The 9th the All-Russian International Reproductive Health Conference has been provided in the period from 26th October, 2024 until 27th October, 2024 in the Endocrinology Research Centre (Moscow, Russian Federation), The aim of conference was choice of gold standard way for maintenance of female and male reproductive health of the 21st century. 421 sessions, 1 plenary lecture, 108 presentations, 1 plenary meeting, 8 symposiums, 5 scientific sessions, have been provided. 23149 online participants from 45 world countries and 421 real-time participants from 15 Russian regions and 2 post-Soviet countries joined. The special accent was mentioned during discussion about innovative approaches for diagnostics, treatment and prevention of reproductive diseases. The present conference has been organized according to provided by Russian president Vladimir Putin Year of Family 2024 and 2nd International Metabolic Disease Congress (10th-12th October, 20021, Moscow, Russia).

On March 28, 2024, the Council of Experts “High-dose vitamin D (Devilam) in the practice of obstetrician-gynecologist, gynecologist and endocrinologist” was held in Moscow with the participation of leading experts gynecologists, endocrinologists and obstetricians-gynecologists, during which new possibilities for the use of high-dose vitamin D in patients of various ages who need correction of existing vitamin D deficiency or insufficiency.

BACKGROUND: True gynecomastia is associated with excess body mass, which is caused by an imbalance of androgens/estrogens. Therefore, there is an interest in evaluating the possibility of drug therapy for this condition through the use of antiestrogens or aromatase inhibitors.AIM: To evaluate the possibility of drug therapy for true gynecomastia in adult men with excess body mass through the use of clomiphene or letrozole.MATERIALS AND METHODS: A retrospective study included men with newly developed gynecomastia and excess body mass who sought medical help at the Endocrinology Research Center from January 2020 to May 2024, and received either clomiphene therapy or letrozole for a period of 4 weeks. All patients were evaluated for the condition of their breast glands, total bilirubin, liver transaminases, creatinine, urea, luteinizing hormone, prolactin, sex hormone-binding globulin, estradiol, total testosterone, alpha-fetoprotein, and chorionic gonadotropin. The baseline level of statistical significance was set at p<0.05.RESULTS: With clomiphene treatment, no statistically significant differences were found in the evaluated parameters, except for estradiol and testosterone levels, which increased. Clomiphene therapy worsened the condition of three patients (13% (95% CI 2,8;33,6)) - they experienced breast pain that was not present at the time of prescription. With letrozole treatment, there was a positive trend - all evaluated parameters significantly improved. Comparing the changes in the studied parameters, it was found that letrozole treatment had a better effect in terms of the severity of gynecomastia (-1[0;-1] degree), reduction in estradiol levels (-31,7[-8,8;-90,8] pmol/l), and also reduced the number of patients willing to undergo surgical removal of gynecomastia (-63,4% (95% CI -46,9;-77,9)).CONCLUSION: The use of an aromatase inhibitor reduces the severity of gynecomastia and decreases the number of patients willing to undergo surgical removal.

This article presents main historical moments of formation and evolution of Andrology & Urology Department of the Endocrinology Research Centre, since its establishment in 2016. The mission of the present scientifical and clinical subdivision is organization of medical aid for males with sexual and reproductive disorders caused by endocrinopathies. The crew of the Andrology & Urology Department provides scientific researches of hormonal and reproductive impairment among ageing males, testosterone replacement. This historical and analytic review presents you biographical datas and graphic materials about leaders of the Departments in the period from the 1960 until 2024. The authors dedicate the present article to teachers and scientific supervisors.

Hypoparathyroidism is an endocrine disease characterized by reduced production of parathyroid hormone by the parathyroid glands or tissue resistance to its action. This is accompanied by disturbances in phosphorus-calcium metabolism. The main cause of hypoparathyroidism is damage or removal of the parathyroid glands during surgery on the neck organs. Autoimmune hypoparathyroidism is the second most common form of the disease, which occurs, as a rule, within the autoimmune polyglandular syndrome type 1. The development of chronic hypoparathyroidism of any etiology requires lifelong appointment of multicomponent therapy, as well as careful monitoring and an individual approach. In the absence of adequate dynamic monitoring, multiple complications develop from vital organs, in particular calcification of the urinary system, soft tissues and the brain; cardiovascular pathology; visual disturbances; muscle and bone diseases leading to decreased quality of life of patients. Thus, timely diagnosis, rationally selected drug therapy and competent patient management will reduce the risks of complications, improve the prognosis, and reduce the frequency of hospitalizations and disability of patients with chronic hypoparathyroidism. The article presents the main recommendations of the new project of clinical guidelines for patients with hypoparathyroidism, approved by the Ministry of Health of the Russian Federation in 2021. They include the algorithms of diagnosis, treatment and dynamic monitoring of hypoparathyroidism, as well as management of postsurgical hypocalcemia and medical care of and the disease during pregnancy.

