The purpose of the study was to determine the peculiarities of somatic and gynecological status of women with abnormal uterine bleeding, who have autoimmune thyroiditis. Materials and methods. 120 women of reproductive age, of whom there were 90 patients with abnormal uterine bleeding and 30 women without gynecological pathology (control group), were examined. Patients from the main group were divided into 2 clinical groups: 60 women with autoimmune thyroiditis were included in the main group and 30 women without signs of thyroid gland pathology made up the comparison group. The research was conducted and the results of anamnestic data, somatic and gynecological status, clinical laboratory and ultrasound examinations, conservative and operative treatment were analyzed. The study was conducted in the gynecological department of the Communal Non-Commercial Enterprise of the Kharkiv Regional Council “Kharkiv Regional Clinical Hospital” during 2019-2022. Statistical processing of the obtained data was performed using the “Statistica 6.0” program. Results and discussion. As a result of the analysis of the anamnesis data of the patients of the main group, a hereditary predisposition to thyroid gland diseases was revealed in the closest relatives of every fifth patient with autoimmune thyroiditis. Among the concomitant gynecological pathology, such diseases as uterine leiomyoma, endometriosis of various localization, endometrial hyperplasia were more common in patients with uterine bleeding in combination with autoimmune thyroiditis (38.3%). In addition, fibrocystic mastopathy was also observed almost twice as often in patients with abnormal uterine bleeding against the background of autoimmune thyroiditis (25%) than in the group without thyroid gland pathology, which may be due to the hormonal dependence of the above-mentioned diseases, and is a predictor of the development of hereditary endocrine dysfunction and greater susceptibility of the reproductive system to exogenous and endogenous factors. When studying the somatic status of patients with abnormal uterine bleeding in combination with autoimmune thyroiditis, a significant prevalence of comorbid somatic pathology was noted. Among women with 2-3 concomitant diseases, the following combinations were most common: hypertension and obesity (13%); hypertension, chronic pancreatitis, varicose veins of the lower extremities (7%), chronic pyelonephritis, fibrocystic mastopathy. Every third patient had a combination of obesity, liver disease, and hypertension. It should be noted that in women with abnormal uterine bleeding without autoimmune thyroiditis, the accompanying pathology was twice as low as in the group suffering from the specified thyroid disease. Menstrual cycle disorders of various nature were detected. Irregular menstrual cycle occurred twice as often in women with abnormal uterine bleeding against the background of autoimmune thyroiditis than in women without concomitant thyroid disease – in 8 (13.3%) and 2 (6.7%) women, respectively. The analysis of the peculiarities of the generative function allowed to reveal a statistically significant predominance of women with primary infertility (13.3%). Secondary infertility occurred almost twice as often and was diagnosed in 20% of women. Almost every third woman with abnormal uterine bleeding and autoimmune thyroiditis had a history of reproductive loss (35%). In 16.7% of patients, habitual miscarriage was revealed. 3.33% had a history of ectopic pregnancy. Conclusion. The analysis of somatic diseases in women with autoimmune thyroiditis demonstrates their influence on the development of gynecological pathology, especially menstrual cycle disorders, in particular abnormal uterine bleeding, which requires the search for new approaches to their treatment and prevention

Aim. To analyze the eryptosis degree, the state of cell membranes and redox status of circulating red blood cells and leukocytes in patients with abnormal uterine bleeding and its combination with hypothyroidism. Materials and methods. Patients, 74 women aged 18 to 49 years, were examined, which were divided into 3 groups: group I - women with abnormal uterine bleeding (AUB) (24 patients); group II - with AUB and thyroid pathology (30 patients, of whom 18 women had primary hypothyroidism and 2 - secondary hypothyroidism); group III - control group (20 healthy women, who had never had menstrual irregularities). Eryptosis of circulating erythrocytes was assessed by flow cytometry using annexin V staining and 2′,7′-dichlorodihydrofluorescein diacetate (H2DCFDA) staining. Fluorescent probes O1O (2-(2¢-hydroxy-phenyl)-5-phenyl-1,3-oxazole) and PH7 (2-(2¢-hydroxy-phenyl)-phenanthro[9,10-d]-1,3-oxazole) were used to characterize changes in phospholipid bilayers of circulating erythrocytes and leukocytes. Lysed blood samples were stained with antibodies to CD45, 7-aminoactinomycin D and H2DCFDA to analyze the redox status of circulating viable leukocytes. Results. Annexin V staining revealed eryptosis activation in females with abnormal uterine bleeding combined with hypothyroidism. In addition, in these patients, oxidative stress developed in red blood cells, evidenced by an increase in intracellular reactive oxygen species (ROS) levels. Oxidative stress was accompanied by changes in the physico-chemical properties of erythrocyte membranes, namely a decrease in membrane hydration and an increase in lipid order, which can indicate enhanced lipid peroxidation. These changes were observed in women with abnormal uterine bleeding alone, however, to a lesser extent. In this study, the redox state of leukocytes and phospholipid bilayers of their cell membranes were not affected in the patients from both groups. Conclusions. Abnormal uterine bleeding combined with hypothyroidism is associated with eryptosis activation, oxidative stress development in erythrocytes and changes in the physico-chemical properties of phospholipid bilayer of cell membranes in red blood cells.