The relationship between comorbid pathology, vitamin D status, and disorders of menstrual function in adolescent girls

Abstract

Objective — to determine the nature of comorbid pathology in modern adolescent girls with disorders of menstrual function, and to establish the relationship between vitamin D status and comorbid pathology. Materials and methods. The analysis has been performed for the results of clinical and paraclinical examination of 333 adolescent girls aged 11—17 with menstrual disorders (primary oligomenorrhea and abnormal uterine bleeding). Physical and sexual development was determined, body mass index was calculated. The serum levels of vitamin D, prolactin, thyroid­stimulating hormone were evaluated. Results and discussion. Comorbid pathology was diagnosed in the absolute majority of adolescent girls with disorders of menstrual function, both of abnormal uterine bleeding (AUB) and oligomenorrhea (OM) types. Diseases of the endocrine system were registered mostly often; digestive pathologies and neuropsychological abnormalities were less common. In patients with OM, comorbid conditions of the digestive system and the neuropsychological area were registered significantly more often. Peculiarities of physical, sexual development, and menstrual function were established, which depended on the presence of various comorbid pathologies and the type of menstrual function disorders. Vitamin D insufficiency and its deficiency were observed in the majority of girls with both AUB and OM, and no significant difference was found in various comorbid pathologies. Normative values of vitamin D were noted in no more than 12—18 % of cases and tended to decrease in presence of the diseases of endocrine system. Conclusions. The obtained results demonstrated the importance of a multidisciplinary approach to the examination of patients with menstrual cycle disorders, as a guarantee of increasing the effectiveness of treatment and preventive measures with the aim of restoring reproductive potential.