Impact of Combined Therapy on the Dynamics of Psychopathological Disorders in the Post-Hysterectomy Period: Integration of Pharmacotherapy and Light Environment Factors

Introduction. The use of hysterectomy for the treatment of uterine fibroids is associated with the development of post-hysterectomy syndrome, which affects up to 60% of patients. The pathogenesis of the syndrome involves complex neuroendocrine alterations as well as psychogenic factors related to surgical trauma and the perception of loss of fertility. The aim of this review is to evaluate, based on an analysis of the current literature, the therapeutic potential of combination therapy for the management of the psychopathological manifestations of post-hysterectomy syndrome, to identify the most effective pharmacological support strategies, and to substantiate the need for further investigation of the body's circadian rhythms associated with the influence of light environmental factors. Materials and methods. The study methodology included a theoretical analysis of scientific publications published between 2004 and 2026, selected from the electronic databases CyberLeninka, eLibrary, and PubMed, based on a total of 61 literature sources (52 domestic and 9 international). The inclusion criteria comprised the availability of full-text publications addressing the mechanisms underlying the pathogenesis and therapeutic approaches to post-hysterectomy syndrome. The exclusion criteria included publications in the form of newspaper articles or expert opinions lacking statistical evidence, as well as studies that were not relevant to the research topic. Results. The most pathogenetically justified and effective therapeutic approaches for the management of post-hysterectomy disorders have been systematized. Comprehensive rehabilitation strategies, including psychotherapeutic and pharmacological interventions for the correction and treatment of associated complications, are reviewed. Furthermore, evidence regarding the influence of the light environment on the course of post-hysterectomy syndrome is critically analyzed. Сonclusion. The effectiveness of therapy for post-hysterectomy syndrome depends on the severity of the disorders, their duration, the presence of comorbid conditions, and exposure to adverse light environmental factors. Hormone replacement therapy remains a pathogenetically justified treatment modality, providing a reduction in psycho-emotional and autonomic vascular disorders in 80–90% of cases. However, the wide range of contraindications and the risk of complications significantly limit its use as monotherapy. The scientific value of this study lies in investigating the combined use of pharmacological agents with different mechanisms of action, as well as in substantiating the application of a chronobiological approach. Further research should be directed toward identifying optimal combined therapeutic strategies aimed at stabilizing psycho-emotional status during the post-hysterectomy period.