Эндокринные расстройства у женщин репродуктивного возраста с доброкачественными кистозными опухолями яичников в сочетании с хроническими воспалительными заболеваниями репродуктивных органов

Aim of the study. To examine changes of the endocrine status, to evaluate the effectiveness of pathogenetic and etiologic treatment of patients with BCOT in combination with inflammatory processes of genitals. Materials and methods. 92 patients (group 1a) with cystic ovarian tumors aged from 18 to 44 were examined in the polyclinic of Radiation research Center for Radiation Medicine and Human Ecology. The study plan included detection of sex hormones levels on days 5-8 and 16-25 of the menstrual cycle, bacteriological inoculation from the cervical canal, PCR diagnostics of urogenital infections (Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum), pelvic ultrasound. The patients were provided with treatment, including antibacterial and antifungal medicine, hepatoprotectors, enzymotherapy and probiotics. The course of the treatment ranged from 14 to 21 days. The follow-up control was done 2 months later. Sex hormones were studied in 64 patients (group 1b) by RIA method as well as PCR diagnostics of the causative agents listed above and bacteriological inoculaton during follow-up visits. Results. The studies revealed changes in the levels of sex hormones, in particular, a decrease of testosterone level before the treatment and a significant increase after the treatment. Hormone dysfunction appears, that causes alternation of anovulatory cycles, which leads to infertility. There is reduction of FSH in the follicular phase of the menstrual cycle and increase of LH before the treatment and, accordingly, changes in the ratio of LH/FSH. The increase of LH/FSH level indirectly is evident of BCOT development is related to LH/FSH ratio abnormalities, and that in patients with benign ovarian cysts reveal such tumor processes as cystic disease. The cultural diagnostics made it possible to assess the species composition and the number of typical forms of microorganisms. A total of 92 samples, of them 72 were positive in the cultural study. Conclusion. Cystic benign tumors in most cases are associated with inflammatory processes in genitals, together with genital infections and increased semination by opportunistic microflora. The increase of the LH/FSH ratio in the follicular phase and the lutein phase is evident that BCOT development is related to them and that in the ovaries with benign cystic tumor-like formations occur such tumor processes as cystic disease. The high level of the LH/FSH ratio related to the chronic inflammation leads to decreased testosterone production, which causes menstrual disorders in BCOT. Ovulatory failure takes place and as a result infertility develops. Reduced ratio of LH/FSH gonadotrophins in the follicular phase and the lutein phase after the treatment can serve as a criterion for its effectiveness. Anti-inflammatory treatment has effect in disorders of the menstrual cycle and reproductive function.