Стрес-індуковані ендокринні зміни при порушеннях менструального циклу в дівчат-підлітків під впливом війни в Україні

Hormonal functioning against the background of stress is almost the most discussed problem in Ukraine today. The menstrual cycle as a vital indicator of life activity reacts sharply to changes in the environment. Russian military aggression in Ukraine forced the majority of the population to experience the hardships of war. Research of hormonal support of menstrual cycle disorders in the emergency situations will expand the understanding of the interaction of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes.The objective: to compare the hormonal determinants of stress-related menstrual disorders in adolescent girls in the pre-war period and against the background of war.Materials and methods. 331 adolescent girls with menstrual disorders (in 2018–2021 – 184 girls and in 2022–2024 – 147 girls) aged 11–17 years were examined. 149 girls were diagnosed with abnormal uterine bleeding (AUB) (84 girls before the war and 65 – after the war), and 182 patients with oligomenorrhea (OM) (100 adolescents before the war and 82 – after the war). All patients lived in the territory of the city of Kharkiv and the Kharkiv region, which are subject to constant military attacks during the war. The hormonal examination complex included determination of blood serum concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, testosterone, cortisol, estradiol (E2), dehydroepiandrosterone sulfate (DHEA-S), and their ratios were calculated (LH/FSH, cortisol/DHEA-S, prolactin/cortisol, testosterone/cortisol, testosterone/E2).Results. In adolescents with menstrual disorders of the AUB and OM type, who were in the epicenter of constant bombardment, hormonal determinants changed. The level of stress-dependent hormones probably increased. These are the DHEA-S and prolactin concentrations. Accordingly, the ratio prolactin/cortisol increased and ratio cortisol/DHEA-S decreased, which indicates an increased resistance to a stressful situation. Being in a zone of armed conflict leads to the classic relationship between cortisol and DHEA-S, their correlation appears. Sex hormones also participate in the reaction to a stressful situation, and in AUB – testosterone, and in OM – E2. In girls in a zone of constant air raids and bombardments, against the background of a strong positive relationship between cortisol and DHEA-S, a rather weak correlation between cortisol and testosterone is found, which may indicate a less sensitive relationship between stress and sex hormones.Conclusions. Menstrual disorders are accompanied by impaired regulation of the pituitary-adrenal and pituitary-gonadal axes. Being in a zone of armed conflict increases the tension of stress-dependent and sex hormones in this contingent of patients, which can provoke a complicated course of AUB and OM.