genital candidiasis. The article presents the data of international and domestic studies on the possibilities of using sertaconazole in the therapy of vulvovaginal candidiasis.

The article provides an overview of studies of antioxidant properties of the components contained in AndroDoz, as well as the results of using AndroDoz biocomplex, due to which infertile men showed an increase in concentration, motility and percentage of sperm with a normal form in the ejaculate, a decrease in sperm DNA fragmentation and an increase in pregnancy rates after using assisted reproductive technologies, as well as getting pregnant naturally. Due to absence of adverse events and side effects, AndroDoz can be recommended to a wide range of patients with pathozoospermia and idiopathic infertility.

Aim: Presentation of basic clinical scientific data based on modern evidence of anatomical and physiological changes in the urogenital tract in periand postmenopause and the principles of management of women with genitourinary menopausal syndrome.

Material and methods: The review of domestic and foreign sources devoted to prevalence, modern diagnostics and methods of vaginal atrophy treatment was carried out.

Results: the present article contains modern terminology, data on etiopathogenesis, clinic, diagnostics and treatment methods of VVA, clinical examples.

Menopause is a woman’s journey through the transitional period of life. Along with estrogen deficiency, age-related changes in this period include relative hyperandrogenism and reactivation of renin-angiotensin-aldosterone system (RAAS). These processes can lead to both the manifestation of clinical estrogen-deficient symptoms and the increase in metabolic disorders and cardiovascular diseases. The task of every obstetrician-gynecologist is to provide appropriate professional advice on issues related to the specified period. To date, prescribing MHT in postmenopausal women, along with the mandatory compliance with a healthy lifestyle, is consistent with the general principles of maintaining women’s health and improving the quality of life. The authors of this work provide an overview of possibilities for MHT for the treatment and prevention of conditions associated with estrogen deficiency in menopause.

Uterine fibroids are one of the commonest benign pelvic tumours with an estimated incidence of 20–40% in women during their reproductive years. Incidence rates for uterine fibroid diagnoses were highest in premenopausal age. The gynecologists are frequently faced with need for the administration of menopausal hormone therapy (MHT) in this group of patients with the onset of symptoms associated with estrogen deficiency; however, uterine fibroids represent a relative contraindication for the administration of MHT. In the present paper, we point out the need for conservative therapy of uterine fibroids in premenopausal patients to prepare for the administration of MHT. The paper reflects the efficacy of the drug treatment of uterine fibroids using antigestagens (gynestril).

A woman’s life can be theoretically divided into certain periods: children’s, adolescent, reproductive and ageing. The latter is also called menopause. Everything related to ageing is usually associated with negative expectations and a pessimistic disposition. But if it is remembered, the word «climax» comes from the Greek language, meaning «staircase». Thus, menopause presents a culmination of a «female career». Each period is marked by its physiological characteristics, and menopause is no exception. The completion of the reproductive system functioning is often accompanied by the formation of a number of estrogen-deficient conditions. The latest modern insights, ranging from hormonal substances to alternative compounds, can effectively solve the problems of menopause.

The most effective symptomatic treatment of menopause is menopausal hormone therapy (MHT). It has been shown that MHT administered in proper time can not only reduce the frequency and intensity of vasomotor disorders, but also significantly reduce the risk of osteoporosis and coronary heart disease (CHD). However, several research showed the increased risk of venous thromboembolism, stroke and breast cancer in patients receiving MHT, thereby MHT safety was questioned. Despite the fact that the beneficial properties of MHT significantly exceed the possible risks of side effects, modern international guidelines recommend to use minimal doses of MHT. Low-dose and ultra-low dose MHT regimens make it possible to maintain effectiveness, but at the same time reduce the incidence of undesirable side reactions to a minimum.

Aim of the study: evaluation of the effectiveness of the integrated use of the Vagilac line of intimate hygiene products in young women with bacterial vaginosis (BV). Design of the study: prospective randomized intervention open study. Materials and methods: 45 menstruating young women diagnosed with «BW» at the age of 11-17 years, divided into 3 equal groups, were examined. In the 1st group adolescents received oral probiotic with Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14® within 15 days, in the 2nd group within 30 days. Group 3 girls, along with probiotic, used liquid soap and Vagilac moisturising gel with lactic acid for intimate hygiene for 30 days. Diagnosis and control of the results were assessed taking into account complaints, vulvovaginoscopy, pH-metry, microscopy and molecular-genetic examination of vaginal microbiocenosis. Results: 1 month after the end of oral probiotic use, the share of Lactobacillus spp. in vaginal TBM in girls who received the probiotic within 15 days was 21.3%, 30 days 53.4%. The parallel use of liquid soap and Vagilac gel for intimate hygiene was manifested by the steady normalization of lactobacillus representation in the vagina. Conclusion: In the case of bacterial vaginosis in young girls, the most appropriate way to restore vaginal normocenosis was to use an oral probiotic with Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14® for 30 days with the addition of liquid soap and Vagilac moisturising gel for intimate hygiene.

The article presents our experience in the use of anti-adhesive barrier based on hyaluronic acid and carboxymethylcellulose in gynecological surgery. The study included 63 patients who underwent removal of polyps, uterine fibroids, intrauterine synechiae, removal of ovarian cysts. At the end of operations an anti-adhesive gel was introduced into the uterine cavity and into the abdominal cavity to prevent adhesions. Efficacy and safety were assessed in the early postoperative period and with a further sixmonth follow-up of patients. It is noted that the introduction of the gel does not lead to the development of hyperthermic reactions, and in the postoperative period in patients there is no increase in the level of leukocytes (6.3 ± 0.2 x 109/L before the operation and 5.8 ± 0.5 x 109/L in postoperative period). In 89.7% of patients after surgical interventions, normalization of the menstrual cycle was noted, in 23% of patients with infertility, pregnancy was noted. When carrying out ultrasound of the pelvic organs and control hysteroscopy (in 7 cases), no evidence of the occurrence of adhesions was obtained.

