Vadym M. Goncharenko

Chronic stress in internally displaced persons (IDPs) is a significant risk factor for women’s reproductive health. Non-hormonal approaches serve as a safe alternative under limited conditions of hormonal therapy.The objective: to assess the impact of chronic psychoemotional stress on the reproductive system in women of reproductive age and to study the effectiveness of non-hormonal methods for correcting stress-associated menstrual cycle (MC) disorders.Materials and methods. The study involved 120 women-IDPs aged 18–40 years with stress-associated disorders of MC. The assessment of anxiety level, concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, cortisol, and magnesium was performed. The 3-month therapy regimen included a phytonutriceutical complex (a blend of plant extracts: fruits of Vitex agnus-castus – 87.74 mg, roots of Angelica sinensis – 87.74 mg, roots of Filipendula vulgaris – 87.74 mg, fresh roots of Petroselinum crispum – 36.12 mg, fresh roots of Apium graveolens – 36.12 mg, herb of Galium verum – 32.26 mg, and flowers of Calendula officinalis – 32.26 mg) and a magnesium-vitamin complex (magnesium oxide “SimagTM 55” – 272 mg, orotic acid – 25 mg, pyridoxine hydrochloride – 2.7 mg). In cases of vaginal dryness, hyaluronic acid was applied. The patient’s condition was evaluated at the beginning of the study, and after 3 and 6 months of therapy.Results. Against the background of the therapy, MC irregularity decreased from 73.3% to 29.2%, dysmenorrhea – from 54.2% to 20.8%, and symptoms of premenstrual syndrome – from 60.0% to 25.0% (p < 0.05). These changes were accompanied by positive hormonal dynamics, including an increase in the levels of LH (from 7.52 to 11.5 mIU/mL), FSH (from 6.90 to 10.3 mIU/mL), estradiol (from 109 to 180 pg/mL), progesterone (from 5.54 to 16.9 ng/mL), and a decrease in cortisol from 657 to 492 nmol/L. The magnesium level increased from 0.67 to 0.85 mmol/L.Conclusions. An integrated non-hormonal approach effectively restores neuroendocrine regulation and improves women’s reproductive health under conditions of chronic stress.

Chronic sympathoexcitation (sympathetic overdrive syndrome) is defined as the sustained dominance of sympathetic over parasympathetic tone, measurable at the organ, vascular, and neural levels, and differs fundamentally from brief, adaptive “fight-or-flight” responses. Persistent vasoconstrictor drive perturbs cellular metabolism and reshapes host–tumor interfaces. Although this state is well characterized in cardiometabolic medicine, its oncologic implications remain comparatively underexplored, despite converging evidence that adrenergic inputs modulate tumor and stromal behavior. One of the main reasons for presenting this conceptual innovation study is that the sympathetic overdrive phenotype (SOP) carriers, by far, are not rare in the population. Robust statistics towards SOP incidence and prevalence are still missing, despite the urgency of plausible healthcare solutions. Currently, the best described SOP-relevant subpopulation are the Flammer Syndrome phenotype (FSP) carriers who, for instance, are highly prevalent in the academic career-making professional groups. Certain genetic predispositions play a role, however, the key pathways involved into the health-to-disease transition are epigenetically regulated and, to a large extent, represent systemic modifiable phenotype-associated risk factors which are, therefore, a promising target for holistic proactive medical approaches with a high potential to save lives and financial resources. Graphical Abstract The alternative text for this image may have been generated using AI.

