scholarly journals The effect of hormone therapy on the condition of the mammary glands in women with menstrual disorders of endocrine origin

2020 ◽  
Vol 5 ◽  
pp. 11-15
Author(s):  
S. E. Gladenko
Keyword(s):  
Hormone Therapy ◽  
Mammary Glands ◽  
Reproductive Age ◽  
Dynamic Monitoring ◽  
Normal Mammary Gland ◽  
Endocrine Disorders ◽  
Fibrocystic Disease ◽  
Menstrual Disorders ◽  
Ovulation Stimulation ◽  
Positive Effect

The objective: to study the effect of stimulating hormone therapy on the condition of the mammary glands depending on the initial endocrine status of women with menstrual disorders in the background and after ovulation stimulation.Materials and methods. The study selected a group of 130 patients (n=130) of reproductive age (mean age 27±2,3 years), which by the nature of menstrual disorders are divided into 2 subgroups: 1 subgroup (n=57) – women with regular menstrual rhythm and insufficiency of the luteal phase (ILP), 2 subgroup (n=73) – women with secondary amenorrhea and oligomenorrhea on the background of chronic anovulation. All patients complained of no pregnancy for an average of 4±1,2 years. After a comprehensive assessment of the reproductive system and hormone-dependent organs, women received the proposed treatment with estrogen-progestogen drug, bromocriptine and ovulation stimulation with clomifene citrate.Results. During the preparatory (diagnostic) phase of the study it was found that in 1 subgroup in 89,5% of patients with concomitant diseases of the pelvic organs and only endocrine disorders of the ILP type in 10,5%. In women of 2 subgroup, the frequency of combined pathology was 23,3%, and endocrine disorders – 76,7%. These results confirmed the need for laparoscopic and hysteroscopic examination of all patients with infertility in addressing the issue of ovulation stimulation. After short cycles (3 months) of monophasic estrogen-progestogen therapy, 31,6% of patients with ILP and 17,1% with anovulation had a positive effect on reducing the incidence of pain in the mammary glands, with the most sensitive to therapy were patients with diffuse forms of fibrocystic disease with a predominance of cystic and glandular components. When resuming biphasic ovulatory cycles with clomifene citrate stimulation, only 5,7% of women complained of breast pain during the first 1–2 cycles. No additional foci in the subgroups were detected, and previously diagnosed fibroadenomas did not increase.Conclusion. Analyzing the obtained data, a positive effect of different types of hormone therapy on the condition of the mammary glands in patients with menstrual and reproductive dysfunction, in particular with diffuse forms of fibrocystic disease with a predominance of cystic and glandular components, is structures most sensitive to normal progesterone levels. Despite the lack of negative dynamics on the background of ovulation stimulation and restoration of normal mammary gland structure after therapy in women with menstrual disorders of endocrine origin, menstrual cycle regulation and dynamic monitoring of the mammary glands are shown to prevent the development of hyperplastic processes.

Innovative approaches to operational treatment of women of reproductive eligibility age with hyperplastic processes of the endometrium

2016 ◽  
pp. 41-45
Author(s):  
V.N. Goncharenko ◽  
Keyword(s):  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Intraoperative Complications ◽  
Transvaginal Ultrasound ◽  
Treatment Algorithm ◽  
Hormone Treatment ◽  
Endometrial Ablation ◽  
Reproductive Age ◽  
Dynamic Monitoring ◽  
Atypical Form

