Stress-dependent menstrual disorders: The current state of the problem. A review
- Authors: Podzolkova N.M.1,2, Glazkova O.L.1,2, Cheporev L.А.2, Mass E.E.1, Sumyatina L.V.1
-
Affiliations:
- Russian Medical Academy of Continuous Professional Education
- Botkin Moscow Multidisciplinary Research and Clinical Center
- Issue: Vol 27, No 3 (2025)
- Pages: 203-208
- Section: REVIEW
- URL: https://journals.rcsi.science/2079-5831/article/view/316015
- DOI: https://doi.org/10.26442/20795696.2025.3.203422
- ID: 316015
Cite item
Full Text
Abstract
Changing the features of the menstrual cycle to certain limits up to a short anovulation can be considered as a normal and transient response to adverse living conditions, including stress factors. The line separating such a normal reaction from a disease is very fluid and can be crossed in the setting of a predisposition. Stressful exposures include objectively adverse and subjectively significant factors of different duration and intensity. The predisposition to menstrual irregularities can have genetic prerequisites and be triggered by epigenetic factors. This literature review provides up-to-date data on the issue of stress-dependent menstrual disorders. Due to the significant role of prolactin metabolism disorders in the etiology of such disorders, the prospects of using plant-origin dopaminomimetics, including in young patients, have been considered.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
N. M. Podzolkova
Russian Medical Academy of Continuous Professional Education; Botkin Moscow Multidisciplinary Research and Clinical Center
Author for correspondence.
Email: podzolkova@gmail.com
ORCID iD: 0000-0001-8991-1369
D. Sci. (Med.), Prof., Russian Medical Academy of Continuous Professional Education, Botkin Moscow Multidisciplinary Research and Clinical Center
Russian Federation, Moscow; MoscowO. L. Glazkova
Russian Medical Academy of Continuous Professional Education; Botkin Moscow Multidisciplinary Research and Clinical Center
Email: podzolkova@gmail.com
ORCID iD: 0000-0001-9324-2866
Cand. Sci. (Med.), Russian Medical Academy of Continuous Professional Education, Botkin Moscow Multidisciplinary Research and Clinical Center
Russian Federation, Moscow; MoscowL. А. Cheporev
Botkin Moscow Multidisciplinary Research and Clinical Center
Email: podzolkova@gmail.com
ORCID iD: 0009-0001-0466-4707
Cand. Sci. (Med.)
Russian Federation, MoscowE. E. Mass
Russian Medical Academy of Continuous Professional Education
Email: podzolkova@gmail.com
ORCID iD: 0000-0002-9069-0337
Graduate Student
Russian Federation, MoscowL. V. Sumyatina
Russian Medical Academy of Continuous Professional Education
Email: podzolkova@gmail.com
ORCID iD: 0000-0002-6443-8891
Cand. Sci. (Med.)
Russian Federation, MoscowReferences
- Серов В.Н., Прилепская В.Н., Пшеничникова Т.Я., и др. Практическое руководство по гинекологической эндокринологии. М., 1995 [Serov VN, Prilepskaia VN, Pshenichnikova TIa, et al. Prakticheskoe rukovodstvo po ginekologicheskoi endokrinologii. Moscow, 1995 (in Russian)].
- Подзолкова Н.М., Глазкова О.Л. Репродуктивное здоровье бортпроводниц гражданской авиации: медицинский мониторинг и профилактика. М.: Воздушный транспорт, 2004 [Podzolkova NM, Glazkova OL. Reproduktivnoe zdorov'e bortprovodnits grazhdanskoi aviatsii: meditsinskii monitoring i profilaktika. Moscow: Vozdushnyi transport, 2004 (in Russian)].
- Адамян Л.В., Сибирская Е.В., Пивазян Л.Г., и др. Роль кисспептина в патогенезе функциональной гипоталамической аменореи. Проблемы репродукции. 2023;29(6):81-6 [Adamyan LV, Sibirskaya EV, Pivazyan LG, et al. Role of kisspeptin in the pathogenesis of the functional hypothalamic amenorrhea. Russian Journal of Human Reproduction. 2023;29(6):81-6 (in Russian)]. doi: 10.17116/repro20232906181
- Gordon CM, Ackerman KE, Berga SL, et al. Functional hypothalamic amenorrhea: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2017;102:1413-39. doi: 10.1210/jc.2017-00131
- Practice Committee of the American Society for Reproductive Medicine. Current evaluation of amenorrhea. Fertil Steril. 2006;86:S148-55. doi: 10.1016/j.fertnstert.2006.08.013
- Saadedine M, Kapoor E, Shufelt C. Functional hypothalamic amenorrhea: recognition and management of a challenging diagnosis. Mayo Clin Proc. 2023;98:1376-85. doi: 10.1016/j.mayocp.2023.05.027
- Gordon CM. Clinical practice. Functional hypothalamic amenorrhea. N Engl J Med. 2010;363(4):365-71. doi: 10.1056/NEJMcp0912024
