Hormonal homeostasis in women of reproductive age with adenomyosis

Abstract

The problem of adenomyosis is particularly relevant for patients of reproductive age, as it is accompanied by the significant disturbances of menstrual and generative functions. The article presents the results of studying the condition of the hypothalamic-pituitary-ovarian system in women of reproductive age with adenomyosis.The objective: to study the state of the hypothalamic-pituitary-ovarian system in women of reproductive age with benign endometrial and myometrial pathology.Materials and methods. The main group included 120 women of reproductive age with benign endometrial and myometrial pathology (adenomyosis, endometrial hyperplasia and combined pathology), and the control group included 40 healthy women without gynecological pathology. The functional state of the hypothalamic-pituitary-ovarian system was evaluated by the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2) and progesterone (P) in blood serum in different phases of the menstrual cycle.Results. In women with adenomyosis, endometrial hyperplasia and combined pathology, there is hyperproduction of gonadotropic hormones with an increase of their secretion level compared to a group of healthy women: the average concentration of FSH, regardless of the phase of the menstrual cycle, increased by 1.9 times (p<0.05), LH – 2.2 times, PRL – 2 times, which indicates the presence of hyperprolactinemia. Both in the I and II phases of the menstrual cycle, the occurrence of additional FSH and LH peaks from basal hormone secretion was determined in patients of the main group, which reached the level of hormone concentration in the ovulatory peak. In the patients of the main group, hyperestrogenemia during the entire menstrual cycle and hypoprogesteronemia were detected. The expression of hormonal shifts depended on gynecological pathology (adenomyosis, endometrial hyperplasia and combined pathology) and the functional state of the woman.Conclusions. The indicators of gonadotropic and prolactin-stimulating activity of the pituitary gland in women with benign uterine pathology confirm the participation of FSH, LH and prolactin in the complex processes of regulation of the reproductive system.