The aim of the study: was improvement of results of surgical treatment of patients of reproductive age eligibility with hyperplastic processes of endometrium (HPE) through the introduction of individualized treatment algorithm with the use of monopolar radio wave and hysteroscopic endometrial ablation. Materials and methods. The study included 62 women with non-atypical form of hyperplasia of the endometrium who were treated at the Center of General gynecology of the clinical hospital «Feofania», gynecological Department at the city maternity hospital № 3 of Kyiv. Depending on the age group, nature of the pathological process and method of treatment is randomized, the distribution of women according to groups: group 1 – 41 women's reproductive eligibility age netipichnaya forms of endometrial hyperplasia (PHEBA and KGEB), who were subjected to hysteroscopic monopolar endometrial ablation; group 2 – 21 female reproductive eligibility age netipichnaya forms of endometrial hyperplasia (PHEBA and KGEB), which was held radiowave ablation of the endometrium (RHAE). In the 1st group the age of patients ranged from 42 to 54 years, mean age was 49.9±4.7 years. In the 2nd group the age of patients ranged from 41 to 53 years, mean age of 51.6±4.3 years. Results. A comparative analysis of the techniques for hysteroscopic monopolar ablation and RHEE showed the fact that for RHEE used local anesthesia, while carrying out hysteroscopic monopolar ablation was necessary intravenous anesthesia. The duration of the hysteroscopic monopolar endometrial ablation was 28.6±5.5 min, RAE – according to the standard method – 44.3±0.3 min. When performing hysteroscopic monopolar endometrial ablation in 2 patients (3.7%) patients observed the signs of intravasation of fluid, increased blood pressure and tachycardia. This syndrome was successfully docked, but in the future, women have conducted a thorough examination. When you run RHAE intraoperative complications have been identified. Conclusion. 1. Women with netipichnaya forms of endometrial hyperplasia eligibility and late reproductive age who do not have reproductive plans as an alternative to hysterectomy, in the presence of contraindications or ineffectiveness of hormone treatment may be recommended or radiowave monopolar hysteroscopic ablation of the endometrium. 2. Monopolar hysteroscopic endometrial ablation is indicated for women with netipichnaya forms of endometrial hyperplasia, can be used in the presence of submucous form of uterine fibroids, postoperative scars on the uterus, but in the absence of adenomyosis II–III degree. The effectiveness of monopolar hysteroscopic endometrial ablation in women with non-atypical form of hyperplasia of the endometrium is 87.8%. 3. Women after endometrial ablation should be under observation for two years. The method of choice for dynamic monitoring of the condition of the uterus in women who underwent endometrial ablation is transvaginal ultrasound which should be performed after 1, 3, 6, 12 and 24 months of follow up. 4. In case of recurrence of hyperplastic process of the endometrium (bleeding, thickening of the M-mode echo according to the ultrasound) shows a hysteroscopy with a mandatory histopathological examination and verification of the diagnosis. Key words: endometrial hyperplasia, women eligibility age, women of reproductive age, ablation of the endometrium.

Possibilities and prospects of conservative therapy for endometriosis, as a chronical progressing disease (review of literature)

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Tatyana Yu. Pestrikova ◽  
Elena A. Yurasova ◽  
Igor V. Yurasov
Keyword(s):  
Quality Of Life ◽  
Abnormal Uterine Bleeding ◽  
Modern Medicine ◽  
Reproductive Age ◽  
Aim Analysis ◽  
Scientific Publications ◽  
Terra Incognita ◽  
Positive Effect

Relevance. Endometriosis is a common gynecological disease that affects up to 10% of women of reproductive age worldwide and is the main cause of pain and infertility. Endometriosis is a disease, although it has been known for a long time, nevertheless, in many ways it represents terra incognita for modern medicine. Aim. Analysis of literature on the feasibility of long-term and the use of the drug dienogest 2 mg (Vizanne), which has a positive effect on the quality of life of patients with endometriosis. Materials and methods. To write this review, a search was made for domestic and foreign publications in Russian and international search engines (PubMed, eLibrary, etc.) over the past 13 years. The review included articles from peer-reviewed literature. Results. The review presents data on the difficulties of verifying the diagnosis of endometriosis due to a combination of this pathology with pain, infertility, abnormal uterine bleeding. The pathogenesis of the origin of endometriosis-associated pain is presented. The efficacy of the use of the drug dienogest (Vizanne), which has a powerful antiproliferative effect that reduces the main symptoms of endometriosis (pain, bleeding), is substantiated. The expediency of long-term and safe use of the drug dienogest (Vizanne), which has a positive effect on the quality of life of patients with endometriosis, has been proved. Conclusions. Numerous scientific publications confirm the feasibility of prolonged use of the drug dienogest (Vizanne), to achieve remission during endometriosis.

