FEATURES OF HYPERPLASTIC ENDOMETRIAL PATHOLOGY ON THE BACKGROUND OF ENDOCRINE AND METABOLIC DISORDERS

As part of a clinical and statistical study, an assessment was conducted of the course and characteristics of endometrial hyperplastic changes in women of reproductive age with metabolic disorders.Aim. The aim of this study is to elucidate the pathogenetic mechanisms underlying endometrial hyperplastic transformations in the context of endocrine-metabolic dysfunction, with the goal of optimizing diagnostic and therapeutic approaches to this pathology.Materials and methods. The study analyzed data from 180 reproductive-aged women diagnosed with non-atypical endometrial hyperplastic pathology (including endometrial hyperplasia and polyps) developed against the background of metabolic syndrome. The diagnostic protocol included hysteroscopy and histomorphological examination of endometrial tissue samples.Results of the study. In the analysis of family history, oncological diseases of the uterus and breasts were found among close relatives in 38 patients, and ovarian cancer was present in 11 women. Early menarche was observed in 52 women, and 61 women had chronic inflammatory diseases of the internal genital organs. Infertility was identified in 49 patients, 19 of which were due to an endocrine cause. The most common comorbidities were arterial hypertension (47.7%) and obesity (14.4%). Recurrent uterine bleeding was present in 124 women, requiring either hormonal therapy or symptomatic treatment. All patients had confirmed endometrial hyperplasia, 43.3% of whom also had cervical background or precancerous conditions. Treatment included surgical intervention and hormone therapy aimed at normalizing the menstrual cycle and preventing recurrent bleeding.Conclusions. Endometrial hyperplastic changes constitute a complex pathology resulting from the interaction of multiple functional systems within the body. This pathogenesis necessitates a personalized approach to patient evaluation and treatment, with careful consideration of age-related factors, reproductive history, endocrine system status, the presence of metabolic syndrome, as well as accompanying somatic and gynecological conditions.