Evaluation of vascular tone in patients with menorrhagia: the role of apelin and norepinephrine

Abstract Objectives Menorrhagia, characterized by excessive menstrual bleeding, impacts 30 % of women of childbearing period and is frequently linked to anemia and discomfort in the pelvic region. Understanding the vascular and hormonal mechanisms underlying this condition could aid in developing non-surgical treatment options. This research focused on exploring the role of apelin and norepinephrine (NE), along with nitric oxide (NO) and prostacyclin (PGI 2 ), in the pathophysiology of menorrhagia. Methods The study included 44 women diagnosed with menorrhagia and 44 healthy controls. Blood specimens were taken on the 2nd or 3rd day of menstruation, and serum specimens were prepared. The levels of apelin, NE, NO, and PGI 2 were determined using commercially available ELISA kits. Furthermore, standard biochemical analyses were conducted on all specimens. Results Apelin and NE levels were significantly reduced in the menorrhagia group compared to control group (p<0.05). The comparison of NO and PGI 2 levels showed no statistically significant difference between the menorrhagia and control groups (p>0.05). In the menorrhagia group, total cholesterol, iron-binding capacity, platelet count, and FSH concentrations were markedly higher than those in control individuals, conversely, albumin, iron, hemoglobin, MCV, hematocrit, and progesterone levels were notably reduced (p<0.05). Conclusions The study identified apelin and NE as moderately discriminative markers in menorrhagia and suggested that these markers could potentially contribute to impaired vasoconstriction and excessive menstrual bleeding. Future research should focus on evaluating biomarkers across different menstrual phases and exploring new therapeutic strategies for uterine protection.