In recent years in Ukraine and in the world there has been a clear tendency towards deterioration in the indicators of the somatic health of children and adolescents, that is negatively affects the processes of reproductive health formation and it state in the future. Concern for adolescent girl's health, including their reproductive system, forms an enormous contribution to the society future. That's why big attention is paid to the formation and saving reproductive health of adolescent girls. The period of sexual development is defining in a woman's life and is considered a key moment on the path of reproductive maturity. Today it has been established that the reproductive health formation is influenced by environmental, socio-economic factors and the presence of somatic diseases. Despite the fact that the pathogenetic mechanisms of the reproductive system formation are extremely complex and sensitive to the effects of negative factors, the appearance of destructive factors at this time can disrupt the physiological chain of functioning of the hormonal mechanisms which regulate the reproductive system. Disorders of the menstrual cycle is one of the most common pathological conditions, combining pathogenetically different diseases, which are manifested by a violation of the menstrual duration and frequency, amount of menstrual flow. According to domestic literature, hypomenstrual syndrome (oligomenorrhea, amenorrhea) is in the first place among menstrual dysfunctions in adolescent girls in the structure of gynecological morbidity and is up to 45%. Menstrual irregularities that occur during adolescence often persist into the future, causing infertility, obstetric pathology, perinatal loss and other reproductive health problems during childbearing years. The problem of the menstrual cycle formation has been little studied, but it is socially significant, very relevant and requires further study.Thus, girls with menstrual disorders constitute a group of increased risk of gynecological diseases in women of reproductive age, since many chronic diseases of adults are a protracted pathology of adolescents. Therefore, adolescent girls should be examined and treated by a specialist in pediatric and adolescent gynecology, pediatric endocrinologist, pediatrician and family doctor.

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Polycystic ovary syndrome (PCOS) is one of the most common diseases in the population of women of reproductive age. Due to the wide range of symptoms, PCOS can affect different body systems and be one of the comorbid diseases during a woman’s life. A family doctor may suspect the diagnosis of PCOS in a woman of reproductive age if there are symptoms of menstrual irregularities and/or concomitant symptoms of androgen excess, namely acne, hirsutism, etc. According to the Rotterdam criteria, the diagnosis of PCOS can be established if there are two of the following three criteria: hyperandrogenism (established clinically or biochemically), irregular menstrual cycle (< 9 cycles per year or interval between cycles > 35 days) and polycystic ovaries at the ultrasound study (> 12 antral follicles in one ovary and/or ovarian volume > 10 cm2). Differential diagnosis of PCOS requires the exclusion of other diseases, most often these are: pregnancy, thyroid gland dysfunction, hyperprolactinemia, Cushing’s syndrome; less often – congenital hyperplasia of the adrenal glands and androgen-secreting tumors. Anthropometric research is also one of the examination of patients with PCOS. First-line therapy for obese women with PCOS is lifestyle modification through behavioral therapy, moderate physical activity, and healthy eating habits. In addition to lifestyle modification, PCOS treatment should be multitargeted to match each patient’s phenotype, symptoms, personal goals, and expectations, such as desire to become pregnant. Screening for diabetes, dyslipidemia, hypertension, anemia, and vitamin D deficiency is important in the management of PCOS patients. All patients with a severe or rapidly progressive course, or those with testosterone levels greater than twice the upper limit of normal, should be referred to an endocrinologist or gynecologist to rule out other causes of the condition.

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