COMPLEX THERAPY OF ADENOMYOSIS IN WOMEN OF REPRODUCTIVE AGE

Background: Adenomyosis is accompanied by impaired menstrual function, reproductive health, pain syndrome, anemia, and reduces the quality of life of women. Aim: to assess the impact of complex therapy for adenomyosis on immunological status, hormonal homeostasis, and quality of life in women of reproductive age. Materials and methods. The effect of hormone therapy was evaluated in 90 women with adenomyosis (main group), who were divided into two comparable groups depending on the treatment received. Women in group I (n=45) used complex therapy: gonadotropin-releasing hormone agonist, immunomodulator, vaginal suppositories with hyaluronic acid, rectal suppositories with streptokinase and streptodornase; group II (n=45) received dienogest once a day for 6 months. Health indicators were assessed 3, 6 and 12 months. Control group of 30 healthy women of reproductive age. Results. The effects of combination therapy and dienogest on the clinical course, menstrual blood loss volume, and indicators of immune and humoral homeostasis in women with adenomyosis were studied. The treatment led to a 3.7-fold decrease in the tumor marker CA 125, a 1.3-fold increase in hemoglobin levels, a 4.4-fold increase in ferritin, a 2.5-fold increase in serum iron, a 1.7-fold increase in the cytotoxic index of NK cells, a 2-fold decrease in FSH, a 1.5-fold decrease in LH, and a 1.9-fold decrease in estradiol during the observation period compared to dienogest therapy. The use of combination therapy for adenomyosis improves the physical and psychological health components. Conclusions. Comprehensive therapy for adenomyosis normalizes the levels of tumor markers, immune and humoral status, stabilizes hematological parameters compared to dienogest therapy, and improves quality of life.