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The objective: to assess the quality of life of women with a history of adenomyosis and papillary thyroid carcinoma (thyroid).Materials and methods. 124 women aged 24–45 years old were examined: the I group included 61 women with a history of adenomyosis and papillary thyroid carcinoma, and the II group included 63 women with adenomyosis and normal thyroid status. The severity of pelvic pain was assessed on a visual-analog scale (VAS) in the intermenstrual and menstrual periods. Quality of life of the persons was assessed on the basis of a non-specific quality of life questionnaire Short Form Health Status Survey (SF-36).Results. According to results of VAS there was no significant difference in the intensity of pain between patients of the I and II groups. The average intensity of pelvic pain in menstrual (6.9±0.76 cm in the I group and 6.7±0.79 cm – in the II one) and intermenstrual periods (5.9±1.0 and 5.5±0.85 cm, respectively) corresponded to the level of “severe pain”.Analysis of the results of the SF-36 questionnaire demonstrated a decrease in quality of life scales in patients of both groups. Despite the absence of a significant difference in the intensity of pain between women in both groups, the indicators of physical functioning scale (61.5±13.1 points in the I group and 78.50±8.2 points – II group; p<0.05), general health (21.8±11.2 and 48.2±12.0 points, respectively; p<0.05), vital activity (31.5±9.9 and 51.0±7.4 points; p<0.05), mental health (40.4±10.4 and 50.4±7.1 points; p<0.05) and integrated indicators of physical (37.3±5.5 and 41.4±4.3 points; p<0.05) and psychological components of patient health (32.6±5.3 and 36.9±7.5, points; p<0.05) in the I group were significantly lower compared to patients in the II group.Conclusions. The physical and psychological health of women with a history of adenomyosis and papillary thyroid carcinoma is influenced by a combination of factors, including clinical manifestations of adenomyosis and the effects of thyroid carcinogenesis, which lead to reduced physical and psychological functioning.

Objectives: to evaluate the hormonal status and receptor apparatus of the eutopic endometrium in patients with adenomyosis who had a history of papillary thyroid carcinoma.Materials and methods. 63 women were examined: group I consisted of 31 patients with adenomyosis and papillary carcinoma of the thyroid gland in history, group II consisted of 32 patients with adenomyosis and unencumbered thyroid status. The severity of pelvic pain was assessed using a visual analog scale. The level of luteinizing and follicle-stimulating hormones, estradiol, prolactin, thyroid-stimulating hormone and progesterone was determined in the peripheral blood serum. The material for the morphological study was obtained using endometrial pipelle biopsy. Morphological research was performed on 30 biopsies of eutopic endometrium (15 samples from patients of group I and 15 samples from patients of group II). Immunohistochemical study was performed on 20 paraffin sections (10 samples from patients of group I and 10 samples from patients of group II) using monoclonal antibodies.Results. High ER-α expression was detected in the endometrial glandular epithelial cells (EGECs) in 80 and 50% of samples of patients from groups I and II, respectively (р < 0.05), no significant difference in the number of positive cells was found between groups. High ER-α expression in endometrial stromal cells (ESCs) was detected in 50% of samples in patients from both groups, the number of positive cells was significantly higher in the endometrium specimens from I group (84.0 (10.5%) in group I versus 62.2 (12.3%) in group II, р < 0.05). High PgR expression in the EGECs was detected in 90 and 75% of samples in groups I and II respectively (р < 0.05), ESCs expressed PgR in 100% of samples of patients from both groups. Significant difference in the number of positive cells was found between groups – 96.0 (8.4%) and 84.9 (12.6%) in groups I and II respectively, р < 0.05.Conclusions. Our results suggest that the ectopic endometrium in female thyroid cancer survivors with adenomyosis has high expression of ER and PgR, that may have important implications for the survival and proliferation of the eutopic endometrial cells. Further research is needed to optimise prevention and treatment algorithms for this group of patients.

Dysmenorrhoea and intermenstrual pelvic pain are the most common symptoms of clinical manifestations of adenomyosis, which significantly impair the quality of women’s life. Adequate and long-term pain correction and alternative therapeutic approaches became extremely important for patients with adenomyosis during the COVID-19 pandemic. Research objective: to examine the clinical efficacy of nitric oxide donor (L-arginine) in the complex treatment of pelvic pain syndrome associated with adenomyosis.Materials and methods. The study included 63 women diagnosed with adenomyosis. Patients were divided into 2 groups by simple randomization: I (D) group (n = 31) received dydrogesterone 30 mg from 5 to 25 days of the menstrual cycle, II (D+T) group (n = 32) in addition to dydrogesterone received a nitric oxide donor L-arginine (Тivortin) according to the scheme. Pelvic pain was assessed before treatment with a Visual Analogue Scale and a McGill Pain Questionnaire, and an assessment of the overall pain impact on women's well-being was based on the SF-36 Health Status Survey. The effectiveness of pelvic pain therapy was assessed after the first and third months of treatment, as well as three months after the end of therapy with the above methods.Results. Researchers achieved a therapeutic effect in the treatment of chronic pelvic pain in both study groups, but in group II (D + T) after 3 months of treatment there was a significant reduction in pelvic pain, while patients of the standard therapy group have prolonged progestogen intake. There was a further improvement in the clinical condition in group I (D) after 6 months of follow-up, as well as no recurrence of pain in group II (D + T).Conclusions. The results of study demonstrate a significant effect of Tivortin as part of complex therapy on the rate of achievement and duration of therapeutic effect in the treatment of pelvic pain associated with adenomyosis.