Вплив ендометріозу на репродуктивне здоров’я та якість життя жінок (Огляд літератури)

Endometriosis is one of the most common chronic gynecological disorders affecting approximately 10–15% of women of reproductive age and exerting a significant negative impact on reproductive health, fertility, physical and psycho-emotional well-being in patients, as well as their quality of life. The disease is characterized by the presence of endometrium-like tissue outside the uterine cavity, which is accompanied by chronic inflammation, pain syndrome of varying intensity, disorders of the menstrual cycle, and infertility.The article summarizes current scientific data regarding the mechanisms of pathogenesis, clinical manifestations, diagnostic approaches, and treatment methods for endometriosis. The etiology of the disease is shown to be multifactorial and involves the interaction of hormonal, immunological, genetic, epigenetic, and microbiological factors. Important pathogenetic links include the formation of a local estrogen-dependent microenvironment, the development of progesterone resistance, and dysregulation of cellular immunity accompanied by increased levels of pro-inflammatory cytokines and angiogenic factors.Particular attention is paid to the role of the gut and reproductive tract microbiota in the formation of the immune response, regulation of estrogen metabolism, maintenance of chronic inflammation, and promotion of the progression of endometriotic lesions. Current therapeutic strategies, including hormonal treatment, surgical methods, combined approaches, and the use of assisted reproductive technologies in women with impaired fertility, are analyzed. Promising therapeutic directions aimed to correct microbiota imbalance as a potential pathogenetic target are presented. The importance of early diagnosis, a multidisciplinary approach, and individualized treatment taking into account the clinical features of the disease and patients’ reproductive plans is emphasized.