The objective: to study the concentration of estradiol, progesterone, follicle-stimulating and luteinizing hormones, testosterone, prolactin and cortisol in women with abnormal uterine bleeding (AUB) and of chronic psycho-emotional stress.Materials and methods. We examined 100 women of reproductive age with AUB and chronic stress (main group) and 50 patients with AUB without chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. The AUB diagnosis was made on the basis of order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The concentrations of estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin and cortisol were determined in blood serum in all the women in the follicular phase of the menstrual cycle using the ELISA method.Results. In patients with AUB and chronic stress, a significant decrease of estradiol by 37.50% relative to healthy women, FSH – 44.42%, LH – 22.12%, progesterone – 38.23% and a significant increase in prolactin by 41.92% and cortisol – 82.96% were established. In the patients with AUB without chronic stress a significant decrease in estradiol level by 23.95%, FSH by 22.09% and progesterone by 21.91%, and a significant increase in cortisol by 21.55% were found. The concentration of testosterone in the main group and the comparison group, as well as changes in the levels of LH and prolactin in the patients of the comparison group, were insignificant relative to the control group. Conclusions. In women of reproductive age with abnormal uterine bleeding and chronic stress, there is a significant decrease in the concentration of estradiol, progesterone, follicle-stimulating and luteinizing hormones in the blood serum, an increase of prolactin and cortisol, and the absence of significant changes in testosterone level in the follicular phase of the menstrual cycle.

The objective: to assess the effectiveness of the complex optimized treatment approach to abnormal uterine bleeding (AUB) in women with chronic psychogenic stress on the quality of life.Materials and methods. We examined 100 women of reproductive age with AUB and chronic psychogenic stress, 50 patients of them consisted the I group and received the optimized treatment, and 50 persons (II group) received the standard AUB treatment. 30 women without AUB and chronic stress were included in the control group. The examination of all persons included: anamnesis, clinical and gynecological examinations, ultrasound examination, general blood test, blood ferritin, vitamin D in serum blood. The quality of life was determined according to the 36-Item Short Form Health Survey before treatment and after three months. The standard approach included diagnostic and therapeutic measures according to the recommendations of Order N 353 dated 13.04.2016 of the Ministry of Health of Ukraine. The optimized treatment additionally included recommendations for lifestyle changes, melatonin, the use of vitamin D depending on its level, the medicament correction of iron deficiency without anemia.Results. The results of the questionnaire 36-Item Survey scales indicate that in patients with AUB and chronic psychogenic stress there is a decrease in the scales relative to the values of healthy women, especially in psychological component. In the persons of the II group there was no significant dynamics of the scales “Bodily pain” and “Physical role functioning” relative to the indicators before treatment, while the scales “Physical function” (p<0,001) and “General health perceptions” (p=0.01) increased significantly. The optimized treatment lead to a significant increase in all physical component scales compared till normal indices. In patients of the II group the indicators of psychological scales after treatment were significantly lower than the average values of healthy women. Thus, the value of the scale “Mental Health” was lower by 14,34% relative to the control group (p=0,18), “Emotional role functioning” – 18,38% (p=0,007), “Social role functioning” – 15,46% (p=0,003), “Vitality” – 23,27% (p=0,005). In the women of the I group there was a significant increase in the indicators of the psychological scales, which after treatment reached the values of healthy women.Conclusions. In women with AUB and chronic psychogenic stress, there is an insufficient positive dynamics in improving the quality of life after the standard treatment, especially the scales of the psychological component. The optimized treatment approach leads to the improvement of all parameters of quality of life of the patients.

