The problem of preserving reproductive health in patients with hyperplastic endometrial patology against the background of metabolic disorders

Abstract

DOI: 10.52705/2788-6190-2025-02.1-10
УДК 618.14-007.61-036.1-037-07-08-084-053.8

The objective: to investigate the characteristics of endometrial hyperplastic processes in women with combined endocrine and metabolic disorders in order to optimize the management strategy for this category of patients.
Materials and methods: The study was conducted at the gynecology department of the Sumy Regional Clinical Perinatal Center from 2020 to 2024. A clinical and statistical analysis was carried out on medical records of 180 women of reproductive age with confirmed non-atypical hyperplastic endometrial pathology, including endometrial hyperplasia and polyps, which developed against the background of metabolic disorders. To diagnose hyperplastic endometrial pathology, hysteroscopy with endometrial biopsy was performed. Hysteroscopy was carried out on days 5–7 of the menstrual cycle, followed by histological examination of endometrial tissue samples obtained from the uterine cavity. Morphological evaluation, including both traditional histological examination and immunohistochemical assessment, was conducted using standard techniques at the Department of Pathological Anatomy of Sumy State University.
Results. Key risk factors for the development of endometrial hyperplastic changes among the study participants were identified, including hereditary predisposition, a high incidence of prior medical abortions, spontaneous miscarriages, and complicated deliveries. The study confirmed that hyperplastic endometrial lesions have a multifactorial nature, involving several functional systems of the body in the pathological process. This highlights the need for a comprehensive diagnostic approach, including individual assessment of age, reproductive history, presence of metabolic disorders, endocrine system status, and comorbid somatic conditions, followed by personalized treatment strategies.
Conclusions. In women of reproductive age with endocrine-metabolic dysfunctions, endometrial hyperplastic lesions are characterized by a tendency to recur, prolonged menstrual irregularities, anovulatory cycles, and difficulties in achieving pregnancy.