The role of orexin A in pathophysiological mechanisms of sleep disorder in postmenopausal women

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 50-54
Author(s):  
Zukhra Kh. Ebzieva ◽  
Svetlana V. Yureneva ◽  
Tatiana Yu. Ivanets
Keyword(s):  
Hormone Therapy ◽  
Sleep Disorder ◽  
Postmenopausal Women ◽  
Menopausal Hormone Therapy ◽  
Reproductive Age ◽  
Vasomotor Symptoms ◽  
Women Of Reproductive Age ◽  
Orexin A ◽  
Group 1

Aim. To conduct a comparative analysis of serum orexin A levels in women of different age periods with and without sleep disorder and vasomotor symptoms. To evaluate the dynamics of orexin A levels under menopausal hormone therapy. Materials and methods. The study included 50 postmenopausal women and 30 women of reproductive age with a regular menstrual cycle. Using block randomization, patients are divided into 3 groups: group 1 (main group), n=25, -STRAW+ 10 (+1b and +1c), patients with sleep disorder and vasomotor symptoms; group 2 (comparison group), n=25, STRAW+ 10 (+1b and +1c), patients with vasomotor symptoms without sleep disorder; group 3 (control group), n=30, STRAW+ 10 (-4), women of reproductive age without sleep disorder. Group 1 patients were given menopausal hormone therapy. A comparative analysis was carried out using the questionnaire for assessing menopausal symptoms severity by the Greene Scale (the Greene Climacteric Scale) and Rating Scale for subjective sleep characteristics. After 12 weeks of treatment, a control examination was performed. Results. In group 1 women, the serum orexin A levels were significantly higher compared to the women without the symptoms. The link between the orexin A levels and menopause syndrome severity was established. A significant decrease in the menopausal symptoms severity after 12 weeks of menopausal hormone therapy was shown. It was accompanied by a 1,3-fold decrease in orexin A levels. Conclusions. The obtained data indicate the possible role of orexin A and the orexin neuropeptide system in the pathogenesis of sleep disorder and vasomotor symptoms in postmenopausal women.

ANALYSIS OF ACCOMPANYING PATHOLOGIES IN WOMEN WITH VARIOUS DISORDERS OF THE MENSTRUAL CYCLE

2020 ◽  
pp. 33-43
Author(s):  
Ольга Александровна Судакова ◽  
Михаил Вадимович Фролов ◽  
Алина Сергеевна Позднякова ◽  
Евгений Владимирович Белов ◽  
Данаил Красимирович Назлиев
Keyword(s):  
Antenatal Clinic ◽  
Reproductive Age ◽  
General Will ◽  
Organ Systems ◽  
Depth Analysis ◽  
Menstrual Irregularities ◽  
Positive Effect ◽  
Female Genital ◽  
Number Of Authors

Статья посвящена изучению сопутствующей патологии, у женщин репродуктивного возраста, обращающихся в стационар с жалобами на нарушения менструального цикла (НМЦ). Актуальность данной тематики не вызывает сомнения, так как с каждым годом в России и во всем мире регистрируется все большее количество случаев НМЦ. По мнению ряда авторов, данные нарушения могут составлять до 50% всех патологий женской половой сферы. Большой интерес представляет и изучение ряда сопутствующих заболеваний, которые могут отягощать течение НМЦ или наоборот, приводить к их развитию. Целью работы стал анализ разнообразной сопутствующей патологии при НМЦ, с выявлением основных причин нарушений менструального цикла у женщин фертильного возраста. Объектами исследования стали 300 пациенток, с диагнозом НМЦ, которые были разделены на 3 группы, в зависимости от уровня лечебного учреждения, где они проходили обследование - по 100 пациенток: проходивших обследование в больнице скорой медицинской помощи, обследующиеся в женской консультации и проходящие лечение сопутствующей онкопатологии в областном онкологическом диспансере. В дальнейшем проводилась дополнительное деление в каждой группе на 2 подгруппы, в зависимости от того был ли НМЦ впервые выявленным или повторно выявленным. В самой работе проводился подробный анализ сопутствующей патологии у женщин в зависимости от группы и их возраста. Определялись не только «пораженные» системы органов, но и проводился углубленный анализ по нозологиям. Работа интересна еще и тем, что в ней у всех пациенток на протяжении исследования определялся уровень стресса и наличие возможных депрессивных состояний. Определение наиболее вероятных причин НМЦ стало завершающим этапом исследования. Полученные данные могут приблизить практикующих акушеров-гинекологов к более полному пониманию различных нарушений менструального цикла, что в целом, положительно скажется на качестве и эффективности оказываемой медицинской помощи The article is devoted to the study of concomitant pathology in women of reproductive age who go to the hospital with complaints of menstrual irregularities (NMC). The relevance of this topic is beyond doubt, since every year in Russia and around the world an increasing number of cases of NMC are registered. According to a number of authors, these violations can account for up to 50% of all pathologies of the female genital area. Of great interest is the study of a number of concomitant diseases that can aggravate the course of NMC or, conversely, lead to their development. The aim of the work was to analyze a variety of concomitant pathologies in NMC, with the identification of the main causes of menstrual irregularities in women of fertile age. The objects of the study were 300 patients diagnosed with NMC, who were divided into 3 groups, depending on the level of the medical institution where they were examined - 100 patients each: who were examined in an emergency hospital, examined in an antenatal clinic and undergoing treatment for concomitant oncopathology in the regional oncological dispensary. Subsequently, an additional division was carried out in each group into 2 subgroups, depending on whether the NMC was newly detected or re-identified. In the work itself, a detailed analysis of comorbidities in women was carried out, depending on the group and their age. Not only the "affected" organ systems were identified, but an in-depth analysis of nosologies was also carried out. The work is also interesting in that during the study the level of stress and the presence of possible depressive states were determined in all patients. Determination of the most probable causes of NMC was the final stage of the study. The data obtained can bring practicing obstetricians and gynecologists closer to a more complete understanding of various menstrual irregularities, which, in general, will have a positive effect on the quality and effectiveness of medical care

