Gynecology

SciteSore by SCOPUS

 

 

About

Gynecology is the peer-review journal dedicated to providing the very latest information in clinical and research fields related to a wide range of topics in obstetrics, gynecology and women’s health. 

The journal publishes editorial conference updates, original research, reviews, clinical case reports, commentaries, clinical and laboratory observations by Russian and international authors, pertinent to readers in CIS countries and around the world.

The Journal emphasizes vigorous peer-reviewing and accepts papers in Russian and English with most rapid turnaround time possible from submission to publication. Abstracts for all papers are available in both languages.

It has served the interests of gynecologists, endocrinologists and all other professionals in gynecology and women's health by providing on bimonthly basis clinical information and practical recommendations to various aspects in the field of women's health. 

Special area focus/ journal sections:

  • Inflammatory diseases of the pelvic organs
  • Endometriosis
  • Contraception
  • Pregnancy failure
  • Hysteromyoma
  • Current methods of diagnosis and treatment

The journal welcomes papers both from researcher and clinical gynecologist, endocrinologist and pharmacologist from all around the globe to deliver up-to-date and authoritative coverage of leading research and clinical practice relevant to specialists in CIS and other countries. 

 

Publications

Bimonthly issues publish since 1999 in print and online in Open Access under the Creative Commons NC-SA 4.0 International Licensee.

 

Editor-in-Chief

Vera N.Prilepskaya
MD, PhD, Professor
ORCID: https://orcid.org/0000-0003-3993-7629

 

Indexation

  • SCOPUS
  • Russian Science Citation Index (RSCI) on Web of Science
  • Core Collection on e-library.ru
  • Directory of Open Access Journals (DOAJ)
  • Ulrich’s Periodicals Directory
  • Dimensions
  • WorldCat
  • EBSCO
  • VINITI Database RAS
  • ROAD

Announcements More Announcements...

 
No announcements have been published.

Current Issue

Vol 27, No 3 (2025)

Full Issue

REVIEW

The role of microbiota in the etiology of dysplastic and oncological diseases of the cervix, vagina, and vulva: A review
Mgeryan A.N., Prilepskaya V.N., Dovletkhanova E.R., Abakarova P.R., Mejevitinova E.A.
Abstract

The vaginal microbiota of a healthy woman is a unique microecosystem comprising more than 300 bacterial species. The main vaginal bacteria of a healthy woman are Lactobacillus spp. (90–95%), with the most common being L. crispatus, L. iners, L. jensenii, and L. gasseri. Based on the dominant Lactobacillus species, five types of communities are distinguished: CST I, II, III, IV, and V. Lactobacilli ensure a normal vaginal pH (3.8–4.4) and inhibit the growth of other microorganisms, particularly Escherichia coli, Trichomonas vaginalis, Gardnerella vaginalis, Prevotella bivia, etc. Different lactobacilli species produce different levels of reactive oxygen species. Many studies demonstrated a close relationship between vaginal microbiota disturbance and the development of malignancies, particularly cervical, vagina, and vulvar cancer. This review analyzes published studies, which showed a positive correlation between a low content of lactobacilli, an increase in the abundance of pathogenic bacteria, and cancer of the anogenital region; the association between some bacteria, the persistence of the human papillomavirus, and the development of dysplasia of the lower reproductive system was demonstrated. Timely diagnosis and treatment of vulvovaginal infections and vaginal dysbiosis would reduce the risk of human papillomavirus persistence and, consequently, the development of dysplasia and cancers of the lower genital tract.

Gynecology. 2025;27(3):176-182
pages 176-182 views
Iron deficiency and von Willebrand disease: the relationship and interdisciplinary approach. A review and own data
Vinogradova M.А.
Abstract

Iron deficiency conditions are common for clinical practice especially in women of reproductive age. In coagulopathies, chronic blood loss, in particular heavy menstrual bleeding, becomes the main cause of iron deficiency anemia. The most common form of coagulopathy is von Willebrand disease, and if its severe forms are established in childhood, then mild ones can proceed latent for a long time. Iron deficiency not only worsens the quality of life but can also complicate the course of the underlying disease, creating a vicious circle. Management of such patients is a clinical challenge and requires a comprehensive interdisciplinary approach: timely diagnosis, assessment of the volume of blood loss, its correction, selection of the optimal scheme for replenishing iron deficiency and mandatory elimination of the main hemostasis disorder. This article discusses modern principles of diagnosis and therapy of iron deficiency in women with coagulopathies. The patient model for a preventive approach is presented. The basis of therapy in case of persistent excessive blood loss are iron preparations for parenteral administration, in particular, ferric carboxymaltose. The timely administration of adequate doses of a well-tolerated iron preparation, which became possible with the advent of ferric carboxymaltose, makes it possible to prevent severe forms of anemia and improve the patients’ quality of life.

