The causes of abnormal uterine bleeding in women with chronic psychogenic stress
Keywords:
metrorrhagia, chronic psychogenic stress, reproductive age, etiologyAbstract
Abnormal uterine bleeding (AUB) is a common pathology in women of reproductive age. Chronic psychogenic stress significantly impacts the parameters of the menstrual cycle and can result in its disorders and AUB.
The aim of the study was to determine the main etiological causes of AUB in women of reproductive age with chronic psychogenic stress.
Materials and methods. We studied the causes of AUB using PALM-COEIN classification in 100 women of reproductive age with chronic psychogenic stress (group I) and 50 patients without chronic psychogenic stress (group II). 30 practically healthy women without AUB and chronic psychogenic stress were the control group.
Results. The most often disorders of menstrual cycle in women in group I were intermenstrual bleeding (IMB) – 38.00 %, prolonged menstrual bleeding – 31.00 %, heavy menstrual bleeding (HMB) – 29.00 %, in group II– HMB (36.00 %), prolonged menstrual bleeding – 34.00 % and IMB – 30.00 %. The most often reasons of AUB in group I were ovulatory dysfunction – 36.00 %, leiomyoma – 24.00 % and adenomyosis – 18.00 %, in group II – leiomyoma – 38.00 %, polyps – 26.00 % and adenomyosis – 20.00 %. In patients of reproductive age, the rate of structural causes for AUB predominated over functional factors but the organic reasons occurred more often in persons without stress factor (80.33 %, P = 0.01) than those in individuals with chronic psychogenic stress (60.71 %). But the frequency of ovulatory dysfunction was 2.57 times more (χ2 = 6.85, P = 0.009) in persons with chronic psychogenic stress compared to the patients without chronic psychogenic stress (14.00 %).
Conclusions. In patients of reproductive age, the structural causes predominate over non-structural factors in the development of abnormal uterine bleeding. But in women with chronic psychogenic stress, ovulatory dysfunction is the most common reason of AUB.
References
Munro, M. G., Critchley, H. O. D., Fraser, I. S., Haththotuwa, R., Kriplani, A., Bahamondes, L., Füchtner, C., Tonye, R., Archer, D., Abbott, J., Abdel-Wahed, A., Berbic, M., Brache, V., Breitkoph, D., Brill, A., Broder, M., Brosens, I., Chwalisz, K., Clark, J., & Warner, P. (2018). The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. International Journal of Gynecology and Obstetrics, 143(3), 393-408. https://doi.org/10.1002/ijgo.12666
Ding, C., Wang, J., Cao, Y., Pan, Y., Lu, X., Wang, W., Zhuo, L., Tian, Q., & Zhan, S. (2019). Heavy menstrual bleeding among women aged 18-50 years living in Beijing, China: prevalence, risk factors, and impact on daily life. BMC women's health, 19(1), 27. https://doi.org/10.1186/s12905-019-0726-1
Henry, C., Jefferies, R., Ekeroma, A., & Filoche, S. (2020). Beyond the numbers-understanding women's experiences of accessing care for abnormal uterine bleeding (AUB): a qualitative study. BMJ open, 10(11), e041853. https://doi.org/10.1136/bmjopen-2020-041853
Munro, M. G., Critchley, H. O., Broder, M. S., Fraser, I. S., & FIGO Working Group on Menstrual Disorders (2011). FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. International journal of gynaecology and obstetrics, 113(1), 3-13. https://doi.org/10.1016/j.ijgo.2010.11.011
Huhmann, K. (2020). Menses Requires Energy: A Review of How Disordered Eating, Excessive Exercise, and High Stress Lead to Menstrual Irregularities. Clinical therapeutics, 42(3), 401-407. https://doi.org/10.1016/j.clinthera.2020.01.016
Maqbool, R., Maqbool, M., Zehravi, M., & Ara, I. (2021). Menstrual distress in females of reproductive age: a literature review. International journal of adolescent medicine and health, 34(2), 11-17. https://doi.org/10.1515/ijamh-2021-0081
Kuznetsova I. V., Burchakova M. N., Burchakov D. I., Khadzhieva N. Kh., & Filippova G. G. (2018). Psykhohennyj stress-zavysymye narushenyia menstrualnoho tsykla: rol nehormonalnoi korektsyy [Psychogenic stress-dependent disorders of the menstrual cycle: the role of non-hormonal correction]. Health of a woman, (10), 68-72. [in Russian].
