Характер психічних відхилень та їх гормональний супровід у дівчат-підлітків з розладами менструальної функції

Abstract

The pubertal period is accompanied by the tension of the adaptation system during the hormonal adjustment. Purpose - to define the hormonal determinants of stress-related menstrual disorders in adolescent girls with comorbid mental disorders and the peculiarities of adaptation reactions. Materials and methods. 150 adolescent girls with menstrual cycle disorders were examined. The levels of luteotropic hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), estradiol (E2), testosterone (T), cortisol (K), dehydroepiandrosterone sulfate (DHEA-S) were determined. They were divided into three groups depending on the examination by a psychiatrist: without mental status disorders, with anxiety-phobic disorders and depressive states. The control group included 35 girls of similar age with a normal menstrual cycle who were examined in the early follicular phase. Results. There were no significant differences in the content of gonadotropic hormones in girls with menstrual function disorders in view of the state of mental health. However, in girls with oligomenorrhea (OM), in relation to patients with abnormal uterine bleeding (AUB), elevated LH values are significantly more often registered (p<0.03). Levels of peripheral T, as well as its precursor DHEA-S and metabolite (E2), were associated with mental health status. The lowering of E2 significantly elevated in adolescents with comorbid psychopathology. The number of girls with high T values increased in the presence of psychopathology in AUB and remained unchanged in OM. Cortisol in psychopathology, regardless of the type of menstrual function disorders, was reduced in relation to the control group, however, in girls with OM, its content was significantly higher, especially in depressive states (p˂0.05). The specific gravity of girls with a reduced level of DHEA-S in patients with AUB increased with comorbid psychopathology. In case of OM, a reduced and increased content of DHEA-S was registered with the same frequency. An increase in the C/DHEA-S indicator of the functioning of the hypothalamic-pituitary-adrenal system in patients with OM was noted much less frequently than in patients with AUB (p˂0.006). Conclusions. It is believed that the hormonal relationship between cortisol and DHEA-S indicates the body’s response to stressors and can be used as one of the biomarkers of neurotic and depressive states. An increase in the C/DHEA-S ratio suggests a possible dissociation of their secretion. Adolescents with AUB, unlike girls with OM, have a decrease in the “protective” hormone DHEA-S, which can affect the deterioration of mental health. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.