Objective. To obtain new experimental and clinical data on the features of postoperative intraperitoneal adhesion formation in estrogen deficiency. Materials and methods. Experimental and clinical studies were conducted. The experimental study consisted of simulation of postoperative adhesion formation in estrogen deficiency. The experiment was carried out on mature female Wistar rats. The animals were divided into three equal groups of 30 animals each according to the volume of operative trauma. The procedure was implemented by comparing the results in the three parallel experimental groups having different volumes of operative trauma. The level of an adhesive process and the nature of adhesions were assessed on 10, 20, and 30 days after surgery. The clinical trial was conducted with the participation of 160 women aged 30—55 years, who were divided into 2 groups: 1) laparotomy, hysterectomy without appendages (n=80); 2) laparotomy, hysterectomy with appendages (n=80). In the postoperative period, both groups were comparatively studied, by estimating blood fibrinogen concentrations using the Clauss assay, by determining the postoperative blood estradiol and follicle-stimulating hormone levels, by performing pelvic ultrasonography with Antares or Voluson 730 vaginal sensor devices (Siemens) 30—60 days after surgery. In addition, the features of adhesion formation depending on the extent of surgery were assessed during repeated laparotomic or laparoscopic interventions in 22 patients after subtotal hysterectomies via laparotomy, which had been carried out within one month to 16 years before. Results. Evaluation of an adhesive process in the animals of the three experimental groups revealed postoperative adhesion formation in 89, 91, and 94% of the animals in Groups 1, 2, and 3, respectively. Calculation and comparison of the level of an adhesive process in three experimental groups on 10, 20, and 30 days showed that its level was highest (0.65±0.013 cm3) in Group 3. During the clinical trial, surgery-related complaints were seen in 86 and 95% of the women in Groups 1 and 2, respectively. The laboratory monitoring of the blood concentration of estradiol as the most active estrogen indicated that all cases in Group 2 had its postoperative level of less than 82 pg/ml (the minimum, maximum, and mean concentrations were 13, 60, and 27.75 pg/ml, respectively), which corresponds even to the lower level of the hormone in natural menopause. In Group 1, the concentration of estradiol averaged 128.88 pg/ml. A postoperative normal or slight decreased peripheral estrogen concentration was observed in 86.2% of cases. Conclusion. The abdominal adhesive process in women after hysterectomy with appendages has characteristic morphological features accompanied by certain clinical manifestations and differs from that with preserved ovarian function.