Overweight and obesity play a negative role in gynecological and obstetric practicE.In women, the frequency of infectious pathology increases against the background of metabolic disorderS.The most common form of infectious vaginitis is bacterial urogenital candidiasis, in the etiological structure of which a significant role belongs to the fungi Candida albicans, as well as Candida non-albicans: C.glabrata, C.tropicalis, C.parapsilosis, C.krusei. Associations of Candida fungi with various representatives of opportunistic microflora, such as gram-positive and gram-negative aerobic, facultative-anaerobic and obligate-anaerobic microorganisms, are often formed. As a result, numerous bacterial pathogens multiply and the number of lactobacilli, which are usually part of the bacterial flora of the vagina, is significantly reduced. In bacterial vaginosis (BV), the concentration of anaerobic pathogens Peptostreptococcus sp, Gardnerella vaginalis, Peptostreptococcus Mobiluncus sp, Mycoplasma hominis can increase 100 timeS.Activation of Atopobium vaginae and Gardnerella vaginalis, which play a “key” role in the pathogenesis of BV, has been proven. The aim of the study was to study changes in the vaginal microbiome in women with candidiasis and bacterial vaginosis in order to improve existing treatment regimenS.We examined 120 women of reproductive age with overweight and obesity. The degree of microbial contamination was determined and the maximum possible spectrum of aerobic and facultative-anaerobic microflora was detected. In women with vulvovaginal candidiasis, overweight and obesity, a high concentration (lg5.8 CFU/ml) of Candida fungi was found, and in 95% of patients two-, three- and four-component associations of Candida fungi with various representatives of conditional pathogenic microflora. Lactobacillus deficiency was found in 58.3% of patients, and their complete absence – in 10.0%. Bacteriological examination of the vaginal contents of women with vaginosis and obesity revealed significant dysbiotic disorders of the vaginal microflora, three-, four- and even five-component associations of anaerobic and facultative anaerobic microflora with a predominance of anaerobeS.A low seeding level of lactobacilli (lg2.2 CFU/ml) was established. Thus, the gram-positive anaerobic and facultative anaerobic microflora of Firmicutes have a significant share in the spectrum of vaginal microflora in overweight and obese patients, in contrast to non-obese women of reproductive agE.In women of reproductive age with vulvovaginal candidiasis and obesity, in contrast to non-obese patients, a higher frequency of fungal-bacterial associations, a higher quantitative level of vaginal contamination by Candida albicans and non-albicans with a lack or general absence of lactoflora.

Among the variety of factors that affect the female organism, obesity is of great importance in the formation, development and functioning of the reproductive system, the development of gynecological diseases in which metabolic syndrome plays an important pathogenetic role (polycystic ovary syndrome is diagnosed in 35-60% of obese women; menstrual dysfunction – in 6 times more often, primary infertility – 2 times more). The components of the metabolic syndrome have a significant effect on the body: insulin resistance, hyperinsulinemia, dyslipoproteinemia, elevated levels of thrombosis factors. This article reviews the current scientific literature on the role of sirtuins in the regulatory cellular processes and metabolic cascades, with special emphasis on the possibilities of their pharmacological activation by resveratrol. The role of resveratrol as a promoter of sirtuin activity at different levels of homeostasis disturbance was analyzed, and the properties of resveratrol, its effects and impact on the female body in the presence of metabolic pathology were analyzed in order to prescribe timely treatment and slow down the reproductive aging process.Literature data prove the importance of polyphenols (resveratrol) use as an effective and pathogenetically determined activator of sirtuins for the regulation of oxidative stress, inflammation, correction of dysbiosis and imbalance of the immune system in the concept of treatment of women with gynecological diseases and metabolic disorders. Resveratrol itself has a wide range of pharmacological effects with proven antilipogenic properties and a safe harmonizing estrogen-like effect on various regulatory levels. The natural plant composition and long history of use of resveratrol have repeatedly revealed its clinical achievements, including polycystic ovary syndrome treatment. The high clinical effectiveness and safety profile allow to recommend the inclusion of resveratrol in treatment regimens and to prevent the relapses of metabolically determined gynecological and somatic diseases in women of various age periods.

In a review article of literary sources, domestic, foreign authors and their own research, modern views are highlighted, often problems and debatable, the prevalence of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) among women with overweight and obesity, women of reproductive age. Vulvovaginal candidiasis (VVC) It ranks second among all vaginal infections and is one of the most common mental reasons for women to visit a gynecologist. Obesity and overweight play an important negative role in gynecological and obstetric practice. There has been a significant increase in C. albicans non-albicans in overweight women of reproductive age, and has a negative effect on the reproductive health of women. The article presents the results of a comparative study on the clinical and laboratory effectiveness of local therapy for bacterial vaginosis and IHC in overweight women. Against the background of metabolic disorders, there is an increase in the frequency of infectious pathology of the urogenital tract. Numerous literature data indicate that fungi of the city of Candida are part of various microbial associations and an important factor in their active growth is the deficiency of lactobacilli that produce H2O2. Data on bacterial vaginosis and vulvovaginal candidiasis, development and role of metabolic disorders in the pathogenesis of BV and VVC are presented. Increasing the effectiveness of local treatment of disorders of the vaginal biocenosis in women with overweight and obesity by using individualized dietary nutrition, means of correcting the intestinal biocenosis and metabolic therapy, an integrated approach to the therapy of women of reproductive age showed more effective results. It has been found that overweight and obesity negatively affect the reproductive system of women. Irregular menstrual cycles, secondary amenorrhea, infertility, endometrial hyperplastic processes are often associated with overweight and obesity. In many cases, BV is combined with intestinal dysbiosis. In this case, vaginosis can be considered as a manifestation of a systemic dysbiotic process, affects not only the microbiota of the genitourinary system, but also the endogenous microflora in various cavities of the macroorganism, provided that it is influenced by any exogenous and endogenous factors. No conflict of interest was declared by the author. Key words: bacterial vaginosis, vulvovaginal candidiasis, overweight, obesity.