scholarly journals TMD in Females with Menstrual Disorders

2021 ◽  
Vol 18 (14) ◽  
pp. 7263
Author(s):  
Bożena Jedynak ◽  
Marta Jaworska-Zaremba ◽  
Barbara Grzechocińska ◽  
Magdalena Chmurska ◽  
Justyna Janicka ◽  
...  
Keyword(s):  
Temporomandibular Disorders ◽  
Reproductive Age ◽  
Estrogen Metabolism ◽  
Menstrual Disorders ◽  
Female Patients ◽  
University Center ◽  
Dental Offices ◽  
Cycle Disorders ◽  
Masticatory Muscle Pain ◽  
The University

Background: Temporomandibular disorders (TMD) are a common reason for patients to present at dental offices. The majority of people with TMD are women between the age of 20 and 40 years. The purpose of this study was to assess the types and prevalence of temporomandibular disorders in female patients of reproductive age with menstrual disorders. Materials and methods: The study involved 65 females of reproductive age (18–40 years, an average of 28.00 ± 6.27 years). The women who qualified for the study were patients of the University Center for Maternal and Newborn’s Health hospitalized because of infertility or menstrual cycle disorders. Women with confirmed estrogen metabolism disorders participated in a clinical study with the use of Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Results: In the studied female patients with menstrual disorders, temporomandibular disorders (92.3%) were frequent occurrences. The most common type was intra-articular joint disorders (68%). Other reported complaints included masticatory muscle pain (44.62%), and degenerative joint diseases (12.3%). Conclusions: 1. In women with menstrual disorders, TMD may exist. 2. In women with TMD symptoms, their medical history should be extended to include the diagnosis of female hormone disorders.

scholarly journals Hormonal Status of Females in Reproductive Age Group with Benign Breast Disease: A Study of 150 Cases

2018 ◽  
Vol 8 (2) ◽  
pp. 54-57
Author(s):  
Md Monoarul Islam Talukdar ◽  
Nadim Ahmed ◽  
Md Abul Kalam Azad ◽  
Mohammad Emrul Hasan Khan ◽  
Fayem Chowdhury ◽  
...  
Keyword(s):  
Benign Breast Disease ◽  
Small Sample Size ◽  
Breast Disease ◽  
Reproductive Period ◽  
Small Sample ◽  
Reproductive Age ◽  
Base Line ◽  
Fibrocystic Disease ◽  
College Hospital ◽  
Common Diagnosis

