Combined hyperproliferative disorders of the reproductive organs - from pathogenesis to effective therapy

Mekan R. Orazov, Долгов Евгений Денисович
In: Clinical review for general practice · 2026 · vol. 7(8) , pp. 115–120 · doi:10.47407/kr2026.7.8.00915 · W7225322507
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This review examines the shared pathogenetic mechanisms underlying hyperproliferative gynecological disorders, specifically focusing on abnormal proliferation, inflammation, neoangiogenesis, and apoptosis dysfunction. It highlights adenomyosis and uterine fibroids as frequently co-existing conditions that significantly impair women's quality of life across various age groups. The authors discuss current medication-based management strategies for these combined disorders, referencing domestic and international protocols involving agents such as GnRH agonists, antagonists, relugolix, and norethisterone acetate. Relevance to endometriosis: listed among other conditions in the keywords and context of hyperproliferative reproductive disorders, though the primary focus is on adenomyosis and uterine fibroids.

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Abstract

The 21st century created a number of insurmountable challenges for the global medical community. Unfortunately, comorbidity remains one of the main attributes of modern medicine in general and reproductive medicine in particular. An absolute majority of hyperproliferative gynecological disorders have common pathogenetic patterns that are based on the following: abnormal proliferation, abnormal inflammation, neoangiogenesis, and dysfunction of apoptosis. Adenomyosis and uterine fibroid are still among the commonly co-existing hyperproliferative disorders of the reproductive system significantly reducing the quality of life of women, regardless of the age. The review considers the key features of the adenomyosis and uterine fibroid pathogenesis, provides modern approaches to the medication-based management of adenomyosis and uterine fibroid in cases of the combination of these disorders in terms of modern domestic and international protocols. Keywords: uterine fibroid, endometriosis, adenomyosis, pathogenesis, gonadotropin-releasing hormone agonists, gonadotropin-releasing hormone antagonists, relugolix, norethisterone acetate, estradiol hemihydrate.
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Abstract

The 21st century created a number of insurmountable challenges for the global medical community. Unfortunately, comorbidity remains one of the main attributes of modern medicine in general and reproductive medicine in particular. An absolute majority of hyperproliferative gynecological disorders have common pathogenetic patterns that are based on the following: abnormal proliferation, abnormal inflammation, neoangiogenesis, and dysfunction of apoptosis. Adenomyosis and uterine fibroid are still among the commonly co-existing hyperproliferative disorders of the reproductive system significantly reducing the quality of life of women, regardless of the age. The review considers the key features of the adenomyosis and uterine fibroid pathogenesis, provides modern approaches to the medication-based management of adenomyosis and uterine fibroid in cases of the combination of these disorders in terms of modern domestic and international protocols.

Keywords

uterine fibroid, endometriosis, adenomyosis, pathogenesis, gonadotropin-releasing hormone agonists, gonadotropin-releasing hormone antagonists, relugolix, norethisterone acetate, estradiol hemihydrate. For citation:Orazov M.R., Dolgov E.D. Combined hyperproliferative disorders of the reproductive organs: from pathogenesis to effective therapy. Clinical review for general practice. 2026; 7 (8): 115–120 (In Russ.). DOI: 10.47407/kr2026.7.8.00915 All accepted articles publish licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

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