The aim of the research was to evaluate the effectiveness of the optimized treatment in the correction of hormonal disorders in women with abnormal uterine bleeding (AUB) and chronic psycho-emotional stress. Materials and methods. 100 women of reproductive age with AUB and chronic psycho-emotional stress were examined. I group included 50 patients who received complex optimized treatment, II group included 50 persons who received standard treatment. The control group included 30 healthy women without AUB and chronic psycho-emotional stress. The standard approach provided for diagnostic and therapeutic measures in accordance with the recommendations of the order of the Ministry of Health of Ukraine N 353 dated 13.04.2016. Inclusion criteria: AUB, age 18-45 years, satisfactory condition of the sample of the material from the uterine cavity for histological examination, chronic psychogenic stress, patient consent. Exclusion criteria: pregnancy, premenstrual dysphoric disorder, acute pelvic inflammatory disease, mental disorders, blood diseases associated with coagulation disorders, hypothyroidism, hyperthyroidism, hormonal adrenal tumors, chronic intestinal diseases, severe somatic pathology. Optimized treatment additionally included recommendations for lifestyle changes, melatonin, vitamin D, medicament’ correction of iron deficiency without anemia. Estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, progesterone, prolactin, and cortisol levels were determined in all subjects. Results of the research. In the follicular phase of menstrual cycle after the standard treatment there is a positive dynamics of progesterone and FSH levels in the patients in the I and II groups whose concentrations reached the control group. However, LH level in patients in both groups and estradiol amount in the II group differed significantly from those in healthy women. After optimized treatment, the levels of prolactin and cortisol reached the amount of healthy women, while after the standard treatment the prolactin concentration was increased by 17.22 % (p=0.049), cortisol – by 43.84 % (p<0.001) compared with controls. In the luteal phase, the greatest correction of estradiol and progesterone concentrations in the I and II groups and prolactin level in women in the I group were determined. However, the amount of prolactin in patients of the II group remained high, exceeding the rate of healthy women by 33.64 % (p=0.007), while in the I group it corresponded to the control value. No significant changes in the concentration of FSH, LH and testosterone on the background of treatment in women of the two groups were observed, as their levels corresponded to the control group. FSH and LH levels in patients before and after the standard and optimized treatment were at the lower limit of healthy persons. Conclusions. The use of standard and optimized approaches in the management of patients with abnormal uterine bleeding and chronic psycho-emotional stress has been successful in normalizing in female sex hormones, but the standard approach has demonstrated an insufficient correction of stress-induced hormone levels, in contrast, the optimized treatment led to a more effective correction of all hormonal disorders.

The objective: a study the levels of anxiety and stress in women with abnormal uterine bleeding (AUB) and chronic psycho-emotional stress. Materials and methods. We examined 100 women of reproductive age with AUB and chronic stress (basic group) and 50 patients with AUB without chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. The AUB diagnosis according to the order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The level of stress was assessed on Reeder stress scale, anxiety – scale of the Spielberger State-Trait Anxiety Inventory.Results. It was found that the mean trait anxiety score in all groups of women corresponded to the middle level, however, in patients with AUB and chronic stress, this indicator (44.07±1.05 points) was significantly higher than in the other two groups (40.08±1.20 points – in the comparison group and 37.80±1.29 – control group). The level of state anxiety in patients with AUB and chronic stress was high (48.15±0.85 points) and significantly more (p<0.001) relative to the patients with AUB without chronic psycho-emotional stress (42.42±1.21 points) and healthy women (39.80±1.43 points). The largest number of women with a high level of state anxiety was found in the basic group (58.00%, p=0.03) relative to the control group (33.33%). The mean of the stress level in patients with AUB and chronic stress was 2.11±0.05 points and was significantly less (p<0.001) relative to healthy women (2.94±0.09 points) and patients with AUB without chronic stress (2.88±0.05 points). A high level of stress was found in more than one third of patients in the basic group (37.00%) versus absence of such persons in the control and comparison groups (p<0.001). Conclusions. In women of reproductive age with AUB and chronic stress, there is an increase in the level of state anxiety and stress.

The objective: to study the level of vitamin D (25-hydroxycalciferol – (25(OH)D) in blood serum of women with abnormal uterine bleeding (AUB) and chronic psychogenic stress.Materials and methods. We examined 100 women of reproductive age with AUB and chronic psychogenic stress (basic group) and 50 patients with AUB without psychogenic chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. AUB was diagnosis according to the Order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The concentration of vitamin D was determined in blood serum in all the women using the ELISA method.Results. The concentration of vitamin D in the blood serum in patients with AUB and chronic psychogenic stress was on 28.01 % lower compared to the controls (p < 0.001), in the patients with AUB without psychogenic chronic stress – 13.94 % (p = 0.045). The number of individuals with optimal concentration of vitamin D in the control group (36.67 %) was in 2.29 times higher compared to the basic group (16.00 %; p=0.03) and in 1.41 times more compared to the comparison group (26.00 %). Suboptimal level of vitamin D had 53.33 % women in the control group, 43.00 % – basic and 58.00 % – comparison one. The rate of persons with deficiency of vitamin D among the patients with AUB and chronic psychogenic stress was in 4.56 times higher compared to the healthy women (41.00 % and 9.00 % individuals, respectively; p = 0.003), and in patients with AUB without chronic stress –1.78 time (16.00 % women).Conclusions. There is the insufficient vitamin D concentration in women with abnormal uterine bleeding which is more severe in the persons with chronic psychogenic stress.