INFLAMMATORY DISEASES OF THE PELVIC ORGANS AND CHANGES IN THE MAMMARY GLAND IN WOMEN OF REPRODUCTIVE AGE
Keywords:
Pelvic Inflammatory Disease (PID), Reproductive Age, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Antibiotic Therapy, Complications, Tubal Infertility, Chronic Pelvic Pain, Prevention, STI Screening, Antimicrobial Resistance.Abstract
This review summarizes current data (2018-2024) on pelvic inflammatory diseases (PID) in women of reproductive age. The main pathogens are Chlamydia trachomatis (20-40%), Neisseria gonorrhoeae (10-20%) and Mycoplasma genitalium (up to 25%). Diagnosis is based on clinical criteria (CDC), NAAT tests and ultrasound. Empirical treatment includes ceftriaxone, doxycycline ± metronidazole, but is complicated by increasing resistance. Remote consequences are severe: infertility (up to 40% after 3 episodes), ectopic pregnancy (risk ↑6-10 times), chronic pelvic pain (15-30%). Key prevention measures are screening for STIs and treatment of partners. Early diagnosis and adequate therapy are critical to maintaining reproductive health.
References
American College of Radiology (ACR). ACR Appropriateness Criteria® Breast Pain. Revised 2022. https://acsearch.acr.org/docs/69446/Narrative/
Bhattacharya S, Gupta M. Hormonal interplay in benign breast disorders: a comprehensive review. Horm Mol Biol Clin Investig. 2021;42(3):281-288. doi:10.1515/hmbci-2020-0065
Gierisch JM, Coeytaux RR, Urrutia RP, et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomarkers Prev. 2023;32(6):735-747. doi:10.1158/1055-9965.EPI-22-1086
Groer MW, Jevitt CM, Ji M. Immune and HPA axis responses to chronic pelvic pain and comorbid symptoms. Biol Res Nurs. 2020;22(1):119-128. doi:10.1177/1099800419889675
Khan SA, Apkarian AV. Chronic pelvic pain: a review of pathophysiology, biomarkers, and treatment options. Pain Med. 2021;22(Suppl 1):S4-S14. doi:10.1093/pm/pnaa473
Kudratovna A. F. ВОСПАЛИТЕЛЬНЫЕ ЗАБОЛЕВАНИЯ В ГИНЕКОЛОГИИ И НОВЫЕ МЕТОДЫ ИХ ДИАГНОСТИКИ И ЛЕЧЕНИЯ //Eurasian Journal of Medical and Natural Sciences. – 2024. – Т. 5. – №. 1. – С. 7-12.
Libby P. Inflammatory mechanisms: the molecular basis of inflammation and disease. Nutr Rev. 2023;81(Suppl 1):1-13. doi:10.1093/nutrit/nuac073
Melmed S, Casanueva FF, Hoffman AR, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2023;108(5):e1-e33. doi:10.1210/clinem/dgad034
National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Risk Reduction. Version 1.2024. https://www.nccn.org/professionals/physician_gls/pdf/breast_risk.pdf (Разделы по доброкачественным изменениям и факторам риска)
Peters F, Schuth W. Hyperprolactinemia and nonpuerperal mastitis (duct ectasia). JAMA. 1989;261(11):1618-1620. doi:10.1001/jama.1989.03420110090032
Ross J, Guaschino S, Cusini M, Jensen J. 2017 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2018;29(2):108-114. doi:10.1177/0956462417744099
Sabel MS. Overview of benign breast disease. UpToDate. Last updated Mar 2024. Wolters Kluwer. https://www.uptodate.com/contents/overview-of-benign-breast-disease
Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005;353(3):275-285. doi:10.1056/NEJMra035692
Santen RJ, Stuenkel CA, Davis SR, et al. Managing Menopausal Symptoms and Associated Clinical Issues in Breast Cancer Survivors. J Clin Endocrinol Metab. 2022;107(5):1427-1449. doi:10.1210/clinem/dgab888
Smyth PP. The thyroid and breast cancer: a significant association? Ann Med. 2021;53(1):227-238. doi:10.1080/07853890.2020.1840620
Trent M, Bass D, Ness RB, Haggerty C. Recurrent PID, subsequent STI, and reproductive health outcomes: findings from the PID evaluation and clinical health (PEACH) study. Sex Transm Dis. 2018;45(4):236-242. doi:10.1097/OLQ.0000000000000740
Vodstrcil LA, Plummer EL, Doyle M, et al. Treating Pelvic Inflammatory Disease to Prevent Adverse Reproductive Health Outcomes: The Evidence and Future Directions. Curr Epidemiol Rep. 2021;8(2):33-44. doi:10.1007/s40471-021-00269-2 (Важность комплексного подхода к ВЗОМТ)
Warren JW, Langenberg P, Clauw DJ. The number of existing functional somatic syndromes (FSSs) is an important risk factor for new, different FSSs. J Psychosom Res. 2023;164:111077. doi:10.1016/j.jpsychores.2022.111077
Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021: Pelvic Inflammatory Disease (PID). MMWR Recomm Rep. 2021;70(No. RR-4):1-187. doi:10.15585/mmwr.rr7004a1. https://www.cdc.gov/std/treatment-guidelines/pid.htm