Background: Benign disorder of breast in female usually seen in reproductive period of life, is thought to be largely hormone induced and there is a dramatic fall in the incidence after menopause due to cessation of ovarian stimulation.Objectives: To find out the relationship between different types of benign breast disease and hormones acting on breast mainly oestrogen, testesteron and prolactin.Methodology: This is a prospective observational study conducted in the department of surgery, Shaheed Suhrawardy Medical College Hospital. Total 150 female patients of reproductive age were included in the study. Serum levels of oestrogen, testosterone and prolactin were done in all patients. Other relevant radiological and cytological investigations were done accordingly where indicated.Results: Mean age of the study subjects were 28 ±8.46 years. Among the study subjects 64 (42.7%) patients used hormonal contraception, on the other hand 86 patients (57.3%) did not used hormonal contraceptive. 68 (45.3%) patients were non parous, 29( 19.3%) were primi parous and 53 ( 35.3%) were multiparous. 87 (58%) had positive history of breast feeding, 63 (42%) patients did not breast fed their babies. Fibrocystic disease was most common diagnosis among study group followed by fibroadenoma. 96 (64%) patients had fibrocystic disease followed by 38 (25.3%) had fibroadenoma. Mean oestrogen, testosterone and prolactin level was 71.16± 57.63 pg/ml, 0.59 ± 0.42 nmol/L and 22.61 ± 16.65 ng/ml respectively.Conclusion: With this small sample size it is difficult to conclude regarding relation between oestrogen, testosterone, prolactin and benign breast disease. But this study can be used as a base line document regarding benign breast disease, hormone profile, type, distribution and frequency of benign breast disease.J Shaheed Suhrawardy Med Coll, December 2016, Vol.8(2); 54-57

scholarly journals Hormonal regulation of menstrual function in patients of reproductive age with acromegaly

2019 ◽  
Vol 15 (4) ◽  
pp. 59-64 ◽  
Author(s):  
Svetlana Yu. Vorotnikova ◽  
Larisa K. Dzeranova ◽  
Irina V. Stanoevich ◽  
Ekaterina A. Pigarova ◽  
Elena N. Andreeva ◽  
...  
Keyword(s):  
Hormonal Regulation ◽  
Hypogonadotropic Hypogonadism ◽  
Mass Effect ◽  
Reproductive Age ◽  
Menstrual Disorders ◽  
Serum Samples ◽  
Menstrual Function ◽  
Healthy Women ◽  
Excessive Secretion ◽  
Preliminary Extraction

Background: The frequency of menstrual disorders in patients with acromegaly is 4084% and are caused by three main reasons the development of normal or hypogonadotropic hypogonadism due to hyperprolactinemia or a mass effect of the tumor and direct effects of GH and IGF-1 on the reproductive system. Nevertheless the exact mechanisms of reproductive dysfunction are not clear now. Hypothalamic structures play significant role in the regulation of hypothalamic-pituitary-ovary axis, so its important to study key neuropeptides and evaluate their effects to the pathogenesis of ovarian dysfunction during excessive secretion of growth hormone. Aim: The aim of the work is to study the hormonal regulation of menstrual function in patients of reproductive age with acromegaly in the active stage of the disease. Material and methods: The study included patients with a confirmed diagnosis of acromegaly and healthy women, comparable in age and BMI. Blood serum samples were taken in the morning (89 hours) on an empty stomach for 35 days of the menstrual cycle or on any day with amenorrhea and frozen at -70C. The hormonal study was carried out by an enzyme immunoassay, in the case of a kisspeptin, with the preliminary extraction of serum samples. Results: The study included 31 patients with acromegaly and 15 healthy women. Between groups there was a statistically significant decrease in levels of LH (p = 0.001), FSH (p = 0.09), inhibin B (p = 0.003), and kisspeptin (p = 0.00005). The frequency of hyperprolactinemia in the cohort of patients was 51.6%. During the correlation analysis, a negative dependence of kisspeptin on the levels of GH and IGF-1 was detected (r = -0.54, p = 0.002 and r = -0.63, p = 0.0002). Conclusions: The severity of the central depression of regulation of menstrual function in patients with acromegaly may be due to the degree of disease activity.

scholarly journals Simultaneous alterations in ovaries and bone as a result of Polycystic Ovary Syndrome

