Репродуктивная эндокринология (Mar 2024)
Features of steroid hormone levels in girls with menstrual cycle disorders and mental health disorders
Abstract
Objectives of the study: to investigate the peculiarities of the steroid hormone status in girls with menstrual function disorders, depending on comorbid psychopathology. Materials and methods. A total of 174 girls with menstrual function disorders (78 with abnormal uterine bleedings (AUB) and 96 with oligomenorrhea (OM)) were examined. The diagnosis of psychopathology was determined based on the clinical presentation at the time of examination. The comparison group consisted of 35 girls with a normal menstrual cycle. The laboratory examination included the assessment of estradiol, testosterone, cortisol (C), and dehydroepiandrosterone sulfate (DHEA-S) levels. The C/DHEA-S ratio was calculated using the unprocessed raw values. Results. Menstrual function disorders are often associated with hypoestrogenemia, a prevalent phenomenon. It was observed in almost a third of patients with AUB, whereas in girls with OM this number was significantly higher. Significant reduced values are found in girls with accompanying depressive states, especially in cases of AUB and OM. In instances of AUB and OM, the number of individuals with elevated levels of testosterone increased by 1.97–2.2 times in the presence of psychopathology. DHEA-S in patients with AUB was reduced in more than half of the girls, while in patients with OM it varies evenly in both directions, regardless of the presence or absence of psychopathology. A C level were more often reduced than increased, and achieves statistical significance when OM combined with neurotic disorders and AUB combined with depressive states. The C/DHEA-S ratio, as a stress indicator, was statistically significantly elevated in patients with AUB. This may suggest more pronounced manifestations of stress in patients with AUB than in girls with OM and a higher adaptability of the girls’ bodies with OM. Conclusions. Thus, the understanding of the role of reproductive steroids in the development of menstrual function disorders during adolescence has been deepened. Distinctive features of their interrelations in the presence of psychopathology have been identified. The impact of cortisol and DHEA-S, as well as C/DHEA-S ratio, on mental well-being in endocrine-related gynecological disorders in girls has been established
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