Horbatiuk, O. H., Shatkovska, A. S., Hryhorenko, A. P., Vaskiv, O. V., Bets, I. O., Kustovska, I. M., Petrash, A. I., & Palahniuk, M. H. (2019). Features of women’s reproductive dysfunctions associated with prolonged stressful situations. Zaporozhye medical journal, 21(6), 764-769. https://doi.org/10.14739/2310-1210.2019.6.186501
Yamamoto, K., Okazaki, A., Sakamoto, Y., & Funatsu, M. (2009). The relationship between premenstrual symptoms, menstrual pain, irregular menstrual cycles, and psychosocial stress among Japanese college students. Journal of physiological anthropology, 28(3), 129-136. https://doi.org/10.2114/jpa2.28.129
Pakharenko, L. V. (2018). Clinical and social aspects of dysmenorrhea development. Zaporozhye medical journal, 20(5), 687-691. https://doi.org/10.14739/2310-1210.2018.5.141539
Nauholnyk, L. B. (2015). Psykholohiia stresu [Psychology of stress]. Lvivskyi derzhavnyi universytet vnutrishnikh sprav. [in Ukrainian].
Mintser, O. P. (Ed.). (2010). Suchasni metody i zasoby dlia vyznachennia i diahnostuvannia emotsiinoho stresu [Modern methods and means for determining and diagnosing emotional stress]. Vinnytsia : VNTU [in Ukrainian].
Cohen, S. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan, & S. Oskamp (Eds.), The social psychology of health (pp. 31-67). Sage Publications, Inc.
Tatarchuk, T. F., Tutchenko, T. N., & Zakharenko, N. F. (2009). Shkala otsenki perezhivaniya stressa Perceived Stress Scale (PSS): osnovnye etapy adaptatsii dlya zhenskogo naseleniya Ukrainy [Perceived Stress Scale (PSS): the main stages of adaptation for the female population of Ukraine]. Zbirnyk naukovykh prats Asotsiatsii akusheriv-hinekolohiv Ukrainy (pp. 606-613). Intermed. [in Russian].
Mayama, M., Umazume, T., Watari, H., Nishiguchi, S., Moromizato, T., & Watari, T. (2020). Frequency of night shift and menstrual cycle characteristics in Japanese nurses working under two or three rotating shifts. Journal of occupational health, 62(1), e12180. https://doi.org/10.1002/1348-9585.12180
Krut, Yu. Ya, & Zemliana N. A. (2020). Markery proliferatsii ta anhiohenezu pry hiperplastychnykh protsesakh endometriia v poiednanni z miomoiu matky [Markers of proliferation and angiogenesis in endometrial hyperplastic processes combined with uterine fibroids]. Zaporozhye medical journal, 22(2), 181-185. [in Ukrainian]. https://doi.org/10.14739/2310-1210.2020.2.200583
Mutakha, G. S., Mwaliko, E., & Kirwa, P. (2020). Clinical bleeding patterns and management techniques of abnormal uterine bleeding at a teaching and referral hospital in Western Kenya. PloS one, 15(12), e0243166. https://doi.org/10.1371/journal.pone.0243166
Singh, K., Agarwal, C., Pujani, M., Raychaudhuri, S., Sharma, N., Chauhan, V., Chawla, R., Ahuja, R., & Singh, M. (2019). A Clinicopathological Correlation of International Federation of Gynecology and Obstetrics's PALM-COEIN Classification of Abnormal Uterine Bleeding: Indian Scenario. Journal of mid-life health, 10(3), 147-152. https://doi.org/10.4103/jmh.JMH_128_18
Ansari, A., & Urooj, U. (2020). Study of causes behind abnormal uterine bleeding according to PALM- COEIN classification at a tertiary care hospital. JPMA. The Journal of the Pakistan Medical Association, 70(1), 154-157. https://doi.org/10.5455/JPMA.2749
Poliakova, Ye. M., Lutsenko, N. S., & Haidai, N. V. (2019). Diahnostyka hiperplazii endometriia u rutynnii hinekolohichnii praktytsi [Diagnosis of endometrial hyperplasia in routine gynecological practice]. Zaporozhye medical journal, 21(1), 95-99. [in Ukrainian]. https://doi.org/10.14739/2310-1210.2019.1.155836
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