OBJECTIVE. To summarize current evidence on painful forms of female sexual dysfunction—dyspareunia, vulvodynia, and vaginismus—with emphasis on pathogenesis, neurophysiological mechanisms, and diagnostic strategies, as well as to outline possibilities for comprehensive therapy based on the biopsychosocial model. MATERIALS AND METHODS. A systematic analytical review of scientific literature published between 2018 and 2024 was conducted using PubMed, Scopus, Google Scholar, and ISSWSH databases. Publications with evidence level ≥ II (randomized clinical trials, prospective studies, meta-analyses, systematic reviews) that included standardized assessments of sexual function (FSFI, FSDS), pain intensity (VAS), psychological state (HADS, BAI), and diagnostic tools (Q-tip test, pelvic floor tone evaluation, neuroimaging, EMG) were analyzed. From 97 initial sources, 58 most relevant publications on dyspareunia, vulvodynia, vaginismus, and Genito-Pelvic Pain/Penetration Disorder (GPPPD) were selected. RESULTS. Dyspareunia was shown to be predominantly secondary and associated with hypoestrogenism, chronic inflammatory conditions, myofascial hypertonicity of the pelvic floor, and psychosexual factors. Vulvodynia is recognized as a chronic neuropathic pain syndrome involving peripheral nociceptor sensitization, mast cell activation, alterations in hormonal receptors, and central neuroplastic changes. Vaginismus is described as a biopsychosocial disorder characte¬rized by a conditioned reflex connection between fear of pain and involuntary pelvic floor muscle spasm. A comprehensive diagnostic algorithm was summarized, including clinical examination, Q-tip testing, pelvic floor tone assessment, FSFI, VAS, HADS, FSDS scores, psychosexual evaluation, and, when indicated, mucosal biopsy and neuroimaging. The effectiveness of multidisciplinary treatment approaches was highlighted, combining topical hormonal therapy, regenerative methods (PRP, laser biostimulation), neuromodulating pharmacotherapy, pelvic floor physiotherapy, cognitive-behavioral and body-oriented psychotherapy, and partner-based sex therapy; for refractory vaginismus, botulinum toxin type A may be used as part of multimodal treatment protocols. CONCLUSIONS. Painful forms of female sexual dysfunction are multifactorial disorders involving complex interactions between neurohumoral, psychosexual, and behavioral mechanisms. Dyspareunia, vulvodynia, and vaginismus represent a continuum of chronic sexual pain requiring personalized diagnostics and stepwise multidisciplinary treatment. Implementation of comprehensive clinical pathways with involvement of gynecologists, urologists, neurologists, psychotherapists, and pelvic floor rehabilitation specialists can significantly reduce chronic pain intensity, improve psychosexual well-being, and restore sexual comfort and quality of life.

Precancerous diseases of the cervix continue to remain an urgent medical and social problem of today and occupy one of the leading places in the structure of gynecological morbidity. A typical representative of precancerous diseases of the cervix is cervical intraepithelial neoplasia, which is closely associated with the human papillomavirus (HPV). Women under the age of 25 who have risk factors that may become an obstacle to self-elimination of the virus, as well as to reducing the viral load, deserve special attention.The objective: to evaluate the effectiveness of phytotherapy in the complex treatment of papilloma-associated cervical lesions in young women.Materials and methods. 236 women aged 18–25 years were examined. All women underwent vaginal biocenosis, as well as co-testing (according to the results obtained, 9 women (3.8%) were found to be HPV-negative, which served as the basis for their exclusion from the study), depending on the results of which, women were divided into groups I, II and III. Group I included 83 women with HPV and cytological result Negative for Intraepithelial Lesion or Malignancy. Group II included 77 women with HPV and cytological conclusion Atypical Squamous Cells of Undetermined Significance. Group III included 67 with HPV and cytological conclusion Low-grade Squamous Intraepithelial Lesion. Subsequently, depending on the therapy received, women in groups I, II and III were additionally divided into two subgroups. Subgroups IA, IIA and IIIA included women who received local anti-inflammatory therapy depending on the identified pathogen in combination with a phytotherapy based on an oil solution of a mixture of herbs of sodden pike, ground wormwood and oil extract of echinacea roots once a day in the form of oral capsules for 1 year. Women in subgroups IB, IIB and IIIB were offered only local anti-inflammatory therapy depending on the identified pathogen. Treatment results were monitored after 6 months by repeated quantitative HPV testing and liquid cytology. Vaginal biocenosis was monitored 4 months after the start of treatment.Results. According to the results of quantitative HPV testing, women in group I had a low viral load – 67 (80.7%); p < 0.05), moderate load – 16 (19.3%) cases, and the absence of cases of high viral load. 50 (64.9%) and 48 (62.3%), p > 0.05, women in groups II and III had a moderate viral load. The number of cases of high viral load was found to be significantly higher among women in group III – 22 (28.6%), group II – 13 (16.9%), p > 0.05. When assessing the vaginal biocenosis after 4 months, women in subgroup IIIA had significant improvements in the results of repeated bacteriological examination compared to women in subgroup IIIB and the results of the initial examination. It should be noted that in subgroup IIIA, according to the results of the determination of Enterococcus faecalis – 4 (12.1%) (subgroup IIA – 2 (5.6%)) and Candida albicans – 6 (18.2%) (subgroup IIA – 4 (11.1%)) showed a non-significant higher number of results containing diagnostically significant titers of pathogens.Conclusions. The inclusion of a phytotherapy based on an oil solution of a mixture of herbs of sodden pike, ground wormwood and oil extract of echinacea roots in the complex treatment of young women with papilloma-associated cervical lesions contributes to a decrease in viral load, the transition to a lower viral load which is reflected in significantly better results of cytological examination in women of subgroups A. The combined use of a phytotherapy with local anti-inflammatory therapy aimed at correcting the vaginal biocenosis is effective in the context of reducing the amount of opportunistic microflora in a diagnostically significant concentration.

