MODERN APPROACHES TO THE DIAGNOSIS AND TREATMENT OF ABNORMAL UTERINE BLEEDING IN THE PREMENOPAUSAL PERIOD

The study was aimed at assessing the clinical, hormonal, metabolic, and morphological characteristics of abnormal uterine bleeding (ABB) in the premenopausal period, as well as optimizing diagnostic and treatment approaches. Between 2021 and 2025, we examined 500 premenopausal women and 100 control group participants who sought treatment for MAP. Clinical-anamnestic, laboratory, transvaginal ultrasound, hysteroscopic, histological, and immunohistochemical methods were used. The highest proportion of MCI was observed in the 48–50 age group. The detection of endometrial hyperplasia, myomas, polyps, adenomyosis, and functional hemorrhages showed a multifactorial etiological nature. Age, obesity, high stress, a reproductive history, and metabolic disorders were noted as risk factors. The sensitivity of the new diagnostic algorithm, which integrates clinical, laboratory, and instrumental data, was 93%, specificity was 89%, and overall accuracy was 91%. Based on the individual treatment model, the overall efficacy was 88%, and the recurrence rate decreased to 14% at 6 months of observation. The results demonstrate the practical significance of a comprehensive and individualized approach in premenopausal ACC.