Gynecology. 2025;27(3):183-189
pages 183-189 views
Combined oral contraceptives with estetrol: Reduced risk of thrombosis and other benefits. A review
Podzolkova N.M., Korennaya V.V., Sumyatina L.V., Golubenko E.O.
Abstract

Demographic trends indicate a decrease in the number of children per woman, a change in reproductive patterns and a late age of motherhood. These factors increase the importance of effective contraception. The article is devoted to the study of current trends in the use of combined oral contraceptives (COCs) with estherol (E4). E4 is a new estrogen secreted by the fetus during pregnancy. The focus is on estherol's unique pharmacological profile, its effects on various tissues and organs of the female body, as well as its potential advantages over traditional synthetic estrogens such as ethinyl estradiol. A distinctive feature of E4 is its ability to selectively affect different types of tissues and organs, which reduces the risk of side effects. E4 has minimal effect on the hemostasis system, reduces the risk of venous thromboembolic complications. Preclinical and clinical studies confirm the absence of a proliferative effect of E4 on breast cancer cells, which makes it a promising candidate for the development of new selective estrogen receptor modulators. Taking COCs with E4 is not accompanied by significant changes in the metabolic profile, provides weight control and maintains blood pressure stability. Multicenter studies have confirmed the high efficacy and acceptability of COCs with E4, a low percentage of serious adverse events, and a high degree of user satisfaction.

Gynecology. 2025;27(3):190-197
pages 190-197 views
Dysmenorrhea associated with endometriosis in adolescents: Is there a therapy? A review
Orazov M.R., Radzinskiy V.E., Dolgov Е.D.
Abstract

Endometriosis is now recognized as a significant issue in the global health system. According to the available data, endometriosis affects women not only of reproductive age, but also other age cohorts. Recent studies demonstrate that the clinical manifestation of the disease is present in absolute prevalence long before adulthood. Dysmenorrhea and pelvic pain often begin in adolescence, negatively affecting learning, daily activities, and interpersonal relationships. In addition, adolescent patients have several not only medical, but also social characteristics, which require adjustments to the clinical management of endometriosis. Underestimation of the severity of disease symptoms in adolescents leads to a significant progression of severe forms with a negative impact on fertility. The article discusses the characteristics of the clinical course of adolescent endometriosis and outlines the management of patients in accordance with current Russian and international guidelines. Given the diverse symptoms of endometriosis and the high prevalence of other pain syndromes in adolescents, it is recommended to use a multidisciplinary approach to treatment whenever possible; in particular, it should involve a pediatrician, algologists, and medical psychologists, in order to reduce pain sensitivity and eliminate concomitant mood disorders. In the pharmacological arsenal, there is an option for effective treatment of adolescent endometriosis − a combined oral contraceptive based on ethinyl estradiol and dienogest, which effectively suppresses the pathogenetic cascade of endometriosis, relieves clinical symptoms, and improves the quality of life for patients in this cohort.

Gynecology. 2025;27(3):198-202
pages 198-202 views
Stress-dependent menstrual disorders: The current state of the problem. A review
Podzolkova N.M., Glazkova O.L., Cheporev L.А., Mass E.E., Sumyatina L.V.
Abstract

Changing the features of the menstrual cycle to certain limits up to a short anovulation can be considered as a normal and transient response to adverse living conditions, including stress factors. The line separating such a normal reaction from a disease is very fluid and can be crossed in the setting of a predisposition. Stressful exposures include objectively adverse and subjectively significant factors of different duration and intensity. The predisposition to menstrual irregularities can have genetic prerequisites and be triggered by epigenetic factors. This literature review provides up-to-date data on the issue of stress-dependent menstrual disorders. Due to the significant role of prolactin metabolism disorders in the etiology of such disorders, the prospects of using plant-origin dopaminomimetics, including in young patients, have been considered.