Premenstrual syndrome (PMS) is a complex of cyclical psycho-emotional, vegetative, and metabolic disturbances that occur during the luteal phase of the menstrual cycle. In recent years, there has been an increase in the prevalence and severity of PMS manifestations, which negatively affects women’s quality of life and is considered a pressing medical and social issue.The objective: to identify the features of symptom dynamics of PMS under the influence of comprehensive phytotherapy aimed at correcting biochemical, emotional-behavioral, and reproductive indicators of the female body.Materials and methods. A prospective multicenter observational study was conducted from 2022 to 2025 at women’s outpatient clinics of communal non-commercial enterprises across all regions of Ukraine. The study included 1,413 women aged 18–40 years who had PMS symptoms. Participants received a nutraceutical with a multi-component composition containing standardized extracts of medicinal plants (Vitex agnus-castus – 150 mg, Trigonella foenum-graecum – 100 mg, Cimicifuga racemosa – 50 mg), along with vitamins and microelements with hormone-regulating, anti-inflammatory, sedative, and metabolic effects. The supplement was administered at a dose of one capsule per day for three months. Treatment effectiveness was assessed using a specially developed questionnaire that covered the main PMS symptoms – emotional-behavioral, cognitive, and somatic, as well as features of the menstrual cycle and impact on daily activity. Symptom intensity was recorded using a visual analog scale (0–3 points).Results. Analysis of PMS impact on various life domains showed significant differentiation in negative effects on general activity (76%), work (64%), education (62.5%), and interpersonal relationships (60%). Phytotherapeutic approaches led to a significant reduction in the severity of main PMS symptoms. The proportion of women with the highest levels of anger and irritability decreased from 16.1 to 0.1%, while the proportion of asymptomatic individuals increased from 28.7 to 85.5%. Similarly, there was a decreased rate of respondents with the following symptoms: feeling of helplessness, depressed mood, and self-criticism (from 10.8 to 0.1%, the rate of asymptomatic cases increased from 44.0 to 89.8%), tension and anxiety (from 13.4 to 0.2%, the asymptomatic cases – from 26.3 to 83.9%), difficulty concentrating (from 6.8 to 1.1%, the asymptomatic cases – from 49.8 to 89.9%), significant appetite changes (from 11.9 to 0.1%, the asymptomatic cases – 44.0 to 86.2%), decreased interest in daily activities (from 7.6 to 0%, asymptomatic cases – from 50.7 to 91.0%), rapid fatigue and low energy (from 11.0 to 0.1%, asymptomatic cases – to 84.4%), feelings of oppression and loss of control (from 7.4 to 0.1%, asymptomatic cases – from 55.4 to 91.7%), somatic symptoms (breast pain, bloating, weight gain, joint/muscle pain; from 22.6 to 0.1%, asymptomatic cases – from 17.5 to 78.5%), drowsiness/insomnia (from 8.6 to 0%, asymptomatic cases – from 40.4 to 88.0%), headaches (from 5.7 to 0%, asymptomatic cases – from 5.7 to 91.3%), and heartbeat (from 3.0 to 0%, asymptomatic cases – from 72.0 to 95.0%) (p < 0.05). The highest mean pre-treatment symptom scores were recorded for the somatic symptom complex (breast pain, bloating, weight gain, joint/muscle pain) – 1.43 ± 0.03 points, anger and irritability – 1.19 ± 0.03 points, feelings of depression and loss of control – 0.91 ± 0.03, and tension and anxiety – 1.19 ± 0.03. After one month of therapy, these scores decreased to 0.87 ± 0.02, 0.83 ± 0.02, 0.69 ± 0.02, and 0.92 ± 0.03 points, respectively, continuing to decline by the end of the course (3 months): to 0.26 ± 0.01, 0.16 ± 0.01, 0.21 ± 0.01, and 0.21 ± 0.01 (p < 0.05). A positive effect of the three-month therapy on menstrual function was also established: the average duration of the menstrual cycle decreased (from 32.18 ± 7.91 to 29.11 ± 4.28 days), and the average duration of menstruation decreased (from 5.91 ± 2.13 to 4.98 ± 1.12 days), with a simultaneous stabilization of both indicators within the physiological norm.Conclusions. The results of the multicenter study confirmed the clinical effectiveness of a complex product containing standardized extracts of Vitex agnus-castus (150 mg), Trigonella foenum-graecum (100 mg), Cimicifuga racemosa (50 mg), along with vitamins and microelements, in patients with PMS. The supplement reduced the severity of PMS symptoms and had a positive effect on the functional state of the reproductive system. A full three-month course of therapy contributed to a more stable therapeutic effect and the maintenance of reproductive rhythms.

