Сharacter of mental disorders and their hormonal accompaniment in adolescent girls with disorders of menstrual function
DOI:
https://doi.org/10.15574/SP.2023.135.65Keywords:
disorders of menstrual function, adolescent girls, cortisol, dehydroepiandrosterone sulfate, neurotic disorders, depressionAbstract
The pubertal period is accompanied by the tension of the adaptation system during the hormonal adjustment.
Purpose - to define the hormonal determinants of stress-related menstrual disorders in adolescent girls with comorbid mental disorders and the peculiarities of adaptation reactions.
Materials and methods. 150 adolescent girls with menstrual cycle disorders were examined. The levels of luteotropic hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), estradiol (E2), testosterone (T), cortisol (K), dehydroepiandrosterone sulfate (DHEA-S) were determined. They were divided into three groups depending on the examination by a psychiatrist: without mental status disorders, with anxiety-phobic disorders and depressive states. The control group included 35 girls of similar age with a normal menstrual cycle who were examined in the early follicular phase.
Results. There were no significant differences in the content of gonadotropic hormones in girls with menstrual function disorders in view of the state of mental health. However, in girls with oligomenorrhea (OM), in relation to patients with abnormal uterine bleeding (AUB), elevated LH values are significantly more often registered (p<0.03). Levels of peripheral T, as well as its precursor DHEA-S and metabolite (E2), were associated with mental health status. The lowering of E2 significantly elevated in adolescents with comorbid psychopathology. The number of girls with high T values increased in the presence of psychopathology in AUB and remained unchanged in OM. Cortisol in psychopathology, regardless of the type of menstrual function disorders, was reduced in relation to the control group, however, in girls with OM, its content was significantly higher, especially in depressive states (p˂0.05). The specific gravity of girls with a reduced level of DHEA-S in patients with AUB increased with comorbid psychopathology. In case of OM, a reduced and increased content of DHEA-S was registered with the same frequency. An increase in the C/DHEA-S indicator of the functioning of the hypothalamic-pituitary-adrenal system in patients with OM was noted much less frequently than in patients with AUB (p˂0.006).
Conclusions. It is believed that the hormonal relationship between cortisol and DHEA-S indicates the body’s response to stressors and can be used as one of the biomarkers of neurotic and depressive states. An increase in the C/DHEA-S ratio suggests a possible dissociation of their secretion. Adolescents with AUB, unlike girls with OM, have a decrease in the “protective” hormone DHEA-S, which can affect the deterioration of mental health.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Asgari S, Alimoardi Z, Soleimani MA. (2020). The effect of psychoeducational intervention, based on a self-regulation model on menstrual distress in adolescents: a protocol of a randomized controlled trial. Trials. 21: 747. https://doi.org/10.1186/s13063-020-04629-z; PMid:32854752 PMCid:PMC7450926
Babbar K, Martin J, Ruiz J et al. (2022). Menstrual health is a public health and human rights issue. Lancet Public Health. 7(1): 10-11. https://doi.org/10.1016/S2468-2667(21)00212-7; PMid:34717798
Bajalan Z, Moafi F, MoradiBaglooei M, Alimoradi Z. (2019). Mental health and primary dysmenorrhea: a systematic review. J Psychosom Obstet Gynaecol. 40(3): 185-194. https://doi.org/10.1080/0167482X.2018.1470619; PMid:29745745
Barba-Müller E, Craddock S, Carmona S, Hoekzema E. (2019). Brain plasticity in pregnancy and the postpartum period: links to maternal caregiving and mental health. Arch Womens Ment Health. 22(2): 289-299. https://doi.org/10.1007/s00737-018-0889-z; PMid:30008085 PMCid:PMC6440938
Borjigen A, Huang C, Liu M et al. (2019). Status and factors of menstrual knowledge, attitudes, behaviors and their correlation with psychological stress in adolescent girls. J Pediatr Adolesc Gynecol. 32(6): 584-589. https://doi.org/10.1016/j.jpag.2019.08.007; PMid:31445139
