Age-Differentiated Algorithm for the Assessment of Refugee Women Considering Stress-Associated Disorders

Background: Chronic stress is a key pathophysiological driver of neuroendocrine, psychological, and somatic disorders. Among refugee women, stress is typically prolonged and cumulative, and, when combined with social vulnerability and limited access to healthcare, contributes to a broad spectrum of health impairments. Objective: To identify age-related patterns of stress response in refugee women and to develop a differentiated algorithm for clinical assessment and management, integrating clinical, neuroendocrine, and social determinants of health. Methods: A total of 149 refugee women aged 18–70 years residing in compact settlements were enrolled in the study. Participants were stratified into three age groups: 18–35 years (n=54), 36–54 years (n=61), and ≥55 years (n=34). All participants underwent comprehensive clinical evaluation, including medical history assessment, laboratory and instrumental investigations, and quality of life assessment using the SF-36 questionnaire. The analysis encompassed reproductive health status, gynecological and extragenital pathology, neurotransmitter profiling, and social determinants. Comparative statistical analysis was performed, with significance set at p<0.05. Results: Clear age-related patterns in health status were observed. Women aged 18–35 years predominantly exhibited functional and stress-related disorders, including dysmenorrhea (55.6%), menstrual irregularities (35.2%), and a high prevalence of pelvic inflammatory disease (72.2%).In the 36–54 age group, organic gynecological pathology increased significantly, including uterine fibroids/endometriosis (45.9%) and cervical dysplasia (59%), alongside pronounced multimorbidity.In women aged ≥55 years, chronic somatic conditions and cognitive impairment predominated. Neurotransmitter analysis showed reduced dopamine and serotonin levels with elevated norepinephrine and histamine in younger women, indicating sustained stress activation, with relative stabilization in older groups.Intergroup differences were statistically significant (p < 0.05). Conclusion: Chronic stress is a key determinant of reproductive, somatic, and psychoemotional disorders in refugee women, with distinct age-related patterns. An age-oriented clinical algorithm integrating psychoemotional, neuroendocrine, and social assessments may improve early detection and prevention of stress-associated disorders in this vulnerable population.