REPRODUCTIVE ENDOCRINOLOGY

The issue of changes of physical development indicators, their harmony and possible relation with puberty in girls and boys aged 6–11 under modern conditions

2025-12-19T16:14:08+02:00

Objective of the study: to determine features of physical development and its possible relationship with puberty of girls and boys of the age of 6вЂ“11 under modern conditions.
Materials and methods. 266 children of the age of 6вЂ“11 without congenital and hereditary pathology who live in Kyiv (98 boys and 168 girls) were examined. Anthropometric indicators, namely weight, height, were determined. Harmony of physical development was evaluated based on the body mass index. Both average and individual values of the indicators, which were evaluated based on centile tables, were assessed. The stage of sexual development was clinically assessed using the Tanner scale.
Results. Among examined children of the age of 6вЂ“11 disharmony of physical development occurred more often in boys вЂ“ 67,8%, compared to girls вЂ“ 32,2%, which can probably be explained by later onset of puberty in boys. Disharmony of physical development in boys was pronounced and statistically significantly different from that in girls due to significant underweight (2.21 and 0.35%, respectively) and overweight (11.74 and 7.50%). Almost half (53.54%) children had deviations in physical development indicators, which were diagnosed regardless of the childвЂ™s gender. 13.7% boys with normal growth indicators had obesity and were overweight. Girls with normal growth indicators had obesity and overweight more often вЂ“ in 16.67% of cases, a one-third of which occurred at the age of 8-9 years.
Conclusions. Assessment of physical development by height, weight and body mass index can be a screening method. The most detailed assessment of individual characteristics of physical development of boys and girls can be done using the centile standards method. A steady trend towards an increase in growth and weight indicators with normal body mass index in the majority of cases in children regardless of gender has been identified which indicates that there is a need to review anthropometric standards every 10вЂ“15 years.

Phytocombinations as a way to comfort: non-hormonal support for women in perimenopause

2025-12-18T14:12:46+02:00

Objective of the study: To compare a multicomponent herbal supplement Lifemin® Intense (multicomponent phytocomplex concluded Cimicifuga racemosa, Humulus lupulus, Pueraria lobata, Dioscorea villosa, Angelica sinensis, and Crocus sativus) with a cimicifuga-based product on clinical outcomes in perimenopausal women over 90 days.
Materials and methods. An open comparative study was conducted. It is included 60 women aged 45–58 years (mean age 52.3 ± 3.8 years) with moderate menopausal disorders and follicle-stimulating hormone levels > 20 mIU/ml. The participants were divided into two groups of 30 women each: the main group took Lifemin® Intense, the comparison group took the Cimicifuga preparation. The course of treatment was 90 days. Assessment was carried out on the 1st, 30th and 90th day using validated scales: MRS, HADS (A/D), PSM–25, PSQI, SF–36 (PCS/MCS), and body mass index (BMI). Minimal clinically important differences (MCID) was: MRS ≥ 4 points; HADS ≥ 1.5 points; PSQI ≥ 3 points; SF–36 (PCS/MCS) ≥ 5 points; BMI ≥ 5%.
Results. Baseline MRS score was 14.0 ± 1.7; the complaint profile was typical (hot flashes, insomnia, irritability, fatigue). After 90 days of treatment , the main group showed the following results: MRS -43%, HADS -26% (A and D), PSQI -45% reaching the clinical “normal” threshold (≤ 5), PSM–25 -12%, SF-36: PCS +21% and MCS +20%, BMI -6% (most changes exceeding MCID; p < 0.05). In the comparison group, the following data were obtained: MRS -29%, HADS -12%, PSQI -22%, PSM–25 -6%, SF-36: PCS +11% and MCS +7%, BMI stable.
The proportion of patients with clinically significant improvement in MRS scores in the main group was 80% versus 53% in the comparison group; the relative risk of symptom remission was 1.52 (95% confidence interval: 1.14–2.03).
Key correlations supported multidomain recovery: HADS-A↔PSQI r = 0.66; HADS-D↔PSM–25 r = 0.72; HADS-Total↔SF-36 MCS r = -0.68 (p < 0.001). The largest gains were observed in sleep latency and efficiency (PSQI) and in the SF-36 Vitality and Mental Health domains.
Conclusions. Lifemin® Intense provides a more pronounced and complex effect compared to Cimicifuga monoextract: faster dynamics (as early as day 30), deeper reduction of vasomotor and psychoemotional symptoms, improved sleep, quality of life, and mild metabolic stabilization (reduced BMI). Findings align with contemporary evidence on phytoestrogens and support combined phytotherapeutic strategies for perimenopausal symptom control.