The article presents data on the relationship of pathogenetic mechanisms for the development of menstrual disorders of functional and organic origin in connection with mental disturbances from the point of view of the psychosomatic concept. According to the latter, functional disorders of the menstrual cycle are considered as psychosomatic, in which gynecological pathology develops as a result of psychopathological illness. A striking example of such a disorder is functional hypothalamic amenorrhea. At the same time, endocrinopathies, such as polycystic ovary syndrome and premature ovarian insufficiency, can also be considered in the paradigm of psychosomatic illnesses of ovarian function due to the high prevalence of anxiety and depressive disorders in this cohort of patients. This review highlights the importance of interdisciplinary collaboration between a gynecologist and a psychiatrist for the most effective reproductive rehabilitation of patients with amenorrhea. Literature search was carried out in national (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The priority was free access to the full text of articles. The choice of sources was prioritized for the period from 2018 to 2023.However, taking into account the insufficient knowledge of the chosen topic, the choice of sources dates back to 1985.

Amenorrhea is a common symptom of a whole range of nosologies among women of reproductive age, which can accompany any endocrinopathy in the stage of decompensation. In all the diversity of various links in the pathogenesis of reproductive disorders, the problem of immunopathology remains a little aside, however, the significance of these disorders is underestimated. This publication provides an overview of immune system abnormalities in a women with amenorrhea. As is known, in polycystic ovary syndrome (PCOS) and premature ovarian insufficiency (POI), one of the clinical manifestations is amenorrhea. On the one hand, these nosologies differ significantly from each other in etiology, pathogenesis and approaches to therapy, and on the other hand, they have a common similarity, manifested by immunological disorders. The article provides information about the immune status of patients with PCOS and POI. Works devoted to various disorders in the immune system, pathologies of humoral and cellular immunity, which in the future may serve as the key to the development of new and non-standard methods of treating such socially significant diseases, are analyzed. Literature search was carried out in national (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The choice of sources was prioritized for the period from 2018 to 2024.

Hyperandrogenism syndrome (HA) is a large group of endocrine diseases that occur due to various pathogenetic mechanisms, but are united by the principle of similar clinical symptoms due to excessive quantity and/or quality (activity) of male sex hormones in the female body. HA is one of the most common pathologies of the endocrine system in women of reproductive age. Patients with HA seek help from various specialists: cosmetic defects — to a cosmetologist, menstrual irregularities and infertility — to a gynecologist, pediatricians (congenital dysfunction of the adrenal cortex), therapists and endocrinologists — remote consequences: dyslipidemia, arterial hypertension and carbohydrate metabolism disorders. Testosterone (T) occupies a key position in the hypothalamus-pituitary-gonads system. In women, it is synthesized by the adrenal cortex, ovarian cells, and is also formed in peripheral tissues. Russian clinical diagnostic laboratories have various diagnostic systems for determining all sorts of biochemical parameters and markers. The accuracy and correctness of the determination depend on the availability of an adequate and accessible method, as well as the characteristics of the woman’s somatic status, for example, the presence of obesity. The emergence and development of modern technology of high-performance liquid chromatography with tandem mass spectrometric detection, which provides high productivity, almost 100% selectivity, the necessary sensitivity and reproducibility, allows using HPLC-MS/MS as a method recommended by clinical guidelines for diagnosing biochemical hyperandrogenism, which allows excluding false diagnoses in routine clinical practice.

The All-Russian Expert Concilium about the influence of combined oral contraceptives on breast tissue took place in the 18th of April 2024 in Moscow. It is necessary to study how to manage controlled risk factors of malign breast tumours. The influence of combined oral contraceptives on female breast tissue is widely discussed due to enlargement of possible estrogen components list. It is also actual to study if the combines oral contraceptives may act as potential enhancer/silencer for benign mammary dysplasia and breast cancer risk. The present article demonstrates. Consensus statement of the Russian society of obstetricians and gynecologists and the Russian association of mammologists on the effect of combined oral contraceptives on breast tissue.

