Sexual dysfunction as an early marker of endometriosis

Preserving the nation’s reproductive health is an important medical and governmental concern. A significant decrease in fertility has led to that Ukraine is among the eight European countries with the lowest levels of childbearing activity [1]. It is now recognized that the quality of life depends on the realization of its reproductive and sexual function. Much attention is paid to the study of the sexual health of women, since disorders in the female sexual sphere are linked to women’s personality disorders and affect relationships in the family and society. Indicators such as spiritual, physical, social, reproductive and sexual health are included in determining a woman’s overall health. All of these components are continuously interconnected [3, 4]. The frequency of disorders of sexual function in women varies widely: from 15 to 45 %, depending on the characteristics of the study population [4]. The basic physiological processes that ensure sexual function of a person are regulated by the endocrine and nervous systems. The neuroendocrine system is the basis of female sexuality: it provides excitement of the corresponding nervous structures responsible for sexual reactions, supports the energy component of sexual desire, sexual motivation (sexual centers of the hypothalamus, which affect the sexual centers of the spinal cord, which in turn regulate the system and cerebral cortex) [5]. Traditionally, disorders of sexual function in women of reproductive age are associated with a number of factors such as birth trauma, chronic stress caused by various experiences and illnesses, environmental impact [6, 7]. To date, there have been isolated reports of the effect of endometriosis on female sexual function [8]. Endometriosis is a disease characterized by the presence of endometrial glands and stroma outside the uterine cavity. It is believed that this disease can occur in 75% of women with gynecological diseases, hyperproliferative processes against the background of high estrogen levels and progesterone deficiency, infertility [9—14]. International population surveys have shown that delaying the diagnosis of endometriosis and prescribing adequate treatment lasts on average 6—7 years from the onset of the first symptoms of the disease, with a woman previously visiting at least 7 doctors of different specialties [15—18]. The economic costs of disability, treatment and rehabilitation are about $ 70 billion per year [15—18]. Therefore, early diagnosis of endometriosis is extremely important in terms of maintaining a woman’s fertile function. Despite numerous publications regarding clinical signs of endometriosis, we have not found any available reports in the available literature to reduce lubrication as a possible marker of external-internal endometriosis. L. M. Semeniuk 1, L. V. Demyanenko 1, L. S. Chernukha 1, O. I. Kryzhanovska 2

Preserving the nation's reproductive health is an important medical and governmental concern. A significant decrease in fertility has led to that Ukraine is among the eight European countries with the lowest levels of childbearing activity [1]. It is now recognized that the quality of life depends on the realization of its reproductive and sexual function. Much attention is paid to the study of the sexual health of women, since disorders in the female sexual sphere are linked to women's personality disorders and affect relationships in the family and society. Indicators such as spiritual, physical, social, reproductive and sexual health are included in determining a woman's overall health. All of these components are continuously interconnected [3,4].
The frequency of disorders of sexual function in women varies widely: from 15 to 45 %, depending on the characteristics of the study population [4].
The basic physiological processes that ensure sexual function of a person are regulated by the endocrine and nervous systems. The neuroendocrine system is the basis of female sexuality: it provides excitement of the corresponding nervous structures responsible for sexual reactions, supports the energy component of sexual desire, sexual motivation (sexual centers of the hypothalamus, which affect the sexual centers of the spinal cord, which in turn regulate the system and cerebral cortex) [5].
Traditionally, disorders of sexual function in women of reproductive age are associated with a number of factors such as birth trauma, chronic stress caused by various experiences and illnesses, environmental impact [6, 7]. To date, there have been isolated reports of the effect of endometriosis on female sexual function Endometriosis is a disease characterized by the presence of endometrial glands and stroma outside the uterine cavity. It is believed that this disease can occur in 75% of women with gynecological diseases, hyperproliferative processes against the background of high estrogen levels and progesterone deficiency, infertility [9][10][11][12][13][14].
