Treatment and rehabilitation of COVID-19 associated menstrual-ovarian dysfunction: effectiveness of hormonal correction and predictive model

Abstract

Aim: To evaluate the effectiveness and predictive value of a monophasic oral preparation containing micronized gestodene and ethinylestradiol in the treatment of COVID-19-associated menstrual-ovarian dysfunction in women of different reproductive ages. Methods: The study included 120 women of various reproductive ages with COVID-19-associated dysfunctions who underwent a 3-month rehabilitation therapy using a combined oral contraceptive (0.060 mg gestodene + 0.015 mg ethinylestradiol). Restoration of menstrual-ovarian function, ovulation, fertility, and endometrial ER and PR receptor expression were assessed; the risk of recurrence was calculated using a predictive model. Results: Restoration rates of menstrual-ovarian function were: 82.5% in early, 76.1% in middle, and 70.1% in late reproductive age. Fertility recovery rates were 72.3%, 65.6%, and 60.3%, respectively. Repeated immunohistochemical analysis showed ER expression increased to 86% and PR to 85.4%. The predictive model for recurrence risk had an ROC AUC of 0.85. Conclusion: Monophasic therapy with micronized gestodene and ethinylestradiol is highly effective in eliminating COVID-19- associated menstrual-ovarian dysfunction. Endometrial ER and PR expression is improved, and the recurrence risk prediction model shows high accuracy. This personalized approach is recommended as an effective and reliable method in clinical practice for such patients.