Prevention of gestational complications in women with uterine leiomyoma

2025-12-18T12:08:26+02:00

Background. Uterine leiomyoma (UL) in a pregnant woman is a risk of complications associated with the implantation process, progesterone transformation of the endometrium, insufficient invasion of the villous chorion, impaired metabolism of decidual tissue, incomplete transformation along the entire line of spiral arteries, etc.
Objective of the study: to determine a set of preventive measures for the occurrence of gestational complications in women with UL.
Materials and methods. 27 women who were under the supervision of a doctor before and during pregnancy according to the algorithm we developed (the main group), and 27 women who came under the supervision of a doctor at different stages of pregnancy without prior preconceptional preparation (the comparison group) were examined. The age of the participants was 29 ± 1.5 years.
Women underwent clinical, laboratory-clinical, biochemical, and instrumental examinations (ultrasound, including Doppler) before and during pregnancy according to the current orders of the Ministry of Health of Ukraine.
A comprehensive staged algorithm for the management of women with UL before and during pregnancy by trimester of gestation was developed and proposed, which included a psycho-emotional regimen, a balanced diet, the use of micronized progesterone, vitamin D, magnesium preparations, and vitamin-macro-microelement complexes.
Results. Pregnant women with UL had a complicated somatic, gynecological, and obstetric history. The frequency of gestational complications significantly prevailed in women of the comparison group in the I, II and III trimesters. In the group of women whose management was carried out according to the proposed algorithm, which included preconceptional preparation, the frequency of threatened abortion, premature birth, anemia, isthmic-cervical insufficiency was significantly lower compared to the comparison group.
Conclusions. Women with LM are recommended pregnancy planning, personalized staged, combined, etiopathogenetically based prevention of gestational complications. Preconceptional preparation for pregnancy for women with UL is recommended to be carried out for 3–4 months before fertilization in order to regulate the menstrual cycle, hormonal homeostasis, prevent hypovitaminosis, microelementosis, normalize the ecosystem of the gastrointestinal tract, urinary system, and genitourinary tract.

Sonographic parameters of placenta thickness and cross-sectional area of umbilical cord as markers of fetal growth restriction

2025-12-18T13:55:07+02:00

Objective of the study: to evaluate sonographic parameters - the cross-sectional area of the umbilical cord and the thickness of the placenta - as criteria for predicting the likelihood of fetal growth restriction (FGR).
Materials and methods. The research was a prospective cohort study. Antenatal assessment of sonographic parameters of the placenta and umbilical cord in comparison with an extended postnatal macroscopic examination was performed in two study groups: the main group included 82 pregnant women with prenatal risk factors for FGR who gave birth to children with a birth weight <10th percentile, the comparison group included 80 women without FGR.
Results. When forming groups, the most common predictors of FGR were taken into account: chronic arterial hypertension (OR = 6.40), history of placental dysfunction (OR = 3.46), manifestations of FGR, preeclampsia in a previous pregnancy or in the mother's history (OR = 2.82), uterine factor (uterine development anomaly, uterine hypoplasia, sexual infantilism) (OR = 9.45), increased body mass index > 25 kg/cm2 (OR = 4.64), smoking (OR = 2.89). In the main group, the fetal weight at birth was below the 10th percentile in 57.3% of cases (47), at the 5th percentile - in 22.0% (18), below the 3rd percentile - in 20.7% (17), and head circumference below the 10th percentile вЂ“ in 42.7% (35). The diagnosis of FGR was established before delivery in 76 pregnant women (92.7%) and before 30 weeks of pregnancy in 31 women (37.8%). In the main group, the average placental thickness parameters did not show an increase during pregnancy and were 23.4 В± 0.08 mm compared to 34.9 В± 1.21 mm in the comparison group (which is 1.5 times lower, p < 0.05). The average parameters of cross-sectional area of the umbilical cord were 1.69 В± 0.04 compared to 2.62 В± 0.05 (which is 1.6 times lower than in the comparison group, p < 0.05). The average placental weight was 294.6 В± 12.4 g compared to 498.8 В± 22.6 g, respectively.
The umbilical cord thickness and the cross-sectional area of the umbilical cord are sensitive parameters for predicting the birth of a fetus that is too small for gestational age when using a threshold value of 25.0 mm for placental thickness and 1.8 cm2 for umbilical cord cross-sectional area at 32вЂ“34 weeks of gestation.
Conclusions. Comparison of the cross-sectional area of the umbilical cord and the estimated fetal weight based on ultrasound data suggested that placental thickness and, in particular, the cross-sectional area of the umbilical cord are acceptable predictors for expecting FGR compared to other parameters. The results of the study suggest that the diameter of the umbilical cord has a higher predictive value for FGR and is a significant predictor of the development of this condition.

