Clinical and ultrasound characteristics of the health status of fertile aged women, who smoke and have metabolic syndrome

Abstract

Objectives: to identify clinical and ultrasound indicators that can determine the need for further examination of fertile aged women who smoke and have metabolic syndrome (MS) regarding the risk of developing somatic pathology or diseases of the reproductive system.Materials and methods. 2 groups of women of fertile age were examined: the first group consisted of 20 women who smoked with MS, the second group included 20 women who smoked without MS. All women were interviewed using a specially designed general and reproductive health questionnaire. Ultrasound examination of the abdominal cavity and pelvic organs was performed using convex and transvaginal sensors according to existing examination protocols.Results. Women of the first group had a higher body mass index and other obesity parameters, which is typical for MS. Women of the second group smoked more cigarettes per day. The identified early onset of menstrual function in women with MS may be a manifestation of hormonal homeostasis disorders at the end of puberty with a predominance of estradiol secretion and insufficient progesterone synthesis in the second phase of the menstrual cycle. A significant amount of blood loss during menstruation and painful menstruation in women of the first group may be a manifestation of adenomyosis, which confirms by echo-positive and echo-negative inclusions in the myometrium and thickening of the uterine walls. In most patients with MS ultrasound showed multifollicular ovaries, which may point at polycystic ovary syndrome, given changes in body mass index and ovarian structure as a response on hyperestrogenemia. Prolonged manifestation of MS also negatively affected the abdominal organs, as evidenced by echo-positive inclusions in the liver and pancreas parenchyma, which is a manifestation of inflammatory diseases of these organs.Conclusions. The combination of prolonged smoking and metabolic syndrome leads to more pronounced changes in the reproductive system and abdominal organs, which in turn expands the range of recommended methods of instrumental examination for such women.