Purpose. Determine efficacy of a drug in patients with pain syndrome in mastopathy. Objectives. Evaluate the efficacy of the drug by measuring its effect on the pain intensity in the mammary glands, tissue density of the mammary glands, changes in size of existing cysts and fibroadenomas performed after 3and 6-month administration of the drug, and 12-month discontinuation of treatment, provided that the prophylactic 3-month course of Indinol Forto was taken.

Material and methods. We examined 60 patients, who applied to the Breast Pathology Department of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakova, and complained of pain in the mammary glands, mainly in the second phase of the menstrual period. The age of the patients ranged from 21 to 55 years (median, 36.3 years).

Results: 3-month use of the drug showed a decrease in pain intensity in half of the patients (51%), a decrease in palpation density in 58% of patients, a decrease in cyst size in 24 patients, a decrease in echo density in 27% of patients. The size of fibroadenodoimas did not change in 100% of cases. The drug showed efficacy in all age groups. During the control examination (third visit), a decrease in pain intensity was observed in 85% of patients 6 months later. Palpation density decreased in 70% of patients. The size of cysts and fibroadenomas did not change in comparison with the third visit. Echo density of the tissue decreased in 55% of women. 3 (5%) of 60 patients refused to take the drug during the 4th month, due to dyspeptic disorders, 2 (3%) patients of reproductive age complained of lengthening of the menstrual period also after the 4th month of taking the drug. No recurrence of the disease was detected as a result of a 6-month follow-up of 11 patients receiving Indinol Forto after surgical treatment of fibroadenomas. 57 patients made the fourth visit 12 months later. All patients received a preventive 3-month course of Indinol Forto. 17 (30%) patients had no pain in the mammary glands no longer. 18 patients reported a periodic pain in the mammary glands. 38% of women reported that soreness was rare and completely absent while taking the drug. 11 patients showed no recurrence of fibroadenomas after surgery. There was no significant change in the size of fibroadenomas in non-operated patients. Slight cystic growth was reported in two patients. After 12 months, punctured cysts did not exceed 1 cm in diameter in six patients, who underwent medical and diagnostic puncture of large cysts. The scheduled mammography and ultrasound imaging showed a steady decrease in echographic and mammographic density.

Objective. To evaluate the clinical efficacy of sertaconazole in the treatment of acute vulvo-vaginal candidiasis (VVC) in pregnant women with caesarean section. Subject and methods. The study included 136 pregnant women. In the treatment, 1 candle of sertaconazole 300 mg once was used. Efficacy was evaluated after 7 and 28 days. Results. At 74.0% of pregnant women identified VVK. After treatment with sertaconazole, positive dynamics was observed in 91.9% of patients, in whom clinical manifestations of the disease disappeared by the third day. Culture testing revealed a normalization of the vaginal biotope at 97.1% of pregnant women. Our experience has shown the effectiveness of the drug, the absence of adverse events and good compliance due to the ease of use and rapid achievement of the therapeutic effect in pregnant women throughout pregnancy.

Recurrent genital herpes and anogenital warts differ in etiological factor and clinical presentation. The main objectives afflicting the gynecologist are to lengthen the period of remission as long as practicable and reduce recurrence rates of genital warts. The article presents the analysis of the effectiveness and safety of the complex therapy for recurrent genital herpes and anogenital (venereal) warts.

Tofisopam is an anxiolytic drug, available for prescription by gynecologist. This paper discusses three typical case vignettes, where woman’s anxiety interfered with her somatic condition and responded on tofisopam. There is also a discussion of combination of tofisopam with hormonal therapy and it’s efficacy and safety.

The article considers the features of Fe deficite anemia in patients with uterine fibroid. Their own studies of preoperative management of such patients using the drug of bivalent iron and selective protein modulator in progesterone receptors are presented.

The purpose and objectives of the study is to identify the hormonal, biochemical and ultrasound features of the gestation course in women with beneficial tumours of the uterus. Results. We conducted a complete clinical examination and prospective observation of 182 pregnant women. Of which, 98 puerperas with a verified diagnosis of uterine fibroids and/or endometriosis, which developed before gestation, but did not prevent the onset of pregnancy, were included into the main group. The comparison group included 84 women with physiological pregnancy. The studies showed that 14 pregnant women in the main group had C677T (Ala222Val) T/T mutation, while only 2 women in the comparison group had a decrease in enzyme activity due to genetic mutation. Accordingly, the homocysteine level was almost 3 times lower in the comparison group than in the main group. The women with hyperhomocisteinemia (HHC) and uterine fibroid in the main group showed the lowest estriol level and hCG level, while women without HHC had higher estriol level and hCG levels. It was found that almost all patients with HHC had subclinical hypothyroidism. Ultrasound imaging and biochemical tests at the beginning of the 2nd trimester: no ultrasound markers of fetal anomalies were identified in women from both groups; however, signs of retrochorial hematoma were detected in 57 women from the main group, which was confirmed by clinical manifestations and previous ultrasound imaging in earlier gestation periods. Conclusion. Thus, placenta formation in women with HHC and uterine fibroids is accompanied by relative hormonal insufficiency, which is clinically manifested as a threat of miscarriage in the early stages, but carrying a child is possible due to appropriate management of a patient as part of the preserving therapy. However, the issue of preventing the development of fetoplacental insufficiency is a valid one for further investigation.