PECULIARITIES OF THE ORGANS OF THE REPRODUCTIVE SYSTEM OF WOMEN OF REPRODUCTIVE AGE WITH LIVER DYSFUNCTION UNDER THE INFLUENCE OF EXOGENOUS POLLUTANTS.

The widespread use of chemicals by modern society and the prevalence of harmful habits (alcoholism, tobacco smoking, drug addiction) leads to an unnaturally high intake of exogenous pollutants in the human body, which can cause damage to internal organs, including the reproductive system. The aim of this study was to determine the peculiarities of the reproductive system of women of reproductive age with liver dysfunction under the influence of exogenous pollutants, namely, due to harmful working conditions and tobacco smoking. Estimation of activity of liver enzymes was determined by the level of activity of alanine aminotransferase, aspartate aminotransferase, and gamma-glutamate transaminase. The first group (control group) included women with no changes in liver enzyme activity and no history of harmful working conditions or bad habits. The second group (comparison group) - women with no history of harmful working conditions and bad habits, but with laboratory data showing changes in liver enzyme activity. The third group included women who have been working with harmful substances for more than 10 years. The fourth group included women who have smoked for more than 10 years. Changes in objective indicators of women's reproductive system have been studied (vaginal discharge, elasticity of the vaginal wall, epithelial integrity, mucous membranes moistness, pH of the vaginal contents, cytological type, vaginal contents) for all groups. Gynecologic examination and evaluation revealed changes indicating the presence of candidiasis and bacterial vaginosis (caused by anaerobic microbiota) in women who worked in harmful working conditions and smoked, both with and without signs of inflammation. During the objective examination, changes in vaginal discharge were observed in women. Only in 20% of women with smoking habits and 10% of women with harmful working conditions there was no vaginal discharge, while in the control group, such women were the majority. In the group with signs of impaired liver function, the absence of discharge was observed in 30% of women. According to the results of cytological studies, a quarter of women who smoked and one in five women who worked in hazardous conditions had estrogen deficiency, apparently as a result of dysregulation disorders under the influence of pollutants. The inflammatory or cytolytic type of smear, which is a consequence of restructuring, was observed in most women from the smoking group. Also, in the two study groups, there was an increase in the number of cases of fungal or Gardnerella vaginal lesions. Disorders of the genital organs in women under the influence of exogenous pollutants are associated with hepatic and endocrine disorders. Obviously, the mechanisms of formation of the pathological condition cause these disorders, and since women working in harmful conditions and smoking have more developed gynecological manifestations, they have more developed symptoms. Inflammatory changes have been revealed in the cervix for up to 30% of women with the influence of xenobiotics. The relationship between the activity of liver enzymes and epithelial integrity has been revealed as the most significant correlation in study parameters (r=0.71 for alanine aminotransferase and epithelial integrity).