Gynecology. 2025;27(3):203-208
pages 203-208 views
Ultrasound features of the internal genitalia functional anatomy in the early postmenarcheal period. A review
Istomina N.G., Razdrogina K.A., Baranov A.N.
Abstract

Early postmenarche, the period from the first menstruation to the end of puberty, is a critical stage in the formation of reproductive function, during which the functional adjustment of the hypothalamus-pituitary-ovarian axis occurs, providing a transition from anovulatory to ovulatory menstrual cycles. The purpose of the study was to summarize current data on the physiological mechanisms of the formation of ovulatory function and neuroendocrine regulation of the menstrual cycle, as well as to characterize the ultrasound features of the reproductive organs during this period. In this context, the emphasis should shift from formal signs to individual trajectories of menstrual cycle development and ovulatory function. Clinical and instrumental observations during this period should include regular evaluation of menstrual cycle characteristics, changes in ovarian volume and morphology over time, the presence of a dominant follicle, as well as the ovarian/uterine ratio. The presented data emphasize the importance of the early postmenarcheal period as a sensitive window for the diagnosis and potential correction of reproductive development disorders.

Gynecology. 2025;27(3):209-214
pages 209-214 views
Various aspects of connective tissue dysplasia in the context of obstetric and gynecological practice. To know so as not to lose. A review
Ahmetyanova G.R., Mateykovich E.A., Legalova T.V., Drozdova N.V.
Abstract

Currently, the problem of connective tissue dysplasia (CTD) remains a significant concern. Its manifestations are highly variable, including in obstetric and gynecological practice. Therefore, it is necessary to address complications of pregnancy associated with CTD. We reviewed key papers, primarily published between 2018 and 2024, on CTD in obstetric and gynecological practice by authors from Russia and the CIS countries, given the virtual absence of scientific publications on this topic in the foreign literature. These data confirm the presence of such a pathology as CTD in women of reproductive age, which can become a trigger for a complicated course of pregnancy. The issues of diagnosis, prevention, and treatment of this disorder remain relevant; therefore, further research is necessary in this area to develop algorithms for the prevention and management of patients with CTD.

Gynecology. 2025;27(3):216-222
pages 216-222 views

ORIGINAL ARTICLE

Obstetric trauma in the etiology of genital prolapse: Clinical and pathogenetic analysis. Case control study
Orazov M.R., Radzinskiy V.E., Minnullina F.F.
Abstract

Background. Pelvic organ prolapse (POP) is a significant medical and social problem with a high prevalence and an upward trend in the incidence. It significantly impacts the quality of life and tends to relapse after surgical treatment of the supporting structures of the pelvic floor. Despite the proven association of POPs with obstetric traumas, their role remains poorly understood.

Aim. To assess the frequency of obstetric traumas in patients with POP and determine the directions for their prevention.

Materials and methods. A prospective case-controlled study was conducted involving 210 women (150 patients with POP and 60 control patients) who underwent surgical treatment in 2023–2024. Obstetric history was reviewed, including perineal trauma, episio-/perineotomy, large foetus, type of delivery.

Results. The absolute number of births did not affect the risk of POP (p>0.05); however, the complicated course of labor was a key predictor; in patients with obstetric traumas, the risk was 4.2 times higher (relative risk – RR 4.20, 95% confidence interval – CI 1.68–8.78), with episio-/perineotomy – 8.8 times higher (RR 8.80, 95% CI 1.9–18.6), with fetal macrosomy – 5.4 times higher (RR 5.40, 95% CI 3.35–13.43). Cesarean section did not show a protective effect on POP prevention (p>0.05).

Conclusion. Obstetric traumas are a significant but partially modifiable risk factor for POP. Prevention of macrosomia, avoidance of routine episiotomy, and minimization of obstetric traumas are key areas for reducing the POP incidence.

Gynecology. 2025;27(3):223-227
pages 223-227 views
Implementation of the idea of a precision approach in the preoperative preparation of patients before hysteroscopy. An prospective study
Tazina T.V., Gabanyan Y.V.
Abstract

Background. Currently, hysteroscopy is considered the "gold standard" for the diagnosis and treatment of intrauterine pathology. Diagnostic and surgical hysteroscopies are one of the most common interventions in gynecology. Despite the recognized safety of hysteroscopy, the procedure is not without risks, which does not allow it to be considered a simple operation. Therefore, the safety issues of hysteroscopy remain relevant.

