CLINICAL AND ANAMNESTIC CHARACTERISTICS AND REPRODUCTIVE FUNCTION OF WOMEN WITH ADENOMYOSIS

Relevance. Adenomyosis is one of the leading gynecological pathologies, significantly impacting the quality of life and reproductive health of women. A comprehensive study of the clinical and anamnestic characteristics of patients with different treatment approaches remains a pressing issue. Objective. To conduct an in-depth analysis and provide a comparative clinical and anamnestic characteristic, as well as an assessment of the reproductive function of women with adenomyosis depending on the management tactics used (conservative therapy, surgery, observation) and the clinical course of the disease. Material and methods. A prospective, controlled study was conducted involving 153 women. The main group consisted of 127 patients with a confirmed diagnosis of adenomyosis, who were divided into 4 subgroups: Group I (n=51) - women treated with the combined oral contraceptive Belara and Indol; Group II (n=27) - patients who received the Mirena IUD; Group III (n=37) included patients undergoing hysterectomy for adenomyosis resistant to conservative therapy; Group IV (n=12) included asymptomatic women undergoing follow-up. The control group (V) consisted of 26 somatically and gynecologically healthy women. A detailed analysis of sociodemographic data, personal and disease history, menstrual and reproductive functions was performed, as well as a quality of life assessment using the EHP-5+6 questionnaire. Results. Patients with adenomyosis were found to have a complicated medical history. A high frequency of menstrual dysfunction was observed, particularly early (27.0% in Group III) and late (35.1% in Group III) menarche (p<0.05). Various menstrual cycle disorders, including hyperpolymenorrhea (24.3% in Group III) and acyclic bleeding (up to 25% in Group IV), were recorded significantly more frequently than in the control group. Reproductive function was characterized by a high rate of spontaneous abortions (over 30%) and secondary infertility (up to 27.2% in Group IV). High comorbidity was observed with chronic endometritis (up to 51.8% in Group II, p < 0.05), cervical pathologies, and extragenital diseases, especially anemia (48.6% in Group III). The clinical picture was manifested by severe pain syndrome (up to 94.5% in Group III), which led to a significant decrease in quality of life, emotional distress (75.6%), and high anxiety about treatment failure (94.5%) in Group III patients. Conclusion. Women with adenomyosis represent a clinically heterogeneous group with a significant medical and gynecological history, as well as significant menstrual and reproductive dysfunction. The severity of clinical manifestations directly correlates with a decreased quality of life, necessitating the development of differentiated approaches to the care of this patient population.