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.

Hypogonadism syndrome, characterized by testosterone deficiency, negatively affects the physical, metabolic and psychoemotional health of men. The main treatments for hypogonadism include androgen replacement and androgen stimulating therapy. Androgen replacement therapy, represented by transdermal and injectable forms of testosterone, effectively restores testosterone levels, improves sexual function, muscle mass, bone mineral density and metabolic parameters.

However, it suppresses spermatogenesis, which limits its use in men planning fatherhood. Androgen stimulating therapy, including gonadotropins, antiestrogens and aromatase inhibitors, stimulates the production of endogenous testosterone and spermatogenesis. Gonadotropins demonstrate high efficacy, but their long-term use is complicated by the need for frequent injections and the lack of long-term results. The long-term studies presented in the review confirm the safety and effectiveness of androgen replacement therapy, but data on androgen stimulating therapy are limited in follow-up time to a maximum of two years.

Vasomotor symptoms during the menopausal transition occur in 80% of women and can last for years, which seriously reduces the quality of life. Typical complaints of patients include hot flashes, increased sweating, and sleep disorders. Treatment and correction of menopausal transition problems is an important task for an obstetrician-gynecologist. Today, menopausal hormone therapy is the gold standard in stopping hot flashes and preventing osteoporosis, but it has serious limitations and contraindications. For those categories of women who cannot or do not want to take hormonal drugs due to personal preferences, non-hormonal alternative methods should be offered. The article provides an overview of possible options for drug and non-drug interventions, and discusses evidence of the effectiveness and safety of alternative means, including dietary correction using a complex of herbal components and vitamins Estrovel in order to prevent the pathological course of menopause and prevent age-associated conditions. The literature search was carried out in Russian (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases. Free access to the full text of publications was preferred. The selection of sources was prioritized by the period from 2018 to 2025, however, the list of references includes works dated earlier.

The present article contains the most actual version of the Russian national clinical recommendations «Polycystic ovary syndrome» (2025 year). Polycystic ovary syndrome (PCOS) is the most common reproductive and hormonal disease among reproductive age females. The incidence of this disease varies from 8% until 21% of females. The present recommendations have been published due to collaboration between Russian Society of Obstetricians and Gynecologists and Russian Association of Endocrinologists. The next revision is planned for year 2028 or earlier (due to potential appearance of new evidence criteria). The document has been approved by scientific practical council of the Russian Ministry of Health.

Bardet-Biedl syndrome is a rare multisystem autosomal recessive disorder that belongs to the spectrum of ciliopathies. Typical features include central obesity and hypogonadism, retinitis pigmentosa, renal dysfunction, polydactyly, mental retardation and learning difficulties. The syndrome diagnostics is based on clinical manifestations and symptoms, and it can be confirmed by molecular genetic testing. The article discusses the clinical features, diagnostics, differential diagnostics, difficulties and possibilities of treatment of a patient with progressive obesity and associated disorders. Bardet-Biedl syndrome was verified at the age of 23 by genetic analysis: homozygous mutation in the BBS1 gene was detected.

People, who born with disorders/differences of sex development (hereinafter -DSD) represent a special cohort of patients, because their observation and treatment requires the cooperative work of endocrinologists, gynecologists, surgeons and psychologists. The execution of gonadectomy at a later age is associated with a high risk of development of herminous tumors, and untimely initiated hormone replacement therapy determines incorrect development of secondary sexual characteristics and growth parameters. The goal of specialists is to help such patients realize their reproductive plans and ensure a full life in society. The right management tactics are largely determined by the level of awareness of the patient and his/her parents. Thus, one of the most important duties of doctors is to provide them with up-to-date data on these conditions.

We present a clinical case of disorders/differences of sex development with karyotype 46 XY, positive SRY gene, which reflects the importance of concepts of international consensus in patients with this condition.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. PCOS is a leading cause of infertility, ovulatory dysfunction, menstrual irregularities and a well-known risk factor for prediabetes, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Depending on the clinical manifestations, patient’s age and reproductive life plans the goals and strategies of PCOS treatment may differ. There is currently clinical evidence of the positive effects of metformin on ovulatory function, menstrual cycle regularity, fertility and pregnancy outcomes in patients with PCOS. These results related to metformin’s effects on insulin resistance, hyperinsulinemia and hyperandrogenism. In patients with PCOS and prediabetes or T2DM metformin improves glycemic control and also exerts a number of pleiotropic effects that reduce the risk of carbohydrate metabolism disorder progression and the development of CVD. In PCOS, ovarian dysfunction contributes to a cascade of metabolic and vascular changes even in the absence of T2DM. Therefore, the indications for metformin in patients with PCOS may extend beyond the glycemic control.

This article is a summary of the expert council on the issues of managing adult patients with PCOS, taking into account current knowledge of reproductive, metabolic, and cardiovascular risks. It also contains the key data on the use of metformin in women with PCOS in various clinical situations and the legal aspects of metformin use in modern clinical practice.