The optimization of abnormal uterine bleeding treatment in women with chronic psychogenic stress

Abstract

The objective: to assess the effectiveness of the complex optimized treatment approach to abnormal uterine bleeding (AUB) in women with chronic psychogenic stress on the quality of life.Materials and methods. We examined 100 women of reproductive age with AUB and chronic psychogenic stress, 50 patients of them consisted the I group and received the optimized treatment, and 50 persons (II group) received the standard AUB treatment. 30 women without AUB and chronic stress were included in the control group. The examination of all persons included: anamnesis, clinical and gynecological examinations, ultrasound examination, general blood test, blood ferritin, vitamin D in serum blood. The quality of life was determined according to the 36-Item Short Form Health Survey before treatment and after three months. The standard approach included diagnostic and therapeutic measures according to the recommendations of Order N 353 dated 13.04.2016 of the Ministry of Health of Ukraine. The optimized treatment additionally included recommendations for lifestyle changes, melatonin, the use of vitamin D depending on its level, the medicament correction of iron deficiency without anemia.Results. The results of the questionnaire 36-Item Survey scales indicate that in patients with AUB and chronic psychogenic stress there is a decrease in the scales relative to the values of healthy women, especially in psychological component. In the persons of the II group there was no significant dynamics of the scales “Bodily pain” and “Physical role functioning” relative to the indicators before treatment, while the scales “Physical function” (p<0,001) and “General health perceptions” (p=0.01) increased significantly. The optimized treatment lead to a significant increase in all physical component scales compared till normal indices. In patients of the II group the indicators of psychological scales after treatment were significantly lower than the average values of healthy women. Thus, the value of the scale “Mental Health” was lower by 14,34% relative to the control group (p=0,18), “Emotional role functioning” – 18,38% (p=0,007), “Social role functioning” – 15,46% (p=0,003), “Vitality” – 23,27% (p=0,005). In the women of the I group there was a significant increase in the indicators of the psychological scales, which after treatment reached the values of healthy women.Conclusions. In women with AUB and chronic psychogenic stress, there is an insufficient positive dynamics in improving the quality of life after the standard treatment, especially the scales of the psychological component. The optimized treatment approach leads to the improvement of all parameters of quality of life of the patients.