The impact of environmental factors including COVID-19 on the reproductive health of refugee women and internally displaced women due to the war in UKRAINE

2025-12-17T11:35:36+02:00

Objective of the study: to assess the impact of environmental factors, namely the war in Ukraine and the COVID-19 pandemic, on the reproductive health of refugee and internally displaced women, taking into account the roles of chronic stress and restricted access to healthcare.
Materials and methods. The study included 100 Ukrainian women aged 18–49 who experienced displacement between 2022 and 2024 years. Study participants were stratified into two groups: Group 1 (n = 50) included women who were directly located in active combat zones (e.g., along the frontlines); Group 2 (n = 50) comprised those who were preemptively displaced or relocated from areas without active combat. Quantitative measures, including menstrual cycle disturbances, pregnancy complications, and contraceptive use, were obtained via structured questionnaires supplemented by mental health assessments (depression, anxiety, post-traumatic stress disorder). In-depth qualitative interviews explored barriers to healthcare access, levels of chronic stress, and the influence of the COVID-19 pandemic on daily life among refugee and internally displaced women.
Results. Women who remained in active combat zones exhibited a higher prevalence of menstrual cycle disturbances (55% vs. 24%), pregnancy complications (18% vs. 8%), and unmet contraceptive needs (40% vs. 20%) compared to those relocated prior to hostilities. Mental health indicators were also significantly worse: depression (66% vs. 30%), anxiety (60% vs. 26%), and post-traumatic stress disorder symptoms (76% vs. 36%). Logistic regression analysis confirmed significant associations between chronic stress and adverse reproductive health outcomes (adjusted OR = 3.2) as well as poor mental health outcomes (adjusted OR = 4.5). Additionally, low COVID-19 vaccination coverage (30% vs. 50%) and limited access to healthcare services further exacerbated the vulnerability of these populations.
Conclusions. The research demonstrated the profound impact of both the war in Ukraine and the COVID-19 pandemic on reproductive and mental health among refugee and internally displaced women. These findings underscore the urgent need to improve healthcare access, implement gender-sensitive humanitarian interventions, launch targeted vaccination programs, and provide comprehensive support to mitigate chronic stress and facilitate health restoration in vulnerable groups.

Privacy of human reproductive health information: digital challenges and regulatory issues

2025-12-19T16:33:52+02:00

Background. The digitalization of healthcare, the rapid expansion of mobile applications and integrated mHealth platforms, as well as the increasing use of artificial intelligence, are reshaping the ways reproductive data are collected, processed, and shared. These data belong to the most sensitive categories of medical information, and their leakage or improper use undermines privacy, violates medical secrecy, creates risks of discrimination and stigmatization, and directly affects the realization of reproductive rights. In the Ukrainian context, these challenges are intensified by fragmented legal regulation, insufficient development of public policy in digital health, and a generally low level of awareness in the field of reproductive rights.
Objective of the study: to conduct an interdisciplinary analysis of the existential challenges posed by digitalization for the confidentiality of information related to human reproductive health.
Materials and methods. The methodological framework combines dialectical, ethical-normative, phenomenological and complementary approaches with comparative-legal, statistical, and doctrinal methods. The empirical component is based on an online survey (n = 643) assessing public trust in mechanisms protecting confidential information in the field of reproductive health. The regulatory analysis covered the General Data Protection Regulation (GDPR), Convention 108+, Ukrainian legislation, and international standards.
Results. The findings indicate that reproductive data are perceived as the most vulnerable to risks associated with digital processing. Users of digital services for fertility or menstrual cycle tracking demonstrated significantly higher levels of concern regarding potential data breaches. Statistically significant associations were revealed between anxiety related to data leakage and behavioral decisions, particularly the tendency to postpone medical consultations. Key challenges were identified, including commercial profiling, unfair data collection practices, algorithmic discrimination, re-identification of genetic data, system vulnerabilities, and insufficient alignment of national regulation with GDPR and Convention 108+. The study also revealed gaps in Ukrainian health law, such as the absence of a distinct category of reproductive data, inadequate technical security standards, and unregulated cross-border data transfers.
Conclusions. The results confirm the need to develop an integrated legal policy aimed at strengthening privacy and medical secrecy in the context of digitalization. Priority steps include: defining reproductive data as a separate protected category; harmonizing national regulation with GDPR and Convention 108+; implementing unified technical security standards for mHealth platforms; creating a legal framework for the use of artificial intelligence in reproductive medicine; reinforcing mechanisms of informed consent; and improving public awareness of reproductive rights.