Endometrial hyperplasia (EH) accounts for 10–18% of gynecological pathology and is associated with a risk of malignancy, particularly in patients with metabolic syndrome and impaired liver function. Nonalcoholic fatty liver disease, with a prevalence of 25–30% among the adult population, promotes proliferative processes in the endometrium.The objective: to evaluate the effectiveness of comprehensive treatment of EH in patients with concomitant hepatic steatosis by individualizing therapy based on metabolic status.Materials and methods. A total of 114 women with histologically confirmed non-atypical EH and hepatic steatosis were exa-mined and divided into two groups. The patients in the I group received monotherapy with dydrogesterone 20 mg/day from the 16th to 25th days of the menstrual cycle. The II group received dydrogesterone in combination with the phytotherapeutic agent Artigel, which contains artichoke and dandelion extracts, choline and inositol. The treatment duration was 6 months. Effectiveness was evaluated based on transvaginal ultrasound of the endometrium, biochemical liver function parameters, lipid metabolism indicators, HOMA (Homeostasis Model Assessment of Insulin Resistance) index, estradiol and sex hormone-binding globulin (SHBG) levels.Results. After the 6-month treatment course, the combined therapy group showed a significant reduction in transaminase levels, in particular, the level of aspartate aminotransferase decreased by 1.5 times (from 42.7 ± 3.1 to 28.4 ± 2.6 U/L), alanine aminotransferase – by 1.4 times (from 46.2 ± 3.5 to 32.8 ± 2.9 U/L); a 1.5-fold reduction in HOMA index (from 4.8 ± 0.6 to 3.1 ± 0.4); improvement in lipid profile, in particular, level of triglycerides decreased from 2.4 ± 0.3 to 1.6 ± 0.2 mmol/L, low-density lipoproteins – from 3.9 ± 0.4 to 2.6 ± 0.3 mmol/L, while the level of high-density lipoproteins increased in 1.4 times (from 1.0 ± 0.1 to 1.4 ± 0.2 mmol/L). These changes were not observed in the monotherapy group. Unlike the dydrogesterone monotherapy group, in the II group of patients an increased level of SHBG (from 95.1 ± 2.1 to 128.5 ± 11.6 nmol/L) was recorded, which was accompanied by a decrease in bioavailable estradiol by 35% (from 118.9 ± 12.5 to 88.4 ± 8.9 pmol/L). The recurrence rate of EH was lower in the combined therapy group – 17.2% versus 37.5% (p < 0.05).Conclusions. Combined therapy with dydrogesterone and the phytotherapeutic agent Artigel demonstrated higher effectiveness in the treatment of EH compared with dydrogesterone monotherapy, as it not only reduced the recurrence rate of EH but also corrected key pathogenetic mechanisms such as insulin resistance, dyslipidemia and hormonal imbalance. These findings confirm the rationale for a comprehensive treatment approach to EH in patients with metabolic disorders.