This short message presents main information about Centre for Treatment of Pregnant Females with endocrinopathies. The aim of the present Centre is organization planning and dynamic control of pregnancy for females with endocrinopathies.

Individual sexual and reproductive life management has been сonfirmed by medical and state communities since 1990s. Every citizen officially received rights for access to appropriate goods and services. Such international agreements as 1994 International Conference on Population and Development (ICPD, Cairo, Egypt) and 2004 WHO Reproductive health strategy, estimated reproductive health and family planning as priorities. Worldwide agreement on the 2005 summit declares achieving of female reproductive health before year 2015 as worldwide progress.WHO created complex of international eligibility criteria for male and female contraception with the aim of medical aid improvement. According to WHO plan, those criteria should be used by countries considering policy, needs, priorities and resources of national healthcare programs. For example, USA, United Kingdom, Russia etc. have successfully adopted medical eligibility criteria for contraception on the national level.The present review is summary product created by interdisciplinary expert group including representers of federal and regional healthcare establishments, medical universities, and international medical organizations.

This article presents the historical review of establishment and formation of Endocrine Gynecology Department (Endocrinology Research Centre, Moscow, Russian Federation) since 1960 until 2024s. The basic aim of establishment of the Endocrine Gynecology Department are organization and providing of conservative and surgery medical aid for female patients with reproductive pathologies and endocrinopathies. The members of the Department also provide scientifical and educational work in the area of personalized diagnostic and treatment approaches of reproductive pathologies. The review is supplied with evolutionary, historical and biographical datas about all leaders of Department throughout its history. Authors group dedicates the present article to scientific supervisors and mentors.

Constant improvement of professional skills and competence are essential components of modern post diploma medical education in the 21st century. Despite of world-wide spread of evidence-based medicine many physicians from such areas as obstetrics, gynecology, andrology, endocrinology, cardiology. gerontology etc. still use outdated and incorrect terminology from reproductive medicine. The such unfavourable trend leads to serious increasement of insufficient/overdiagnosis, treatment mistakes and poor outcomes such as sexual dysfunction, infertility and comorbidity. The present article presents actual interpretations and characterization of gynecological and andrological terms such us menopausal hormonal therapy (MHT) and hormone replacement therapy (HRT) among females and male hypogonadism.

Introduction. Bladder obstruction caused by benign prostatic hyperplasia (BPH) is common disease among males with diabetes mellitus (T2DM). Objective. To evaluate lower urinary tract symptoms (LUTS) and clinical outcomes among patients with/without DM2T after undergoing transurethral resection prostate (TURP). Materials and methods. Retrospective study based on medical data throughout 1,5 years (2021–2022 гг.) and participation of 48 diabetic and non-diabetic patients with persistent LUTS who also have underwent TURP for BPH. Results. Patients with DM2T show higher prevalence of cardiovascular diseases (р=0,01). They also show higher need for alpha-blockers during 1-12 months after TURP for urinary dysorders (OR=5,5, 95% CI: 1,42–21,30, р=0,01). Discussion. Wide-population prospective clinical studies are needed for creating of effective personalized strategies. Conclusion. Patients with T2DM more often need alpha-blockers within 1-12 months after TURP. T2DM leads to higher rate of post-surgery urinary retention and worse results compared with non-diabetic patients.