International population surveys have shown that delaying the diagnosis of endometriosis and prescribing adequate treatment lasts on average 6-7 years from the onset of the first symptoms of the disease, with a woman previously visiting at least 7 doctors of different specialties [15][16][17][18]. The economic costs of disability, treatment and rehabilitation are about $ 70 billion per year [15][16][17][18]. Therefore, early diagnosis of endometriosis is extremely important in terms of maintaining a woman's fertile function.
Despite numerous publications regarding clinical signs of endometriosis, we have not found any available reports in the available literature to reduce lubrication as a possible marker of external-internal endometriosis. On the other hand, many scientists have recognized the hormonal dependence of endometriosis, and only a slight decrease in steroidogenic ovarian function, which is manifested not by a pronounced inferiority of the yellow body and anovulation. This speaks in favor of changes in the rhythmicity of gonadotropinreleasing hormone secretion in patients with endometriosis [19].
We want to cite a clinical case early diagnosis of 2-sided small ovarian endometriomas in a woman of early reproductive age with decreased lubrication.
The survey is conducted within the framework of the research work of the Department of Reproductive In the gynecological anamnesis of special disturbances it is not revealed: menstrual cycle is regular, menstruation from 13 years, 5 days, moderate, sensitive on the first day of the cycle. The woman is married, planning a pregnancy. There were no surgical interventions. The gynecologist visits regularly. Last review 8 months ago (June 2020) -cytology of NILM, normoflora. Ultrasound examination of the pathology was not noted. The structure of the ovaries corresponded to the phase of the menstrual cycle (proliferative, 8 mm). Ultrasound screening (17th dmc -February 2012) revealed changes in the left ovary, which were regarded as LUF syndrome or hemorrhagic cyst of the yellow body. We recommend a hormonal examination for 5-7 days of the menstrual cycle, determination of the level of the tumor marker of the ovary CA-125 before -and after menstruation, ULTM ultrasound on the apparatus of expert class.
According to the results of hormonal examination revealed changes characteristic of impaired conditions of complete maturation of the follicle: at the normal The patient is prescribed individualized therapy aimed at the main links of the etiopathogenesis of the disease and the correction of vitamin D.
Thus, a decrease in lubrication may be an early marker of ovarian endometriosis and may be accompanied by functional hypoestrogenism caused by impaired ovarian folliculogenesis amid vitamin D deficiency. The article reflects the main components of a woman's health; it isstated that a person's quality of life depends on the realization of her reproductive and sexual functions. Traditionally, sexual dysfunctionin wo men of reproductive age is associated with a number of factors such as trauma during childbirth through the natural birth canal, chronic stress caused by various experiences and illnesses, and environmental influences. Endometriosis is a disease characterized by the presence of endometrial glands and stroma outside the uterine cavity. It is believed that this disease can occur in 75 % of women with various gynecological symptoms. Endometriosis has devastating consequences for women's reproductive health, and the economic costs associated with disability, treatment and rehabilitation are about $ 70 billion a year. The traditional clinical signs of endometriosis include menstrual irregularities, pain, and infertility. International population studies have shown that the delay in diagnosing endometriosis and starting of adequate treatment is on average 6-7 years from the onset of the first symptoms of the disease, which leads to irreversible changes in the female reproductive organs. The first stage of treatment of endometriosis is initiation therapy, aimed at stabilizing proliferative processes, restoring conditions favorable for growth and functioning off ollicles, restoring steroid and immunebalances. Estrogen dysfunction creates epigeneticconditions for the progression of endometriosis. Functional hypoestrogenismin women with sexual dysfunction requires non-traditional approaches to treatment. Criteria for treatment effectiveness are regression of end ometriosis foci, restoration of endometrial receptors, absence of pain syndrome, prevention of new fociof endometriosis, restoration off ertility in the natural cycle.
A clinical case of sexual dysfunction(a decrease in lubrication) in a woman of early reproductive age,as an early sign of endometrioid ovarian lesion, is presented.