Methodics of the operational treatment of patients with widespread endometriosis forms were elaborated. The surgical conception for curing patients with widespread forms of genital endometriosis consist in need to detect and then to remove radically all endometriosis seats, thoroughly perform stages and sequences of surgical techniques on genital and next organs, also to correct intra- operational operations and to make their prophylactics.

This publication is devoted to one of the most relevant areas of gynecological practice - the use of combined oral contraceptives (COCs), taking into account their positive non-contraceptive properties. The issue of how to use COCs with the benefit of reproductive health of women, with what to combine them and how to prevent the risks associated with taking hormonal drugs, is reflected in detail. The information is presented in the form of an analytical review of international studies on the benefits and risks of using COCs.

The aim of the study is to identify the most significant clinical and anamnestic risk factors for the onset and progression of endometrial hyperplastic processes and the development of malignant transformation of endometrium in women of perimenopausal age, with taking into account their importance on the basis of statistical analysis. Methods. Based on Spearman’s correlation analysis and determination the degree of dependence of the development of endometrial cancer (from 0 to 1) on clinical-anamnestic and diagnostic risk factors (risk ratio (RR) in groups), there were obtained coefficients for a mathematical model allowing with the use of the binary logistic regression method predict the risk of the appearance of endometrial cancer. Results. The most clinically and statistically significant risk factors for the progression of the pathological process of the endometrium, having a high RR (greater than 1) and a confidence interval of 95% (p < 0.05), are (in the order of significance): recurrence of the endometrial hyperplastic process, obesity, the pronounced blood flow in Ultrasound with color Doppler mapping, polycystic ovary syndrome, abnormal ovarian formations, infertility (primary and secondary), type 2 diabetes mellitus, combined uterine pathology (myoma and/or adenomyosis), hereditary predisposition to cancer development, hypertension, age of 50 years and older. Conclusion. The tactics of the management and treatment of patients with hyperplastic endometrial processes should be based on the detection of the degree of the risk of the progression of pathological processes and the development of the malignant transformation of the endometrium. The study of the individual prognosis of endometrial cancer in patients with hyperplastic endometrial processes currently is becoming increasingly important due to the need to construct a rational treatment plan of the management and performing the follow-up dispensary observation on the basis of a scientifically justified forecast. Results obtained during our work allowed us identify statistically significant risk factors for the development of endometrial cancer. There were obtained coefficients for the creation a reliable mathematical model. With the use of the method of binary logistic regression, it is possible to calculate the risk of developing cancer and choose an effective management tactic for patients with hyperplastic endometrial processes at the perimenopausal age.

In the review there are presented modern aspects of pathogenesis of benign diseases of the uterus (uterine fibroids, adenomyosis, endometrial hyperplasia). There are highlighted questions of a differentiated approach to the treatment of given diseases.

Clinical morphological changes causing development of hyperplastic processes of endometrium are reviewed, According authors assumptions genetic modifications may have place in development of malignant processes in women reproductive system (e.g. endometrium cancer, cervical dysplasia etc.). Specific moleculas markers or their combination can evaluate the prognosis of disease development, facilitate optimal treatment tactics and new therapeutical agents development.

The review deals with the role of endocrine and metabolic deteriorations in the development of overlapping clinically manifested benign hyperplastic lesion of endo- and myometrium. Hyperleptinemia is a powerful potentiating factor of endocrine diseases of the uterus. Modern correction of both endocrine and metabolic disorders is a key component of the comprehensive treatment and prevention of hyperplastic diseases of the uterus.

Clinical morphological changes causing development of hyperplastic processes of endometrium are reviewed, According authors assumptions genetic modifications may have place in development of malignant processes in women reproductive system (e.g. endometrium cancer, cervical dysplasia etc.). Specific moleculas markers or their combination can evaluate the prognosis of disease development, facilitate optimal treatment tactics and new therapeutical agents development.

The development of different types of endometrial hyperplasia is associated with the changes in the proliferation/apoptosis ratio, with the former being predominant in the presence of increased neoangiogenesis and altered endometrial cell receptor status.

В современной гинекологической практике эндометриоз является одним из самых распространенных заболеваний. По статистике, эндометриоз занимает третье место после воспалительных заболеваний внутренних половых органов и миомы матки и приводит к функциональным и структурным изменениям в репродуктивной системе, нередко оказывая отрицательное влияние на психоэмоциональное состояние женщин, значительно ухудшает качество жизни пациенток. Наиболее частая форма заболевания – генитальный эндометриоз (92–94%), значительно реже встречается экстрагенитальная локализация эндометриоза (6–8%). Результаты эпидемиологических исследований указывают на то, что у 90–99% больных эндометриоидные поражения выявляются в возрасте от 20 до 50 лет, причем наиболее часто в репродуктивном периоде независимо от этнической принадлежности и социально-экономических условий.Наиболее адекватным методом лечения эндометриоидной болезни в настоящее время является хирургическое удаление анатомического субстрата и супрессивное гормональное воздействие.Актуальными препаратами при лечении эндометриоза остаются прогестагены.

The following growth factors play a role in the development of uterine leiomyoma: EFR- epidermal growth factor, EFR-R- receptor of EFR, TGF- thrombocytic growth factor, TGFb- transforming growth factor beta, ILGF1 - insulin-like growth factor of the 1st type. These factors stimulate proliferation of cells, stroma and angiogenesis in the tumor. Mitotically active leiomyoma is characterized by a higher content of these growth factors vs ordinary and cellular leiomyomas. Treatment of uterine leiomyoma should be concentrated on removal of tumor cells from the body as leiomyomas especially its mitotically active variant produce growth factors which are able to stimulate tumor growth by the autocrine mechanism.