BACKGROUND:In recent years, the incidence of gynecomastia in adult men has increased significantly. It is of interest to study the specific features of the disease in these patients. AIM:To identify the main characteristics of acute gynecomastia in adult men. MATERIALS AND METHODS:A continuous one-stage study including 160 adult males with acute onset gynecomastia, who were he was treated in Endocrinology Research Centre, Moscow. Total bilirubin, hepatic transaminases, creatinine, urea, luteinizing hormone, prolactin, sex hormone binding globulin, estradiol, total testosterone, alpha-fetoprotein, chorionic gonadotropin and mammary gland condition were evaluated in all patients. Baseline significance threshold level of p&lt;0.05. RESULTS:The incidence of gynecomastia increased from 5,4% in 2020 to 14,4% in 2024. Tumor forms of gynecomastia were rare, with 1,2% (95% CI 0,0; 3,0) of cases. In 30% (95% CI 22,9; 37,1) of men, gynecomastia was due to the intake of anabolic steroids for athletic stimulation. In 11,2% (95% CI 6,4; 16,1) of patients, gynecomastia was hepatogenic. In 7,5% (95% CI 3,4; 11,6), it was due to elevated sex hormone binding globulin. 47,5% (95% CI 39,8; 55,2) were endocrine non-tumorigenic form of gynecomastia due to excess body weight with formation of changes in sex hormone levels. The patients who took anabolic steroids were characterized by young age, as well as decreased luteinizing hormone levels and increased testosterone levels. The group of patients with elevated sex hormone binding globulin had no clinically significant features. Men from the group of hepatogenic gynecomastia were characterized by hyperestrogenism. Patients in the group with altered sex hormone levels were characterized by high body mass index and either increased estradiol or decreased testosterone or a combination of both. CONCLUSION:The number of adult male patients with acute gynecomastia is progressively increasing. In the examined sample of patients, the main causes of gynecomastia were patients taking anabolic steroids, liver dysfunction and weight gain with the formation of changes in sex hormone levels. Patients taking anabolic steroids were characterized by a drug--induced increase in testosterone and estradiol levels, which was accompanied by suppression of pituitary gonadotropic function. Estradiol elevation was also characteristic of patients with hepatogenic form of gynecomastia and men with excess body weight with formation of changes in sex hormone levels.

On November 3, 2024, professor of the Cathedra of Obstetrics, Gynecology and Reproductive Medicine of the Russian University of Medicine, Doctor of Medical Sciences, prominent scientist, lecturer and doctor Marianna A. Gevorkyan died at the age of 68

BACKGROUND : 2025 is going to be the 100th anniversary of the first historical description of Turner syndrome — complex of genomic abnormalities, congenital gonadal disruption and hypergonadotropic hypogonadism. Total estrogenic deficiency triggers development of age-related comorbidities. There is no doubt that personalized search for replicative markers of cellular aging among females with Turner syndrome is needed. AIM: To evaluate features of replicative (telomere length) and biochemical (lipid profile, calcium-phosphate album, thyroid hormones, markers cytolysis and cholestasis, carbohydrate metabolism, nitrogenic metabolism, electrolytes, FSH) markers among females with Turner syndrome. MATERIALS AND METHODS . Research has been provided in collaboration between Endocrinology Research Centre of the Russian Ministry of Health and Lomonosov Moscow State University Medical Research and Educational Centre in the period since 10.01.2021 until 01.08.2022. Females with non-iatrogenic hypergonadotropic hypogonadism caused by Turner syndrome (45,X0; 45,X/46,XX; 45,X/46,X,r(X); 13–40 y.o.; n=26) and primary ovarian insufficiency (18–39 нyears=26); healthy females of reproductive age (15–49 y.o.; n=24). Patients have undergone laboratory genetic (leucocyte telomere length), biochemical (fasting glycaemia, urea, creatinine, common/conjugated bilirubin, ALT, AST, gamma-glutamyl transferase, triglycerides, HDL-P, LDL-P, common cholesterol, common/ionized calcium, phosphate, vitamin D, sodium/potassium/chlorides, FSH, HbA1c) analyses. Body measurements — body mass, body height. DNA extraction — provided with Qiagen DNA blood mini kit (Germany). Leukocyte telomere length — with real-time polymerase chain reaction PCR (Flow-fish). Soft program IBM SPSS Statistics (version 26,0 for Windows). RESULTS. 1. Females with Turner syndrome have significantly lower mean telomere length (8,22 kB [6,63–9,30]) than with primary ovarian insufficiency (10, 34 кБ [8,41–13,08], p<0,001) and healthy reproductive age females (10,77 kB [9,95–13,16], р>0,05). 2. Telomere length correlates directly and significantly with longevity of menopausal hormonal therapy among females with primary ovarian insufficiency (ρ = 505; p<0,001). 3. Patients with Turner syndrome are inclined to vitamin D deficiency (р<0,001), dyslipidemia (р=0,01); increase of levels of aminotransferases, cholestasis markers, phosphate and FSH (р<0,001). CONCLUSION. Turner syndrome is serious genetic disease that leads not only to infertility but to significant decrease of quality/life longevity out of “healthy aging” conception.