Hormonal and Psycho-Emotional Disorders in Women with Psychogenic Amenorrhea
DOI:
https://doi.org/10.6000/2292-2598.2019.07.02.1Keywords:
Psychogenic amenorrhea, hormonal profile, psycho-emotional state, bioelectric activity of the brain.Abstract
The pathogenetic aspects of stress on reproductive health and fertility of a woman are multi-vector, this is justified by the need for timely diagnosis and the development of new approaches to differentiated treatment of PA.
Objective: to determine the characteristics of the hormonal profile, the psycho-emotional state and changes in the bioelectric activity of the brain in women with stress-induced psychogenic amenorrhea (PA).
Material and Methods: The main group included 54 women with PA from 19 to 37 years, the control group – 25 healthy women from 18 to 35 years. Blood plasma FSH, LH, E2, P, Pr, DHEAS, C levels were checked by the immuno-enzymatic method, bioelectric activity measurement of the brain – with an electroencephalography, women psycho-emotional status – by the Spielberg-Hanin test, statistical data processing was performed using Windows SPSS 11.5. and was carried out by means of standard methods.
Results: Patients were divided on 3 subgroups depend on significant (р<0.05) Prl or C or their combination levels increasing. The presence of nonspecific signs of activation of the structures of the brain stem in patients with PA was established by EEG with significantly (р<0.05) higher frequency. The analysis of the psycho-emotional status of women showed a high level of personal and reactive anxiety.
Conclusions: The revealed features of hormonal imbalance and psycho-emotional status in women with PA indicate the necessity of involving adjacent specialists - neurologists and psychotherapists for timely and adequate examination with the appointment of differentiated pathogenetically substantiated treatment.
References
Pinchuk IYa, Babova KD, Gozhenka AI, Eds. Stress and man: medical and psychological help in stress disorders: manual. Kyiv: Publishing house “Kalita” 2014.
Sudakov KV. Psychoemotional stress: prevention and rehabilitation. Therapeutic Archive 1997; 69(1): 70-74.
Chatterjee A, Chatterjee R. How stress affects female reproduction: An overview. Biomed Res-India 2009; 20(2): 79-83. https://doi.org/10.4103/0970-938X.54858 DOI: https://doi.org/10.4103/0970-938X.54858
Campeau S, Liberzon I, Morilak D, Ressler K. Stress modulation of cognitive and affective processes. Stress 2011; 14(5): 503-19. https://doi.org/10.3109/10253890.2011.596864 DOI: https://doi.org/10.3109/10253890.2011.596864
Radley JJ, Kabbaj M, Jacobson L, Heydendael W, Yehuda R, Herman JP. Stress risk factors and stress-related pathology: neuroplasticity, epigenetics and endophenotypes. Stress 2011; 14(5): 481-497. https://doi.org/10.3109/10253890.2011.604751 DOI: https://doi.org/10.3109/10253890.2011.604751
Maksimenko PD, Koval IA, Maksimenko KS, Papucha MV. Medical psychology. Vinnitsa: Nova Knyga 2008.
World Health Organization. Workers' health: a global plan of action. [Internet]. Geneva: WHO. [cited 2012 Nov 5]. Available from: http://origin.who.int/occupational_health/ WHO_health_assembly_ru_web.pdf
Pshenichnikova MG. The phenomenon of stress. Emotional stress and its role in pathology (continuance). Pathological Physiology and Experimental Therapy 2000; 3: 20-26.
Tatarchuk TF. Stress and reproductive function of women. International Endocrinology Journal 2006; 3(5): 2-9.
Korolchuk MS. Activity psychophysiology. Kyiv: Elga 2004.
Nehoroshkova YuV. Modern medical and biological concept of stress: biology, medicine and psychology (review and our own researches). Actual Problems of Transport Medicine 2012; 1(27): 83-95.
Ilyin EP. Psychology of individual differences. St.-Peterburg: Piter 2004.
Aftanas LI, Reva NV, Savotina LN, Maknev VP. Neurophysiological correlates of induced discrete emotions in humans: an individually oriented analysis. Neuroscience and Behavioral Physiology 2006; 36(2): 119-130. https://doi.org/10.1007/s11055-005-0170-6 DOI: https://doi.org/10.1007/s11055-005-0170-6
Baibackova UA, Efremova ОA, Kojin MI. Psychological and immunologic personality status of patients with neurocirculatory dystonia. Scientific Bulletins of the Belgorod State University. Scientific Bulletins. Medicine. Pharmacy 2011; 13: 29-34.
Venckovskaya IB, Zagorodnyaya AS. Stress-induced disorders of reproductive and sexual function. Reproductive Health. Eastern Europe 2013; 2(26): 113-119.
Lachowsky M, Winaver D. Psychogenic amenorrhea. Gynecol Obstet Fertil 2007; 35(1): 45-48. https://doi.org/10.1016/j.gyobfe.2006.10.032 DOI: https://doi.org/10.1016/j.gyobfe.2006.10.032
Pentz I, Nakić Radoš S. Functional hypothalamic amenorrhea and its psychological correlates: a controlled comparison. J Reprod Infant Psychol 2017; 35(2): 137-149. https://doi.org/10.1080/02646838.2016.1278201 DOI: https://doi.org/10.1080/02646838.2016.1278201
Benyuk VO, Makarenko MV, Goncharenko VN. Algorithms in obstetrics and gynecology. Kyiv: TOV "Doctor Media"; 2016.
Tatarchuk TF, Efimenko OA. Modern management of hyperprolactinemia. Health of Woman 2009; 9(45): 33-37.
Ranabir S, Reetu K. Stress and hormones. Indian J Endocr Metab 2011; 15:18-22. https://doi.org/10.4103/2230-8210.77573 DOI: https://doi.org/10.4103/2230-8210.77573
Benyuk VA, Girina ON, Usevich IA, Dyndar EA, Nikonyuk TR, Goncharenko VN, Bozhok EN, Liholay PA. Family Doctor's Guide to Obstetrics and Gynecology. Kyiv: TOV "Doctor Media" 2012.
Tatarchuk TF, Bulavenko OV, Tutchenko TN. Optimization of treatment of luteal phase deficiency in women of reproductive age against the background of hyperprolactinemia. Health of woman 2008; 2(34): 72-77.
Fourman LT, Fazeli PK. Neuroendocrine causes of amenorrhea – an update. J Clin Endocrinol Metab 2015; 100(3): 812-24. https://doi.org/10.1210/jc.2014-3344 DOI: https://doi.org/10.1210/jc.2014-3344
Klein DA, Poth MA. Amenorrhea: an approach to diagnosis and management. Am Fam Physician 2013; 87(11): 781-788.
Sowińska-Przepiera E, Andrysiak-Mamos E, Jarząbek-Bielecka G, Walkowiak A, Osowicz-Korolonek L, Syrenicz M, Kędzia W, Syrenicz A. Functional hypothalamic amenorrhoea – diagnostic challenges, monitoring, and treatment. Endokrynologia Polska 2015; 66(3): 252-260. https://doi.org/10.5603/EP.2015.0033 DOI: https://doi.org/10.5603/EP.2015.0033