CORRECTION OF HORMONAL DISORDERS IN WOMEN WITH ABNOMAL UTERINE BLEEDING AND CHRONIC PSYCHO-EMOTIONAL STRESS

The aimof the research was to evalu-ate the effectiveness of the optimized treatment in the cor-rection of hormonal disorders in women with abnormal uterine bleeding (AUB) and chronic psycho-emotionalstress.Materials and methods.100 women of repro-ductive 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 ac-cordance with the recommendations of the order of the Ministry of Health of Ukraine N 353 dated 13.04.2016. In-clusion criteria: AUB, age 18-45 years, satisfactory condi-tion of the sample of the material from the uterine cavity for histological examination, chronic psychogenic stress, patient consent. Exclusion criteria: pregnancy, premen-strual dysphoric disorder, acute pelvic inflammatory dis-ease, mental disorders, blood diseases associated with co-agulation disorders, hypothyroidism, hyperthyroidism, hormonal adrenal tumors, chronic intestinal diseases, se-vere somatic pathology. Optimized treatment additionally included recommendations for lifestyle changes, melato-nin, vitamin D, medicament'correction of iron deficiency without anemia. Estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, progester-one, 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 pos-itive dynamics of progesterone and FSH levels in the pa-tients in the I and II groups whose concentrations reached the control group. However, LH level inpatients in both groups and estradiol amount in the II group differed sig-nificantly from those in healthy women. After optimized treatment, the levels of prolactin and cortisol reached the amount of healthy women, while after the standard treat-ment 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 1082(22)квітень-червень,2022ISSN2521-1455 (Print)ISSN2523-4250 (Online) «Art of Medicine»control group. FSH and LH levels in patients before and after the standard and optimized treatment were atthe 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.