2021 ◽  
Vol 3 (2) ◽  
pp. 2-14
Author(s):  
Ana Lúcia de Oliveira Bonfá ◽  
Eduardo Donato Alves ◽  
Víctor Fabrício ◽  
Keico Okino Nonaka ◽  
Janete Aparecida Anselmo-Franci ◽  
...  
Keyword(s):  
Cell Culture ◽  
Animal Model ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Estradiol Valerate ◽  
Endocrine Disorders ◽  
Ovary Syndrome ◽  
Bone Properties ◽  
In Vivo Animal Model

Polycystic ovary syndrome (PCOS) is one of the most widely recognized endocrine disorders affecting reproductive-age women. The etiopathogenesis and mechanisms of this syndrome remain unclear. Diagnosis requires two of the following: polycystic ovaries, oligo- or anovulation, and hyperandrogenism. Most women with PCOS display conditions such as metabolic abnormalities, diabetes, obesity, cardiovascular disease, and/or bone dysfunction. Considering the ethical limitations of human studies, animal and cell culture models that reflect some features of PCOS are important for investigation of this syndrome. The aim of the present work was to study some of the endocrine relationships between ovaries and bone tissue in a polycystic ovary syndrome animal model. The study was performed using an estradiol valerate PCOS-induced rat model (n = 30) and bone mesenchymal stem cell cultured from bone marrow of those animals. It was hypothesized that changes of the endocrine relationship between ovaries and bones could be observed in from in vivo animal model and in vitro cell culture assays. The ovarian morphological and endocrine changes seem to be correlated with endocrine, biophysical, and biomechanical changes in bone properties. Mesenchymal stem cells obtained from PCOS-induced rats, cultured for up to 21 days and differentiated into osteoblasts, presented lower viability and reduced mineralization of the extracellular matrix. Taken together, these results indicate important endocrine and structural effects of PCOS in ovaries and bones, contributing to part of the understanding of the pathophysiological mechanisms of PCOS.

scholarly journals Specifics of Hormonal Status in Combined Dishormonal Pathology of the Uterus and Mammary Glands in Reproductive Age

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Mikhail S. Shelygin ◽  
Nadezhda S. Guziy ◽  
Viktoria S. Kaplitskaya
Keyword(s):  
Unplanned Pregnancy ◽  
Reproductive Function ◽  
Mammary Glands ◽  
Reproductive Age ◽  
Reproductive Capacity ◽  
Target Organs ◽  
Hormonal Dysfunction ◽  
Endocrine Status

The combined dyshormonal pathology of the uterus and mammary glands represents a great danger to the health of a woman, as well as impairs the quality of life, reduces the reproductive capacity of a woman and leads to premature loss of reproductive function. Steroid hormones play a large role in the regulation of proliferative changes in the uterus and mammary glands. Regulation of target organs, uterus and mammary glands, due to the presence of common mechanisms associated with the presence of the receptor apparatus in the tissues of these organs to sex hormones. The general links of pathogenesis and the high frequency of combined pathology of the uterus and mammary glands are of interest to study not only isolated forms of proliferation, but also the development of a unified systematic approach to the study of this pathology. In recent times, there are opposing views on the role of hormonal dysfunction as a factor in proliferative processes. The management tactics of patients with pathological changes in the mammary gland in various gynecological diseases is an assessment of endocrine status, normalization of hormonal and metabolic disorders, especially when progesterone and cortisol are excreted, testosterone levels are increased, and hyperprolactinemia is affected. Special attention should be paid to patients with menstrual disorders, reproductive health disorders. We believe that the problem of the hyperproliferative processes of the uterus and mammary glands should not be considered only from the perspective of gynecological or mammological practice. This pathology is polymorphic and should have broad interdisciplinary connections with such disciplines as oncology, endocrinology, gastroenterology, psychiatry, therapy, pathomorphology, histology, obstetrics and gynecology. Only by studying all possible links of etiopathogenesis, by combining interdisciplinary communication, it is possible to effectively fight for the quality of patients with a combined pathology of the uterus and mammary glands. Family planning, prevention of unplanned pregnancy, timely implementation of maternity, prevention of miscarriage, the use of modern contraceptives, support for breastfeeding is also of high importance for the prevention of disorders and the preservation, extension of reproductive capabilities, and the prevention of combined dyshormonal pathology of the uterus and breast.

Sign in / Sign up

Export Citation Format

Share Document