Hyperprolactinemia syndrome is a symptom complex manifested by sexual and reproductive dysfunction caused by chronic pathological hyperprolactinemia. In the structure of endocrine pathology, it ranks third after diabetes mellitus and thyroid diseases. Stress-induced hyperprolactinemia is a common phenomenon in the modern world, including in our country. Chronic stress, lack of sleep, and depression lead to hippocampal dysfunction, destruction of synaptic connections, and deterioration of cognitive and creative abilities, which in turn can lead to the development of hyperprolactinemia.The objective: to optimize the management of women of reproductive age with menstrual dysfunction on the background of stress-induced hyperprolactinaemia.Materials and methods. 30 women of reproductive age with menstrual disorders caused by stress-induced hyperprolactinemia were examined. Comprehensive treatment included: prescription of the prolactin inhibitor cabergoline; psychotherapy consultation and development of an individual management plan; lifestyle optimization (normalization of diet, daily routine, reduction of psycho-emotional, intellectual and physical overload).Results. All patients had menstrual disorders in the form of menstruation delay (average 54.0 ± 2.5 days). Assessment of the psychological state showed that:– 13 (43.3%) women complained of impaired memory, intelligence and attention;– 25 (83.3%) – reported physical and mental discomfort;– 23 (76.7%) – had experienced psychotraumatic situations;– 19 (63.3%) – felt anxious about their health;– 21 (70.0%) – suffered from increased anxiety;– 30 (100.0%) – had a low mood and feelings of depression;– 16 (53.3%) – were worried about their financial and social situation and relationships with relatives;– 14 (46.7%) – had manifestations of tension;– 13 (43.3%) – complained of sleep disturbances;– 20 (66.7%) – experienced panic, fear and despair.The average prolactin level in patients before treatment was 42.4 ± 2.7 ng/ml (normal level – up to 25.0 ng/ml). After the complex therapy, 30 (100.0%) women had normalized prolactin concentration (19.3 ± 2.2 ng/ml) and menstrual cycle (29.0 ± 3.0 days), and improved psycho-emotional state. However, for the prevention of stress-induced hyperprolactinemia, women need careful supervision by a psychotherapist and adherence to the proposed set of measures.Conclusions. This study confirmed the high effectiveness of the prolactin inhibitor cabergoline in the complex treatment of stress-induced hyperprolactinemia in women of reproductive age.

Рostoperative scar endometriosis (РSE) is extragenital endometriosis, develops in 0.03-1.5% of women after surgical interventions. Aim - studying the problem of РSE and evaluating the tactics of managing this pathology in women for 5 years to improve and implement comprehensive treatment. Materials and methods. An analysis of anamnestic and clinical data, examination and treatment of 46 women with РSE was carried out during 2020-2024. Results. There was a 5-fold increase in the frequency of РSE from 2020 to 2024. Tumor-like formation was observed in the scar area in 46 (100%) women, pain in the scar area in 42 (91.3%) women; scar induration in 20 (43.5%) women; abnormal uterine bleeding in 11 (23.9%) women. 21 (45.7%) women with РSE had a hereditary predisposition; a high infectious index in 42 (91.3%) women and concomitant extragenital pathology in 17 (36.9%) women. 32 (69.6%) women had a history of artificial abortions, 7 (15.2%) had spontaneous abortions (electrovacuum aspiration 48.3%); 43 (93.4%) had a cesarean section. Among gynecological diseases: inflammation of the uterus and appendages in 19 (41.3%); cervical pathology in 15 (32.6%); infertility II in 8 (17.3%); appendage operations in 12 (26%) women. Clinical symptoms appeared after previous operations on average 3.2 years. 60.9% of women with РSE were operated on 2-4 years after the onset of complaints, which indicates untimely referral to a medical institution and late diagnosis. In 37% of women, the level of the tumor marker CA 125 is elevated (38.4 U/ml). The complexity of the operation depended on the duration of the appearance of РSE by the time of surgery. The longer the clinical manifestations of РSE, the more widespread the pathological process, which required the involvement of surgeons and urologists. Conclusions. Predictors of РSE were identified: intrauterine operations, complicated heredity, chronic inflammation of the uterus and appendages, cervical pathology, induced abortions. A woman after surgery and histological confirmation of endometriosis of the scar requires observation by a gynecologist and therapy to prevent relapse. The study was conducted in accordance with principles of the Declaration of Helsinki. Research protocol was approved by local ethics committee of the participating institution. Informed consent was obtained. The authors declare no conflict of interest.

