HORMONE IMBALANCE AS A MANIFESTATION OF STRESS IN THE FORMATION OF OLIGOMENORRHEA IN TEENAGE GIRLS

Stress is currently the most significant factor contributing to reproductive function disorders and has become a major public health problem in the 21st century. Stress is implicated in the development of oligomenorrhea (OM), particularly in the context of the ongoing full-scale war in Ukraine. The aim of the study was to determine the characteristics of the content of steroid hormones, including stress-related hormones, in adolescent girls with OM. Materials and methods. A total of 193 girls aged 12–18 years with OM were observed and stratified into groups according to OM duration. Hormonal assessment included serum measurements of estradiol (E2), testosterone (T), cortisol (C), 17-hydroxyprogesterone (17-OH), dehydroepiandrosterone sulfate (DHEA-S), and sex steroid-binding globulin (SSBG). The ratios of C/DHEA-S and the free T index were also calculated. Written informed consent for all medical procedures was obtained from each participant or their parents/guardians. The study protocol was approved by the Bioethics and Deontology Committee of the State Institution “Institute for Children and Adolescents Health Care of the National Academy of Medical Sciences of Ukraine” (protocol No. 7 dated 25.11.2024). Statistical analysis was performed using the computer program Statgraphics Plus. Results were analyzed by one-way analysis of variance. Differences were considered significant at ρ < 0.05. Data are presented as mean ± standard deviation (SD) and frequency counts. The significance of differences between groups was assessed using Fisher’s exact test, the Wilcoxon–Mann–Whitney test, and the χ² test. The study was conducted according to the research plan entitled “Study of the mechanisms of comorbid pathology formation in adolescent girls with menstrual disorders (primary oligomenorrhea and abnormal uterine bleeding)” (state registration number: 0121U114425). Results. At OM onset, nearly 20% of participants exhibited low E2 levels. With increased disease duration (years 2–3), the proportion of adolescents with low E2 decreased while those with elevated E2 increased. E2 is known to influence reproductive potential and correlate with mood alterations; a parallel trend was observed for C. Conversely, DHEA-S levels rose with prolonged OM duration. Early in OM progression, characteristic findings include low E2, C, and DHEA-S levels, accompanied by increased C/DHEA-S ratios, suggesting diminished adaptive capacity. With extended OM duration, the proportion of girls exhibiting elevated free T, 17-OH, DHEA-S, and T/E2 ratios increased, indicative of emerging polycystic ovary syndrome (PCOS). The percentage of adolescents with elevated C/DHEA-S ratios declined, whereas low ratios became more prevalent. Significant positive correlations were observed between C and T (r = 0.31; P < 0.001), DHEA-S and C (r = 0.46; P < 0.0001), and free T and DHEA-S (r = 0.44; P < 0.0005). Conclusions. The findings do not support an association between OM development and dysregulation of adrenal–gonadal interactions, which govern menstrual function regulation and are linked to stress responses and maladaptation.