The influence of socio-psychological factors, adverse effects of hormone therapy on the refusal of patients from its implementation or interruption of therapy after surgical treatment of ovarian endometriosis

Objective. To analyze the role of socio-psychological factors and undesirable effects of hormone therapy on the patient’s refusal to undergo it or discontinue therapy after surgical treatment for ovarian endometriosis. Materials and methods. A prospective study is presented in which the frequency of refusals of patients and the frequency of interruption of anti-relapse hormone therapy after surgical treatment for ovarian endometriosis in the gynecological department of Saratov City Clinical Hospital No. 8 during the period from 2021 to 2025 was evaluated. The study included 133 patients aged 18 to 35 years who underwent surgery for ovarian endometriosis. Combined oral contraceptives were used to prevent the recurrence of endometriosis, according to existing recommendations (ROAG Clinical Recommendations, 2024). Before starting the study, all patients had the severity of alexithymia (Toronto Alexithymia Scale), adherence to treatment (KOP-25 questionnaire), and the indicator of autonomic dysfunction syndrome according to the Wein’s questionnaire. During the first 6 months of taking the drug, patients contacted a doctor who determined the tactics of further treatment when adverse events occurred during treatment. The Statistics IBM SPSS software package for Windows, version 28.0 (Armonk, NY, IBM Corp.) is used for statistical processing of the research results. Results. The risk of adverse events of hormone therapy in the group of women over 30 years of age compared with younger age was comparable: 35.7% and 28.5% (p=0.449). In the absence of autonomic dysfunction syndrome, undesirable phenomena were reported in 18.5% of cases, and in 55.7% of cases with the syndrome (p<0.001). The incidence of complications of hormone therapy did not significantly differ in the subjects with low and high alexithymia values and amounted to 28.5% and 42.8%, respectively (p=0.116). The frequency of treatment failure for subjective and objective reasons in the group of low adherence and high alexithymia was statistically significantly higher than in the groups with high adherence and low alexithymia (p=0.030 and p=0.016, respectively). Conclusion. The presence of signs of autonomic dysfunction syndrome is a significant risk factor for the development of adverse events of anti-relapse hormone therapy. An analysis of the reasons for refusal and interruption of hormone therapy after surgery shows that they are associated with low adherence to treatment (<50%) and high levels of alexithymia (>52 units).