Вступ. Основними медичними проблемами, що впливають на зниження народжуваності, є збільшення соматичної та гінекологічної патології, відсотка безплідних шлюбних пар, кількості абортів, мертвонародження, ранньої неонатальної смертності. Проблема антенатальної загибелі плода дедалі більше поширюється у зв’язку з неможливістю встановити точну причину та ризиком повторних випадків мертвонародження. Мета. Визначити стан соматичного здоров’я подружніх пар з антенатальною загибеллю плода в анамнезі на етапі планування наступної вагітності. Методи дослідження. Проведено клініко-статистичний аналіз соматичного здоров’я 35 подружніх пар з антенатальною загибеллю плода в анамнезі. До групи порівняння увійшли 30 подружніх пар без репродуктивних втрат в анамнезі. Виконано оцінку соціального статусу обстежених, їхнього віку, загального та спадкового анамнезу, оцінено наявність соматичної патології. Результати. У жінок із антенатальною загибеллю плода в анамнезі встановлено достовірно вищий відсоток соматичної патології: частіше зустрічалась патологія серцево-судинної системи (62.9 %), щитоподібної залози (37.1 %), сечовидільної системи (45.7 %); хвороби очей (34.3 %), варикозна хвороба вен нижніх кінцівок (34.3 %) (p<0.05). Підвищений індекс маси тіла спостерігали у кожної другої жінки з антенатальною загибеллю плода в анамнезі (51.4 %), ожиріння – 20.0 %. Аналізуючи соматичне здоров’я чоловіків, дружини яких мали антенатальну загибель плода в анамнезі, виявили достовірне збільшення частоти серцево-судинної патології (14.3 %), патології сечостатевої системи (34.3 %), шлунково-кишкового тракту (37.1 %) та ожиріння (22.9 %). У групі порівняння чоловіків, дружини яких не мали репродуктивних втрат в анамнезі, патологію серцево-судинної системи діагностовано у 6.7 %, патологію сечостатевої системи – у 16.7 % випадків. Це вдвічі менше порівняно з групою чоловіків, дружини яких мали антенатальну загибель плода в анамнезі (p<0.05). Патологію шлунково-кишкового тракту виявлено у кожного шостого чоловіка цієї групи (16.7 %), ожиріння – в кожного десятого (10.0 %). Варто зазначити, що частота впливу шкідливих чинників на здоров’я чоловіків, дружини яких мали антенатальну загибель плода в анамнезі, у 2.9 разів більша порівняно з чоловіками без репродуктивних втрат в анамнезі. Висновки. У сімейних пар з антенатальною загибеллю плода в анамнезі серед соматичної патології частіше зустрічались захворювання серцево-судинної системи, патології урогенітального тракту та шлунково-кишкового тракту. Знання особливостей соматичної патології у подружніх пар з антенатальною загибеллю плода в анамнезі дасть змогу розробити нові підходи щодо профілактики повторних репродуктивних втрат у цієї категорії пацієнтів.

Despite primary and secondary prevention measures and the natural course of human papillomavirus infection, which provides a long latent phase during which its development can be prevented, cervical cancer (CC) is still diagnosed in more than 500,000 women worldwide each year. At the same time, approximately 90% of cervical cancer cases and deaths from it are recorded in low- and middle-income countries.According to current guidelines, cervical cancer screening (WHO, 2018, 2021, 2022) includes testing for the presence of human papillomavirus (HPV) to detect precancerous conditions with subsequent prescription of appropriate treatment, which determines the relevance of studies conducted using the original Ukrainian drug with a direct antiviral effect on papillomavirus – proteflazid, in particular in the form of suppositories for vaginal use.The objective: to analyze the experience of using proteflazid (suppositories and drops) for diseases of the genital organs in women of reproductive age caused by HPV.Materials and methods. An analysis of publications with data from clinical studies was conducted, in which over a ten-year period, approaches to the treatment and prevention of papillomavirus infection with the drug proteflazid (suppositories) in women with cervical intraepithelial neoplasia – CIN I and CIN II were studied and their effectiveness was evaluated.Results. Clinical studies have established high effectiveness of treatment with medications based on the active substance proteflazid CIN of mild and moderate degrees, while a low level of toxicity has been proven. This allows it to be used even during pregnancy and breastfeeding.Conclusions. Proteflazid (drops and suppositories) is currently a medication for specific antiviral therapy of HPV infection with the aim of eradicating the papillomavirus in women with cervical intraepithelial neoplasia (CIN I and CIN II) against the background of HPV infection and with a positive HPV test with a normal cytological picture.When treating cervical epithelial dysplasia caused by papillomavirus infection with proteflazid (suppositories), normalization of the cytological picture or the transition of cervical intraepithelial neoplasia of class CIN II (moderate dysplasia) to class CIN I (mild dysplasia) is determined.The drug proteflazid (suppositories) helps to eliminate dysbiotic disorders of the genital tract microflora, restores the normal biotope of the vagina, accelerates the processes of restoration of the epithelium of the mucous membrane of the cervix, prevents recurrence of diseases.