The objective: to increase the effectiveness of local therapy for recurrent nonspecific vaginitis associated with cervicitis in women of reproductive age on the basis of a comparative evaluation of combined drugs Terzhinan and Neo Penotran Forte. Materials and methods. A prospective, open comparative study included 56 women aged 27.5±2.8 years with recurrent nonspecific vaginitis and cervicitis who were randomized to the main group and comparison group. Patients of the main group (n=28) received the drug Terzhinan® (1 vaginal tablet in the evening, before bed, for 10 days). The comparison group included 28 patients who received Neo-Pentran Forte (1 vaginal suppository in the evening, before bedtime, for 10 days), one vaginal suppository containing 750 mg of metronidazole and 200 mg of miconazole nitrate. The complex clinical-paraclinical examination included the determination of the state of the vaginal microbiota using several methods in parallel: a bacterioscopy of vaginal smears stained by Gram, a bacteriological rapid method using AFGENITAL SYSTEM (Liofilchem®, Italy), real-time PCR (Florocenosis) with detection antigens of chlamydia, herpes simplex virus, human papillomavirus, trichomonads. Results. The main reason for the treatment of patients were abundant pathological discharge from the genital tract (73.2%), pruritus (37.5%) and burning (23.2%) in the vulva, pain during sexual intercourse (8.9%), while 33.9% of women expressed combined complaints. Attention was drawn to the significant frequency of dyshormonal pathology among women with recurrent cervico-vaginal infections. In the examined women, uterine leiomyoma was diagnosed (28.6%), genital endometriosis (19.6%), fibrocystic breast disease (37.5%), combined benign dyshormonal diseases of the genital organs (14.3%). About 21.4% of patients treatment of thyroid gland dysfunction (hypothyroidism). According to the comprehensive examination, in all patients of clinical groups, decompensated vaginal dysbiosis was diagnosed, which was manifested by a sharp decrease in the absence of Lactobacillus spp strains in 39.3% of patients and an increase in the number of isolated opportunistic and pathogenic microorganisms to 1011 CFU/ml with an increase in the number of microorganisms in microbial associations (from 2–3 to 5–6 conditionally pathogenic and pathogenic pathogens) in all the cases analyzed. When using the genital express system in vaginal contents, women of the main group identified Escherichia coli (17.9%), Pseudomonas spp. (10.7%), Gardnerella vaginalis (39.3%), Staphylococcus aureus (17 9%), Enterococcus faecalis (25.0%), Streptococcus Group B (10.7%), Candida spp. (46.4%), Mycoplasma spp./Ureaplasma ur. in the title > 105 (14.0%). In the comparison group, the spectrum of detected pathogenic and conditionally pathogenic microorganisms did not differ significantly from the data of the main group. 92.6% of patients in the main group had a pronounced positive clinical effect, and a positive microbiological effect was achieved in 96.4% of cases that persisted during the next two months of follow-up. Without additional prescription of antifungal agents, a positive effect was achieved in 84.6% of patients in the main group with mixed bacterial-candidiasis vaginitis at 54.5% in the comparison group. The independent recovery of the lactobacilli pool to a titer of 107–109 CFU/ml in 17.9% of patients with a lack of detection of lactobacilli before treatment. A similar effect was not observed in the comparison group. Сonclusion. In a comparative study of the results of the use of Terzhinan and Neo-Penotran Forte in monotherapy in patients with inflammatory diseases of the lower genitalia (nonspecific recurrent vaginitis and cervicitis), the high clinical and microbiological efficacy of Terzhinan has been demonstrated. Key words: mixed vaginitis, cervicitis, Terzhinan, Neo-Penotran Forte.

Diseases of thyroid gland, according to world statistics, are found in almost 30% of the world’s population. Thyroid dysfunctions, according to many epidemiological studies, are quite widespread in the population. Normal development of the reproductive system occurs under the influence of gonadotropic hormones of the pituitary gland and during normal functioning of the thyroid gland. In turn, the state of the reproductive system has a pronounced effect on the function of the thyroid gland, as evidenced by changes in its function during pregnancy and lactation, in patients with abnormal uterine bleeding, in girls during puberty and women during the menstrual cycle. The objective: is to evaluate the prevalence and effectiveness of diagnosis of dysfunction of thyroid dysfunction in women with reproductive health disorders to improve treatment and rehabilitation activities and quality of life. Materials and methods. In the first stage of a prospective study, 989 women of reproductive age were put through the method of continuous sampling. Based on the results of verifying the gynecological pathology, 350 patients who gave informed consent for participation in the second stage of the study, were divided into clinical groups for further comparative analysis of the prevalence of dysfunction of thyroid gland: I group – 159 (51.3%) patients with combined non-hormonal non-inflammatory pathology of reproductive organs and dyshormonal pathology of the mammary glands (genital endometriosis, adenomyosis / uterine leiomyoma in combination with endometrial hyperplasia), II group – 31 (8.9%) female with PCOS, III – 53 (15.1%) with endometriotic disease, IV group – 57 (16.3%) women with uterine leiomyoma. Absence of gynecological pathology and pathology of mammary glands at the time of the survey was found in 50 (14.3%) of women, which amounted to V group. Results. Structural and functional changes of the thyroid gland were found in 53.4% of women, while the frequency of detection of diffuse goiter I–II st. did not differ between clinical groups (p>0.05). The prevalence of autoimmune thyroiditis was higher in patients with dyshormonal pathology of the reproductive system than in healthy women (p=0.0001). The euthyroid state with combined dyshormonal and proliferative pathology occurred 1.5 to 1.9 times less frequently than in patients of other groups (p≤0.0005). Subclinical hypothyroidism was diagnosed in 39,6% of the I group of women at 12.9%, 15.1% and 14.0% in the II, III and IV groups, respectively. At the same time, the incidence of subclinical hypothyroidism was 60.6% for the I group in women who had diffuse goiter and / or autoimmune thyroiditis, with 8.6% of the manifest hypothyroidism that was absent in women with PCOS, and the prevalence of endometriosis disease and uterine leiomyomies were 1.9% and 3.5%, respectively. Conclusion. Thus, the results of a two-stage study of thyroid gland thyroid dysfunction in women with dyshormonal pathology of reproductive organs of non-inflammatory genesis confirm that dysfunction of the thyroid gland, especially hypothyroidism, is a serious problem for reproductive health, requiring changes in diagnostic and therapeutic approaches. Key words: thyroid gland, autoimmune thyroiditis, hypothyroidism, reproductive health, non-inflammatory dyshormonal diseases of reproductive organs.