Chafkin JE, O'Brien JM, Medrano FN et al. (2022). A dual-system, machine-learning approach reveals how daily pubertal hormones relate to psychological well-being in everyday life. Dev CognNeurosci. 58: 101158. https://doi.org/10.1016/j.dcn.2022.101158; PMid:36368088 PMCid:PMC9650000
Çoban ÖG, Tulacı, ÖD, Adanır AS, Önder AJ. (2019). Psychiatric Disorders, Self-Esteem, and Quality of Life in Adolescents with Polycystic Ovary Syndrome. Pediatr Adolesc Gynecol. 32(6): 600-604. https://doi.org/10.1016/j.jpag.2019.07.008; PMid:31362114
Doretto L, Mari FC, Chaves AC. (2020). Polycystic ovary syndrome and psychotic disorder. Front Psychiatry. 11: 543. https://doi.org/10.3389/fpsyt.2020.00543; PMid:32587538 PMCid:PMC7297942
Hennegan J, Winkler IT, Bobel C et al. (2021). Menstrual health: a definition for policy, practice, and research. Sexual and Reproductive Health Matters. 29(1): 31-38. https://doi.org/10.1080/26410397.2021.1911618; PMid:33910492 PMCid:PMC8098749
Kabukçu C, KabukçuBaşay B, Başay Ö. (2021). Primary dysmenorrhea in adolescents: Association with attention deficit hyperactivity disorder and psychological symptoms. Taiwan J Obstet Gynecol. 60(2): 311-317. https://doi.org/10.1016/j.tjog.2021.01.033; PMid:33678333
Kamin HS, Kertes DA. (2017). Cortisol and DHEA in development and psychopathology. Hormones and Behavior. 89: 69-85. https://doi.org/10.1016/j.yhbeh.2016.11.018; PMid:27979632
Khan QU, Zaffar S, Rehan A et al. (2020). Relationship of major depression with body mass index and salivary cortisol. Cureus. 12(1): 6577. https://doi.org/10.7759/cureus.6577
King LS, Graber MG, Colich NL, Gotlib IH. (2020). Associations of waking cortisol with DHEA and testosterone across the pubertal transition: Effects of threat-related early life stress. Psychoneuroendocrinology. 115: 104651. https://doi.org/10.1016/j.psyneuen.2020.104651; PMid:32199287 PMCid:PMC7183417
Marceau K, Shirtcliff EA, Hastings PD et al. (2014). Within-adolescent coupled changes in cortisol with DHEA and testosterone in response to three stressors during adolescence. Psychoneuroendocrinology. 41: 33-45. https://doi.org/10.1016/j.psyneuen.2013.12.002; PMid:24495606 PMCid:PMC3938090
Maurya P, Meher T, Muhammad T. (2022). Relationship between depressive symptoms and self-reported menstrual irregularities during adolescence: evidence from UDAYA, 2016. BMC Public Health. 22(1): 758. https://doi.org/10.1186/s12889-022-13196-8; PMid:35422014 PMCid:PMC9011997
Ozimek N, Velez K, Anvari H et al. (2022). Impact of stress on menstrual cyclicity during the coronavirus disease 2019 pandemic: a survey study. Journal of Women's Health. 31 (1): 84-90. https://doi.org/10.1089/jwh.2021.0158; PMid:34582731
Pakpour AH, Kazemi F, Alimoradi Z, Griffiths MD. (2020). Depression, anxiety, stress, and dysmenorrhea: a protocol for a systematic review. Syst Rev. 9(1): 65. https://doi.org/10.1186/s13643-020-01319-4; PMid:32216827 PMCid:PMC7098110
Phan JM, Van Hulle CA, Shirtcliff EA et al. (2021). Longitudinal effects of family psychopathology and stress on pubertal maturation and hormone coupling in adolescent twins. Dev Psychobiol. 63(3): 512-528. https://doi.org/10.1002/dev.22028; PMid:32862448 PMCid:PMC7914297
Van Dammen L, de Rooij SR, Behnsen PM, Huizink AC. (2020). Sex-specific associations between person and environment-related childhood adverse events and levels of cortisol. PLoSOne. 15(6): e0233718. https://doi.org/10.1371/journal.pone.0233718; PMid:32497103 PMCid:PMC7272021
Vurgun E, Memet B, Kocaturk E, Guntas G. (2021). Evaluation of serum 25-hydroxyvitamin D levels and cortisol/dehydroepiandrosterone sulfate ratio in chronic spontaneous urticarial. Turkish Journal of Biochemistry. 46(2): 191-196. https://doi.org/10.1515/tjb-2020-0304
Yu M, Han K, Nam GE. (2017). The association between mental health problems and menstrual cycle irregularity among adolescent Korean girls. Journal of Affective Disorders. 210: 43-48. https://doi.org/10.1016/j.jad.2016.11.036; PMid:28012351
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