This issue of reproductive medicine news presents current research and data from reviews and meta-analyses on the study and innovative methods of treating diseases of the reproductive system, presented in leading international periodicals

Functional menstrual disorders encompass a broad spectrum of abnormalities in the regularity, duration, and volume of menstrual bleeding in the absence of organic pathology. Over the past decades, substantial progress has been made in understanding the etiological factors, diagnostic criteria, and therapeutic strategies associated with these conditions. The pathogenesis is primarily linked to dysfunction of the hypothalamic–pituitary–ovarian (HPO) axis, in which key regulatory roles are played by kisspeptin, gonadotropin-releasing hormone (GnRH), gonadotropins, and sex steroids.

Contemporary literature places particular emphasis on the neuropeptidergic regulation of GnRH secretion, notably the roles of kisspeptin and neurokinin B, whose impaired expression is implicated in the development of hypothalamic amenorrhea. Lifestyle-related factors exert a significant influence on menstrual function — energy deficiency resulting from intensive physical activity, common among athletes, may lead to secondary amenorrhea. Chronic psychological stress, associated with elevated cortisol levels, can indirectly disrupt neuroendocrine regulatory mechanisms at multiple levels.

The COVID-19 pandemic is considered an additional factor associated with menstrual disturbances, attributed to both the presumed direct damage to reproductive tissues and indirect effects mediated by stress-related and immune-driven pathophysiological mechanisms. Environmental exposures, including air pollution and endocrine-disrupting chemicals, are also gaining attention as relevant contributors to menstrual rhythm disturbances.

This review summarizes current knowledge on hormonal dysregulation mechanisms, the influence of internal and external triggers, viral agents, and emerging diagnostic and therapeutic approaches for managing patients with functional menstrual disorders, including the use of a complex of plant components and microelements Time Factor, the composition of which is aimed at correcting the functioning of the hypothalamic-pituitary axis in case of non-organic disorders of the menstrual cycle.

The present article contains the most actual version of Russian national clinical recommendations (Version of year 2025) "Menopause and climacteric period among females" In case of ignoring timely sex steroid replacement therapy menopause can decrease chances for achieving healthy longevity and ageing. This document has been provided by members of Russian Society of Obstetricicians and Gynaecologists (RSOG). The next revision is planned for year 2027 or earlier. The document has been approved by scientific practical council of the Russian Ministry of Health.

This review examines the terminological ambiguity surrounding the concept of «gestational hyperandrogenism» in domestic literature and clinical practice. An increase in androgen levels during pregnancy, driven by hormonal adaptation, involvement of the fetoplacental complex, and altered synthesis of sex hormone-binding globulins in the liver, represents a physiological norm. Consequently, patient management in most cases is limited to active monitoring and does not require medical intervention. A key emphasis is placed on distinguishing between pregestational hyperandrogenism and true gestational hyperandrogenism — a rare pathological condition that first manifests during pregnancy due to causes such as luteoma, theca-lutein cysts, or placental aromatase deficiency, all of which typically resolve spontaneously after delivery. The review outlines a systematic approach to the differential diagnosis of these conditions, which is crucial for determining further management strategy and preventing inappropriate treatment. Incorrect interpretation of laboratory findings and overdiagnosis often lead to the erroneous prescription of glucocorticoids to pregnant women, posing potential risks. The article delineates patient management strategies based on identifying the source of hyperandrogenism and assessing the risk of fetal virilization, with an emphasis on dynamic monitoring. Particular attention is paid to the need for topical diagnosis using imaging techniques, as well as the dynamic assessment of androgen status postpartum. Treatment options for true gestational hyperandrogenism are limited, whereas glucocorticoid therapy is justified only in cases of pregestational hyperandrogenism due to congenital adrenal hyperplasia.