Features of women’s reproductive dysfunctions associated with prolonged stressful situations

Authors

  • O. H. Horbatiuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • A. S. Shatkovska National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • A. P. Hryhorenko National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • O. V. Vaskiv National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • I. O. Bets Academy of the State Border Guard Service of Ukraine, Khmelnytskyi,
  • I. M. Kustovska National Academy of the State Border Guard Service of Ukraine, Khmelnytskyi,
  • A. I. Petrash National Academy of the State Border Guard Service of Ukraine, Khmelnytskyi,

DOI:

https://doi.org/10.14739/2310-1210.2019.6.186501

Keywords:

stress, menstruation disturbances, menstrual cycle

Abstract

 

The number of appeals of migrant women and servicewomen for specialized gynecological care has increased during the years of the armed conflict in Eastern Ukraine.

The aim of the work was a comprehensive study of the hormonal function of pituitary gland, ovaries, thyroid gland and adrenal glands in women of reproductive age with various types of menstrual cycle disorders caused by a prolonged stressful situation.

Materials and methods. With the help of immune-enzyme analysis the authors have conducted a study of pituitary hormones (FSH, LH, prolactin), ovarian hormones (estradiol, progesterone, free T), thyroid hormones (TSH, FТ4) and thyroid peroxidase antibodies, as well as adrenal glands hormones (ACTH, cortisol (urine), DHEA-s) of 74 migrant women and servicewomen with menstrual disorders caused by a stressful situation. According to complaints, women were divided into 2 subgroups: with amenorrhea 34 (45.9 %) and abnormal uterine bleeding – 40 (54.1 %).

Results. Women with stressed amenorrhea had a significant 2 times (P < 0.05) increase in FSH; 1.9 times – LH; 1.6 times – prolactin (which is not typical for classical hyperprolactinemia) and 3.2 times decrease in estradiol, 3.9 times – progesterone in comparison to the control group. Dysfunction of the thyroid gland was recorded, in particular 2 times decrease in FT4 and 1.7 times increase in thyroperoxidase antibodies relative to the control. A significant 1.6 times increase in ACTH, 1.8 times increase in cortisol (urine) and 1.6 times increase in DHEA-s were detected compared with the control. Women with abnormal uterine bleeding had a significant 1.5 times (P < 0.05) increase in prolactin, 1.3 times increase in estradiol, and a 2.5 times decrease in progesterone compared to the control women group. 90.5 % of women of reproductive age with menstrual cycle disorders caused by the influence of prolonged stress factor had hormonal disorders of the ovaries, adrenal glands and thyroid gland.

Conclusions. In women with stress-related amenorrhea there is a violation of the relationship in the hypothalamic – pituitary system while maintaining the negative feedback loops of the pituitary-ovarian axis or ovarian depletion; post-traumatic stress disorders have a significant pathological effect on the reproductive system of women who have experienced such suffering.

 

References

Hryhorenko, A. P., Shatkovska, A. S., Horbatiuk, O. H., Binkovska, A. M., & Onyshko V. Y. (2016). Porushennia menstrualnoho tsyklu: amenorei, anomalni matkovi krovotechi [Menstrual disorders: amenorrhea, abnormal uterine bleeding]. Vinnytsya. [in Ukrainian].

Kormos, V., & Gaszner, B. (2013). Role of neuropeptides in anxiety, stress, and depression: From animals to humans. Neuropeptides, 47(6), 401-419. doi: 10.1016/j.npep.2013.10.014

Fourman, L., & Fazeli, P. (2015). Neuroendocrine Causes of Amenorrhea – An Update. The Journal Of Clinical Endocrinology & Metabolism, 100(3), 812-824. doi: 10.1210/jc.2014-3344

Shymanska-Horbatiuk, O. H., Hryhorenko, A. P., & Shatkovska N. S. (2012). Menstrualnyi tsykl i yoho rehuliatsiia [The menstrual cycle and its regulation]. Medical aspects of women's health, 4(56), 17-21. [in Ukrainian].