Influence of inositol on the metabolic profile in women with diabetes and other insulin-resistant conditions

2025-12-18T16:35:23+02:00

The literature review summarizes the current data on the biological properties of inositols - a natural group of polyols (sugars) classified as cyclohexanols. These compounds are widely represented in food products (cereals, legumes, nuts, seeds, melons, vegetables and fruits).
In the human body, inositol is an integral component of phospholipids of cell membranes, nuclear phosphates and blood plasma lipoproteins. As a result, inositol participates in numerous cellular functions: osmoregulation, regulation of ion channels and signaling of hormones such as insulin, follicle-stimulating hormone and others. Inositol is a metabolic regulator with a pronounced multisystem effect.
Isomers myo-inositol (MI) and D-chiro-inositol (DCI) increase insulin sensitivity, reducing the need for it and, as a result, reducing hyperinsulinemia. For this reason, inositols are recognized as secondary insulin mediators. They modulate intracellular signaling pathways: translocation of glucose transporters, glycogen synthesis, activity of phosphatidylinositol-3-kinase and protein kinase B. DCI also stimulates pyruvate dehydrogenase and energy metabolism in mitochondria. The tissue-specific ratio of MI: DCI regulates the physiological response of target tissues to insulin. Disruption of this balance correlates with the development of insulin resistance, hyperglycemia, and compensatory hyperinsulinemia.
Meta-analyses have demonstrated the efficacy and safety of MI for the prevention of gestational diabetes and intrauterine fetal development. In particular, in women at high risk of gestational diabetes, MI at a dose of 4 g/day significantly reduces its risk by 47–66%, as well as the risk of preterm birth and macrosomia. MI may also help prevent neural tube defects in conditions of folic acid deficiency or hyperglycemia.
Preclinical and clinical data indicate the benefits of MI and DXI isomers in the treatment of metabolic-associated steatosis of the liver. In addition, MI has a positive effect on glycemia and the HOMA index, atherogenic indices, regulation of SIRT1 genes, antioxidant status and hematological parameters. Osteogenic and anti-osteoclastogenic properties of inositols open new prospects for their use in the therapy of osteoporosis.

Optimization of treatment of abnormal vaginal discharge in women involved in military actions

2025-12-18T11:57:27+02:00

Objective of the study: to investigate the characteristics of vaginal microbiocenosis in military women (including those with polycystic ovary syndrome (PCOS)) and other categories of women involved in the war who complained of abnormal vaginal discharge (AVD), and to develop methods for timely prevention.
Materials and methods. A two-stage study was conducted. Stage I included 100 women aged 25–45 years with AVD: 50 servicewomen and women involved in war activities (main group) and 50 civilian women (comparison group). Comprehensive diagnostics involved microscopy of vaginal discharge according to Hay-Ison criteria, molecular PCR diagnostics of bacterial vaginosis,
and screening for sexually transmitted infections. Stage II included 74 women after etiotropic treatment of AVD: 40 women used Lactofem vaginal gel with lactic acid cyclically for 6 months, while 34 women were recommended only hygiene measures.
Results. Mixed vaginitis was more common in women involved in the war (36.0% vs. 16.0% in civilians; p < 0.05). They also demonstrated more pronounced deficiency of Lactobacillus spp. and higher prevalence of bacterial vaginosis and aerobic vaginitis. Women with PCOS more frequently showed intermediate state and bacterial vaginosis according to Hay-Ison criteria. Preventive use of Lactofem gel significantly reduced recurrence of AVD (7.5% in the main group vs. 52.9% in the control group) and restored normal vaginal microbiocenosis in 85.0% of patients (p < 0.05).
Conclusions. Mixed etiology vaginitis predominates in the structure of AVD causes in women involved in the war, complicating diagnosis and treatment and increasing recurrence risk. Women with PCOS represent a special risk group due to peculiarities of vaginal microbiome. Cyclical use of Lactofem vaginal gel with lactic acid proved effective in preventing AVD recurrence and stabilizing vaginal microbiocenosis in this category of patients