Вплив посттравматичних стресових розладів на репродуктивну функцію жінок

Objective of the study: to investigate the course of secondary amenorrhea in women with posttraumatic stress disorder (PTSD) based on the study of their hormonal and immune system. Materials and methods. The study included 54 women of reproductive age with amenorrhea and PTSD (main group). Using enzyme-linked immunosorbent assay, the levels of prolactin, follicle-stimulating and luteinizing hormones, estradiol, progesterone, free testosterone, anti-Müllerian hormone, thyroid-stimulating hormone, free thyroxine, daily urine cortisol, as well as antibodies to thyroid peroxidase (TPOAb) and ovarian autoantibodies were determined. According to the hormonal study, the women were divided into 2 subgroups: the first subgroup included 35 (64.8%) patients with functional hypothalamic amenorrhea (FHA), the second subgroup included 19 (35.2%) women with premature ovarian insufficiency (POI). The control group consisted of 23 healthy women aged 18–37 years. Results. It was detected a 1.5-fold increase level of prolactin in the subgroup with POI vs. control group. Significantly elevated thyroid-stimulating hormone levels were found only in the POI subgroup (21.1% vs. 0% of in the control). Ovarian antibodies were detected in 26.3% of patients with POI vs. 2.9% in women with FHA (p ˂ 0.05). The increased TPOAb levels were not detected in the subgroup of women with FHA and in the control group, but in patients with POI it was detected in 21.1% of cases. А simultaneous increase in the level of both TPOAb and ovarian antibodies was diagnosed in 10.5% of patients in the subgroup with POI. Conclusions. Disorders of reproductive function in women with PTSD can be manifested by FHA or POI. The presence of TPOAb and ovarian antibodies IgG indicates the significant role of the immune system in the choice of the pathogenetic chain of amenorrhea development.