Issues related to the treatment of HPE are still very relevant, which is due to the high frequency of relapses of this disease. Today, in the arsenal of modern medicine, there are various approaches to the treatment of HPE. However, the development of benign neoplasms of the mammary glands against the background of HPE limits the possibilities of conservative treatment. Hormonal therapy remains one of the most common methods of treating HPE. The purpose of the study: to optimize the treatment of patients with various types of hyperplastic processes of the endometrium in combination with benign diseases of the mammary glands. Materials and methods. A prospective study of 90 women aged 18 to 47 was conducted. The main group consisted of patients who were diagnosed with HPE and benign diseases of the mammary glands. The comparison group included patients who were diagnosed with HPE without accompanying pathology of the mammary glands. For the treatment of endometrial hyperplasia without atypia, medroxyprogesterone was used, for the treatment of atypical endometrial hyperplasia, medroxyprogesterone was used in combination with a gonadotropin-releasing hormone analog. For the treatment of patients with combined pathology, the commercial drug Danazol or medroxyprogesterone in combination with Koberlin was used. The results. The implementation of various treatment regimens for patients with HPE and benign breast neoplasms showed that the more effective treatment regimen was the one involving the use of Danazol. In this group of patients, the levels of estradiol and progesterone in the blood plasma normalized already after six months of using the drug. Conclusion. The study of the levels of estrogens, progestins and gonadotropic hormones showed that in the patients of the comparison group, the best treatment scheme is the combined use of medroxyprogesterone and gonadotropin-releasing hormone analogues compared to the monouse of only medroxyprogesterone. In patients with the combined pathology of HPE and mastopathy, the best treatment scheme is the use of Danazol.

The purpose of the study was to determine the level of expression of estrogen and progesterone receptors in endometrial tissue and to determine their relationship with the level of vitamin D in the blood of women of childbearing age with endometrial hyperplasia and benign breast tumors. Materials and methods. Examination of women of reproductive age who were diagnosed with hyperplastic processes in the endometrium was carried out. The examined patients were divided into two groups: Group I – the comparison group, which included patients with endometrial hyperplasia without concomitant pathology; Group II – women who, along with endometrial hyperplasia, were diagnosed with benign breast disease in the form of mastopathy. An immunohistochemical method using the En Vision imaging system with diaminobenzidine was used to detect estrogen and progesterone receptors in the endometrium. Determination of 25-hydroxyvitamin D (25OHD) content in blood plasma was performed by enzyme-linked immunosorbent assay using the 25-Hydroxy test kit. Results and discussion. It was found that the level of estrogen receptors expression increases in all types of endometrial hyperplasia and is exacerbated in concomitant mastopathy. Along with the increase in the level of estrogen receptors expression in endometrial cells, the expression of progesterone receptors decreases. It was found that the amount of progesterone receptors in the main group decreased by 38.3% – in endometrial hyperplasia without atypia, by 46.3% – in atypical endometrial hyperplasia and by 20.4% – in endometrial polyps compared with the control group of women. Analysis of the results shows an association between the form of hyperplasia and the receptor phenotype of the endometrium. It is established that the greatest changes are observed in atypical endometrial hyperplasia, which are exacerbated during the development of proliferative processes in the mammary glands. The relationship between vitamin D deficiency and estrogen and progesterone receptor expression in women with endometrial hyperplasia has been shown. Thus, when the level of estrogen and progesterone receptors changes in the endometrium of women with endometrial hyperplasia and mastopathy, the concentration of vitamin D in blood plasma decreases. Conclusion. The development of hyperplastic processes in the endometrium and mammary glands occurs against the background of increased expression of estrogen receptors and decreased expression of progesterone receptors. At the same time in the blood plasma of patients a decrease in vitamin D was revealed