Meczekalski, B., Katulski, K., Czyzyk, A., Podfigurna-Stopa, A., & Maciejewska-Jeske, M. (2014). Functional hypothalamic amenorrhea and its influence on women’s health. Journal Of Endocrinological Investigation, 37(11), 1049-1056. doi: 10.1007/s40618-014-0169-3

Collins, T., & Rompolski, K. L. (2017). Hypothalamic Amenorrhea: Causes, Complications, & Controversies. Journal of Student Research, 6(1), 24-32. Retrieved from https://www.jofsr.org/index.php/path/article/view/288.

Genazzani, A., Chierchia, E., Santagni, S., Rattighieri, E., Farinetti, A., & Lanzoni, C. (2010). Hypothalamic amenorrhea: From diagnosis to therapeutical approach. Annales D'endocrinologie, 71(3), 163-169. doi: 10.1016/j.ando.2010.02.006

Manuhin, I. B., Tumilovich, L. G., & Gevorkjan, M. A. (2016). Ginekologicheskaja jendokrinologija: klinicheskie lekcii [Gynecological endocrinology: clinical lectures] (4th ed.). Moscow. [in Russian].

Palm-Fischbacher, S., & Ehlert, U. (2014). Dispositional resilience as a moderator of the relationship between chronic stress and irregular menstrual cycle. Journal Of Psychosomatic Obstetrics & Gynecology, 35(2), 42-50. doi: 10.3109/0167482x.2014.912209

Grigorenko, A. P., Shatkovskaja, N. S., Shimanskaja, O. G., & Onyshko, V. Ju. (2013). Sindrom gipertormozhenija gonadotropnoj funkcii gipofiza [Hypertrophy Syndrome of pituitary gonadotropic function]. Medical aspects of women's health, 9(73), 22-24. [in Russian].

Nagma, S., Kapoor, G., Bharti, R., Batra, Ac., Batra, Ar., Aggarwal, A., & Sablok, A. (2015). To Evaluate the Effect of Perceived Stress on Menstrual Function. Journal of clinical and diagnostic research, 9(3), QC01-QC03. doi: 10.7860/jcdr/2015/6906.5611

Hafiichuk, N. V. (2013). Optymizatsiia diahnostyky ta likuvannia hipotalamo-hipofizarnoi dysfunktsii u zhinok z anovuliatornym bezpliddiam [Optimization of diagnostics and treatment of hypothalamo pituitary dysfunction in women with anovulatory infertility]. Health of woman, 10(86), 163-168. [in Ukrainian].

Tatarchuk, T. F., Kosej, N. V., & Tutchenko, T. N. (2017). Prezhdevremennaja nedostatochnost jaichnikov: sindrom ili diagnoz [Premature ovarian insufficiency: a syndrome or diagnosis]. Reproductive endocrinology, 2(34), 16-22. doi: 10.18370/2309-4117.2017.34.16-22 [in Russian].

The ESHRE Guideline Group on POI, Webber, L., Davies, M., Anderson, R., Bartlett, J., & Braat D. et al. (2016). ESHRE Guideline: management of women with premature ovarian insufficiency. Human Reproduction, 31(5), 926-937. doi: https://doi.org/10.1093/humrep/dew027

Kochetov, A. G., Ljang, O. V., Masenko, V. P., Zhirov, I. V., Nakonechnikov, S. N., & Tereshhenko, S. N. (2012). Metody statisticheskoj obrabotki medicinskih dannyh [Methods of statistical medical data analysis]. Moscow. [in Russian].

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How to Cite

1.
Horbatiuk OH, Shatkovska AS, Hryhorenko AP, Vaskiv OV, Bets IO, Kustovska IM, Petrash AI. Features of women’s reproductive dysfunctions associated with prolonged stressful situations. Zaporozhye medical journal [Internet]. 2019Dec.11 [cited 2024Apr.25];(6). Available from: http://zmj.zsmu.edu.ua/article/view/186501

Issue

No. 6 (2019)

Section

Original research

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