For many years, the use of combined oral contraceptives (COC) with antiandrogenic effects was the main treatment of clinical and biochemical hyperandrogenism in patients with polycystic ovary syndrome (PCOS). At the same time, the creation of an alternative therapy regimen for patients who have contraindications to taking hormonal drugs, as well as planning pregnancy, is obvious. Various combinations of inositol stereoisomers (myoinositol ― MI, and D-chiro-inositol ― DCI) are being actively studied. The review reflects the current understanding of the etiology, pathogenesis of hyperinsulinemia and androgen-dependent dermatological manifestations of polycystic ovary syndrome. The mechanisms of action of inositols at the molecular level are normalization of carbohydrate metabolism in the body and the reduction of hyperinsulinemia, as well as the levels of male sex hormones in PCOS. A comparative analysis of studies with various combinations of inositols was conducted on the effectiveness of treatment of clinical manifestations of hyperandrogenism, such as hirsutism and acne. The use of MI in conjunction with DCI reduces the risk of developing metabolic syndrome and improves the endocrine profile and manifestations of insulin resistance, but further multicenter studies on this problem are required.
Traditional therapy and extensive use of medications and intravaginal autolymphocyte therapy show different results of the treatment of vulvovaginal infections. The purpose of the article was to explore safe and highly effective methods to treat vulvovaginal infections and diseases of the pelvic organs.
The standard clinical and laboratory screening of 70 patients of reproductive age was carried out to diagnose the diseases of the reproductive tract. The screening included the description of quantitative and qualitative characteristics of vaginal discharge, examining the mucous covering of the vulva and vagina, microscopic examination of Gram-stained vaginal swabs, endocervical cultures, and diagnosis of sexually transmitted infections using polymerase chain reaction. Intravaginal autolymphocyte therapy was used together with traditionally-accepted treatment schemes (etiotropic antibacterial and antifungal therapy) in the treatment of the main group (40 patients). Traditional treatment methods depending on the etiology of the development of infection were used in the control group (30 patients). The IgM, IgA, and IgG levels were also observed because of the possibility of causing embryo rejection. This study shows that in case of relapsing vulvovaginitis and mixed infections accompanied by disorders of the immune system at different levels, the use of intravaginal autolymphocyte therapy in a comprehensive therapy can be assessed as advisable and pathogenetically substantiated.
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