Aim. To assess the benefits of preoperative preparation with a topical antimicrobial for the prevention of infectious and inflammatory complications after hysteroscopy.

Materials and methods. The study was conducted at the clinical bases of the Department of Obstetrics and Gynecology of the Pavlov Ryazan State Medical University and the Group of Companies "MEDSI" clinics in the period from February 2023 to August 2024. The prospective study included 143 women aged 18 to 45 years admitted to gynecological departments for diagnostic hysteroscopy due to abnormal uterine bleeding and infertility. Microscopic examination in all patients showed an intermediate type of smear combined with absolute or conditional normocenosis according to real-time polymerase chain reaction data. Patients were randomized into two groups. The experimental group included 72 patients receiving a combined topical gynecological antimicrobial agent, Elgina, in the preoperative period to prevent infectious and inflammatory complications after hysteroscopy. The control group included 71 patients who did not receive this therapy. Elgina (vaginal tablets with applicator, JSC WERTEKS, Russia) was administered intravaginally, 1 vaginal tablet daily for 6 days before bedtime. Elgina contains neomycin sulfate, ornidazole, prednisolone sodium phosphate, and econazole nitrate.

Results. No cases of infectious and inflammatory postoperative complications were reported in the group of patients who underwent preoperative correction of vaginal microbiocenosis with Elgina. In the control group, 5 (7%) patients received anti-inflammatory, antimicrobial, infusion, transfusion, and desensitization therapy due to the development of pelvic inflammatory complications after hysteroscopy.

Conclusion. A personalized approach to the preoperative preparation of patients before hysteroscopy can prevent infectious and inflammatory complications after the procedure. The study demonstrated the benefits of preoperative use of Elgina (vaginal tablets with an applicator) in patients with an intermediate type of smear combined with absolute or conditional normocenosis according to polymerase chain reaction.

Gynecology. 2025;27(3):228-234
pages 228-234 views
Markers of the intrinsic apoptosis pathway in reproductive-age women with various intrauterine pathologies. A retrospective study
Damirov M.M., Ierusalimskiy A.P., Borovkova N.V., Yurchenko O.B., Storozheva M.V., Nefedova G.A.
Abstract

Background. In recent decades, the frequency of various intrauterine pathologies (IUPs) has increased, which is diagnosed in 38–72% of women of reproductive age. An imbalance in cell proliferation, differentiation, and death plays a crucial role in the pathogenesis of IUPs.

Aim. To determine the content of proteins regulating the internal pathway of apoptosis in endometrial cells and circulating lymphocytes in patients of reproductive age with various IUPs.

Materials and methods. A comprehensive clinical, instrumental, and biochemical assessment was conducted in 47 women of reproductive age (mean age was 39.5±2.74 years) with various IUPs. Clinical, ultrasound, hysteroscopic, morphological, and biochemical methods were used in all patients.

Results. In patients with an endometrial polyp, the most pronounced imbalance of apoptotic factors was detected. In such patients, a statistically significant increase in the Bcl-2 anti-apoptotic protein was observed in the endometrium, as well as a considerable increase in pro-apoptotic factors, including p53 protein, cytochrome C, and cleaved PARP, compared to female subjects without IUPs. The simultaneous elevation in Bcl-2 was determined in circulating lymphocytes.

Conclusion. The combination of clinical, instrumental, and biochemical methods of examination enhances the accuracy of diagnosing various IUPs. Interpretation of clinical data should be carried out taking into account the results of instrumental and biochemical research, which will optimize treatment tactics and prevent the likelihood of disease recurrence.

Gynecology. 2025;27(3):235-240
pages 235-240 views
Reproductive health of future doctors: Assessment of the state and influencing factors
Matyushkina L.S., Dell S.S., Shchetinina P.O., Zhurman V.N.
Abstract

Background. Preserving the reproductive health of medical university students and their awareness of key prevention issues and maintenance of reproductive potential are relevant.

Aim. To analyze the state of reproductive health of female medical students and identify adverse factors.

Materials and methods. The study included 115 female medical students, who filled a questionnaire. Statistical analysis was performed by calculating frequencies and fractions. To identify correlations, the Pearson contingency coefficient was calculated. Chi-square test was used to check the significance of the relationships.

Results. During the study, key indicators reflecting the state of the reproductive organs were identified. The analysis of correlations between lifestyle factors of female students and menstrual symptoms showed a positive correlation between the presence of chronic diseases and the age of students, cyclic mastalgia, and symptoms of premenstrual syndrome.

