Adolescent menstrual dysfunction as a marker of future disorders of women’s sexual and reproductive health

Abstract

The literature review considers the health state in wo­men of early reproductive age. This is related to the common factors of formation that arise in adolescence, and are clinically manifested in the reproductive age. Disorders of the reproductive system functioning in puberty often lead to infertility, obstetric complications and perinatal losses. Ghrelin is a factor in the pathogenesis of functional amenorrhea during weight loss. Its concentration has a negative correlation with body mass index and androgen levels in the female body. Excessive physical exertion is one of the causes of functional amenorrhea, because this pathology is associated with increased levels of β-endorphin and ghrelin, as well as extremely low concentrations of leptin. Recent researches have demonstrated the importance of hidden genetic reproductive polymorphisms in women with the above-mentioned risk factors for amenorrhea for the future impairment of fertility. That is why women without genetic polymorphisms are able to restore both menstrual and reproductive functions after eliminating the influence of risk factors. However, in patients with some types of genetic mutations, amenorrhea persists despite the normalization of body weight, disappearance of stress and/or reduction of physical exertion. Under conditions of war in Ukraine, there is an increase in the frequency of hypothalamic dysfunctions in women of active reproductive age with a decrease in body weight against the background of stress, head injuries, which gives the problem an extreme acuteness and urgency. An example of a clinical mani­festation of functional gonadotropin insufficiency is a menstrual disorder with the formation of secondary amenorrhea in 35 % of cases. Stress-induced (psychogenic) amenorrhea is one of the most common causes of functional gonadotropin deficiency. Menstrual and sexual female dysfunction is a multifactorial disorder that impairs women’s fertility, leads to pregnancy loss, infertility, and abnormal gestation. Due to dysmetabolic disorders, violations of ovarian steroidogenesis with hypothalamic-pituitary imbalance, this problem becomes multidisciplinary.