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

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, FТ 4 ) 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 FT 4 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.