Obesity is a common problem among women of reproductive age. There are data from clinical and experimental studies indicating the role of hyperprolactinemia in the development of metabolic syndrome, as well as the metabolic benefits of treating hyperprolactinemia.Research objective: to evaluate the clinical efficacy of Vitex Agnus Castus standardized extract on hormonal and metabolic status in women with menstrual cycle disorders and obesity.Materials and methods. 60 women aged 19 to 35 years with obesity and menstrual cycle disorders with laboratory-confirmed insulin resistance and prolactin near the upper limit of the reference values or was slight increase were examined. All the patients were given recommendations for lifestyle modification. 30 of them, who formed the main group, received Cyclodynon. 30 patients of the control group were not prescribed Cyclodynon therapy.Results. At the end of the treatment, the menstrual cycle was normalized in 93.3% patients of the main group, and in 66.3% patients of the control group (p < 0.05). Ovulation signs were detected in 86.67% women of the main group and only in 30.0% women of the control group (p < 0.05). The mean prolactin value and the HOMA index were significantly lower in the main group; prolactin level did not exceed the physiological values in 86.67% women in the main group after 6 months, and in 40.0% of the control group, p < 0.05. There was a decrease in body mass index and waist/hip circumference ratio in patients of the studied groups; the dynamics was slightly higher in the main group but did not differ significantly. Conclusions. Cyclodynon is effective for the treatment of menstrual cycle disorders and metabolic disorders in women with obesity and metabolic syndrome. Good tolerability, absence of side effects, and sufficient efficacy of Cyclodynon allow it to be recommended as the drug of choice in patients with prolactin levels near the upper limit of the reference values or a slight increase of it and in patients with intolerance to synthetic dopamine agonists.

ABSTRACT. Objective. To study the prevalence of smoking among women with polycystic ovary syndrome (PCOS), as well as to establish the relationship between intensity, duration of smoking and serum levels of manganese and nickel. Materials and methods. A questionnaire survey was performed in two groups of women: the control group (I) included 38 healthy women, and the second group included 52 women with PCOS. In both groups, serum levels of manganese and were determined using inductively coupled plasma mass spectrometry. Statistical processing of the results of the survey was conducted using Statistika 8 software program. The U-Mann-Whitney test was used to assess the statistical significance of the obtained results. Comparison of the prevalence of smoking in both groups was performed using the parameter of statistical significance of differences for two relative values. Spearman coefficient was used for correlation analysis. Results. In women with PCOS, significantly higher manganese (p = 0.0012) and nickel (p = 0.0000) serum levels were found. In group I, 3 women reported smoking, in group II — 13 women. Among women with PCOS, the prevalence of smoking was significantly higher (p = 0.0000). Both groups differ neither in duration (p = 0.9463) nor in intensity of smoking (p = 0.7366). Duration and intensity of smoking were not associated with serum manganese. The intensity of smoking also did not affect serum levels of nickel. A positive correlation was found between serum nickel and the duration of smoking. Authors believe that during smoking manganese directly penetrates cerebral structures via olfactory rout. Only its small portion penetrates the bloodstream. This explains the high toxicity of manganese. Conclusion. Among women with PCOS smoking is much more common, however, the intensity and duration of smoking do not differ from the control group. Serum manganese levels are associated neither with duration nor with the intensity of smoking. Serum nickel levels are affected by the duration of smoking, rather than by the intensity of smoking. Keywords: polycystic ovary syndrome, intensity of smoking, duration of smoking, manganese, nickel.

Vulvovaginal candidiasis is an urgent medical and social problem, a common reason for women to see a doctor. This disease occurs in women of different ages, which leads to a significant decrease in the quality of life, and to more serious complications in some cases (genitourinary system diseases, miscarriage, vaginal stenosis, etc.).Research objective. Comprehensive assessment of the effectiveness of treatment and prevention of recurrent vulvovaginal candidiasis (RVVC) with Candivac (contains inactivated microorganisms in the form of frozen lyophilized 4 original strains, which are the most common causative agents of vaginal candidiasis).Materials and methods. 76 women of reproductive age with RVVC were examined and randomized into 2 groups: the main group consisted of 40 patients who received anti-candidiasis therapy with fluconazole and Candivac; the control group included 36 women who received only the standard fluconazole antifungal regimen. The duration of observation was 12 months.Criteria for evaluating treatment efficacy were no/reduction of clinical symptoms and changes in the vaginal mucosa, positive dynamics of laboratory tests (with control after 3 and 12 months) from the start of treatment. Results. Clinical efficacy of treatment (regression of complaints and normalization of objective data) in two groups was observed in the majority of patients. At the same time, clinical efficiency in the main group was 87% and exceeded that in the comparison group (63%), which was accompanied by the normalization of the vaginal microbiocenosis. However, after complex therapy with Candivac a more reliable result was observed, which was accompanied by a significant decrease in the frequency of disease recurrence.Conclusions. Study showed that Candivac in combination with antifungal therapy and probiotic promotes the elimination of systemic inflammation and the rapid return of normal intravaginal microflora, and reduces the number of RVVC recurrences.