Conclusion. Low physical activity and stress (especially chronic stress) activate the sympathetic nervous system and release cortisol, which also has an adverse effect on hormones and aggravates menstrual symptoms such as dysmenorrhea (painful menstruation), premenstrual syndrome, and menstrual irregularities. The combination of several adverse factors typical for a medical student creates a vicious circle with physiological and psychological problems enhancing each other, leading to a significant decrease in the quality of life and academic performance of female students.

Gynecology. 2025;27(3):241-246
pages 241-246 views
Minimally invasive methods of correction of involutive changes in the genitals and stress urinary incontinence in females using implants based on hyaluronic acid modified with polyethylene glycol diglycidyl ether: A prospective study
Kakhiani M.I., Rusina I.E., Kopteeva Е.V.
Abstract

Background. Surgical interventions for early forms of pelvic organ prolapse and urinary incontinence may be associated with a risk of complications. Correction using hyaluronic acid (HA)-based implants is a modern, minimally invasive technique. Its outcomes depend on the properties of the drugs used and require clarification.

Aim. To evaluate the efficacy and safety of soft tissue implants for intimate contouring and urinary incontinence repair using HA modified with polyethylene glycol diglycidyl ether (PEGDE), REPART G.

Materials and methods. The study included 30 females with a mean age of 45±5.5 years. The patients were divided into two groups: Group 1 (n=15) with mild and moderate stress urinary incontinence (SUI) and Group 2 (n=15) with involutive genital changes. Routine perineological examination methods were used to assess the condition before treatment: gynecological examination, Valsalva test, cough test, assessment of the degree of pelvic organ prolapse according to the POP-Q classification, and pelvic floor muscle strength according to the Oxford scale. Before the treatment and 3 months after the treatment, the frequency of incontinence and sexual dysfunction was compared using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, PISQ-12. To confirm the diagnosis of SUI, Group 1 patients underwent a comprehensive urodynamic examination (according to ICS guidelines), as well as an ultrasound of the urethrovesical segment and perineum before the treatment and 2 weeks, 6, and 9 months after the treatment. In Group 1, patients received paraurethral injections of the 24 mg/mL REPART G Deep implant at 4 points (0, 3, 6, 9 o’clock positions), 1.0 mL at each point. In Group 2, contouring was performed by injecting 1–4 mL (depending on the amount required for the correction of the existing defect) of the REPART G Normal implant.

Results. Questionnaires showed significant improvements in certain aspects of sexual function and a decrease in the frequency of urinary incontinence episodes after treatment. Patients with urinary incontinence demonstrated a significant improvement in the ultrasound parameters of the urethrovesical segment in the early stages, with a partial return to baseline by Month 9 after treatment. Adverse reactions were rare, transient, and had no impact on the overall aesthetic and functional effect.

Conclusion. Soft tissue implants based on HA modified with polyethylene glycol diglycidyl ether (PEGDE), REPART G, demonstrated a good tolerance and significant improvement in tissue structure, urological symptoms, and sexual function in the correction of mild SUI and involuntary changes in the genital area. They enable delicate and safe restoration of the tissue structure, reducing the severity of symptoms in case of age-related tissue changes.

Gynecology. 2025;27(3):247-254
pages 247-254 views

CLINICAL CASE

Surgical management of cystic adenomyosis (adenomyoma) in a 17-year-old female patient: A clinical case
Rukhliada N.N., Nasyrov R.A., Taits A.N., Reznik V.А., Krivolesova T.A., Dudova K.A., Krasnogorskaya O.L.
Abstract

Adenomyosis is a common form of endometriosis that affects fertility and is one of the leading causes of dysmenorrhea. It is typical for women aged 35–50. The most common form is diffuse adenomyosis, while focal adenomyosis, a cystic variant, is very rare, especially in patients younger than 30. The main diagnostic methods are ultrasonic examination and magnetic resonance imaging. The article presents a rare clinical case of cystic juvenile adenomyosis in a 17-year-old adolescent girl with severe primary dysmenorrhea who underwent organ-sparing surgical treatment to preserve fertility and eliminate pain. Pathohistological examination confirmed the cystic form of adenomyosis. Forty days after the surgery, painless menstruation occurred; thus, complete pain relief without hormone therapy was achieved.

Gynecology. 2025;27(3):255-259
pages 255-259 views