- Męczekalski B, Niwczyk O, Battipaglia C, et al. Neuroendocrine disturbances in women with functional hypothalamic amenorrhea: an update and future directions. Endocrine. 2024;84(3):769-85. doi: 10.1007/s12020-023-03619-w
- Seminara SB, Hayes FJ, Crowley WF Jr. Gonadotropin-releasing hormone deficiency in the human (idiopathic hypogonadotropic hypogonadism and Kallmann’s syndrome): pathophysiological and genetic considerations. Endocr Rev. 1998;19:521-39. doi: 10.1210/edrv.19.5.0344
- Laitinen EM, Vaaralahti K, Tommiska J, et al. Incidence, phenotypic features and molecular genetics of Kallmann syndrome in Finland. Orphanet J Rare Dis. 2011;6:41. doi: 10.1186/1750-1172-6-41
- Bianco SD, Kaiser UB. The genetic and molecular basis of idiopathic hypogonadotropic hypogonadism. Nat Rev Endocrinol. 2009;5:569-76. doi: 10.1038/nrendo.2009.177
- Stamou MI, Cox KH, Crowley WF Jr. Discovering genes essential to the hypothalamic regulation of human reproduction using a human disease model: adjusting to life in the “-omics” Era. Endocr Rev. 2015;36:603-21. doi: 10.1210/er.2015-1045
- Stamou MI, Georgopoulos NA. Kallmann syndrome: phenotype and genotype of hypogonadotropic hypogonadism. Metabolism. 2018;86:124-34. doi: 10.1016/j.metabol.2017.10.012
- Franco B, Guioli S, Pragliola A, et al. A gene deleted in Kallmann’s syndrome shares homology with neural cell adhesion and axonal path-finding molecules. Nature. 1991;353:529-36. doi: 10.1038/353529a0
- Gianetti E, Hall JE, Au MG, et al. When genetic load does not correlate with phenotypic spectrum: lessons from the GnRH receptor (GNRHR). J Clin Endocrinol Metab. 2012;97:E1798-807. doi: 10.1210/jc.2012-1264
- Beneduzzi D, Trarbach EB, Min L, et al. Role of gonadotropin-releasing hormone receptor mutations in patients with a wide spectrum of pubertal delay. Fertil Steril. 2014;102:838-46.e2. doi: 10.1016/j.fertnstert.2014.05.044
- Hietamäki J, Hero M, Holopainen E, et al. GnRH receptor gene mutations in adolescents and young adults presenting with signs of partial gonadotropin deficiency. PloS One. 2017;12:e0188750. doi: 10.1371/journal.pone.0188750
- de Roux N, Young J, Misrahi M, et al. A family with hypogonadotropic hypogonadism and mutations in the gonadotropin-releasing hormone receptor. N Engl J Med. 1997;337:1597-602. doi: 10.1056/NEJM199711273372205
- Caronia LM, Martin C, Welt CK, et al. A genetic basis for functional hypothalamic amenorrhea. N Engl J Med. 2011;364:215-25. doi: 10.1056/NEJMoa0911064
- Kim SH, Hu Y, Cadman S, Bouloux P. Diversity in fibroblast growth factor receptor 1 regulation: learning from the investigation of Kallmann syndrome. J Neuroendocrinol. 2008;20:141-63. doi: 10.1111/j.1365-2826.2007.01627.x
- Matsumoto S, Yamazaki C, Masumoto KH, et al. Abnormal development of the olfactory bulb and reproductive system in mice lacking prokineticin receptor PKR2. Proc Natl Acad Sci USA. 2006;103:4140-5. doi: 10.1073/pnas.0508881103
- Delaney A, Burkholder AB, Lavender CA, et al. Increased burden of rare sequence variants in gnRH-associated genes in women with hypothalamic amenorrhea. J Clin Endocrinol Metab. 2021;106:e1441-52. doi: 10.1210/clinem/dgaa609
- Fontana L, Garzia E, Marfia G, et al. Epigenetics of functional hypothalamic amenorrhea. Front Endocrinol (Lausanne). 2022;13:953431. doi: 10.3389/fendo.2022.953431
- Vazquez MJ, Toro CA, Castellano JM, et al. SIRT1 mediates obesity- and nutrient-dependent perturbation of pubertal timing by epigenetically controlling Kiss1 expression. Nat Commun. 2018;9:4194. doi: 10.1038/s41467-018-06459-9
- Frieling H, Gozner A, Römer KD, et al. Global DNA hypomethylation and DNA hypermethylation of the alpha synuclein promoter in females with anorexia nervosa. Mol Psychiatry. 2007;12:229-30. doi: 10.1038/sj.mp.4001931
- Neyazi A, Buchholz V, Burkert A, et al. Association of leptin gene DNA methylation with diagnosis and treatment outcome of anorexia nervosa. Front Psychiatry. 2019;10:197. doi: 10.3389/fpsyt.2019.00197
- Batury VL, Walton E, Tam F, et al. DNA methylation of ghrelin and leptin receptors in underweight and recovered patients with anorexia nervosa. J Psychiatr Res. 2020;131:271-8. doi: 10.1016/j.jpsychires.2020.08.026
- Welt CK, Chan JL, Bullen J, et al. Recombinant human leptin in women with hypothalamic amenorrhea. New Engl J Med. 2004;351:987-97. doi: 10.1056/NEJMoa040388
- Xie Q, Kang Y, Zhang C, et al. The role of kisspeptin in the control of the hypothalamic-pituitary-gonadal axis and reproduction. Front Endocrinol (Lausanne). 2022;13:925206. doi: 10.3389/fendo.2022.925206
- Morrison AE, Fleming S, Levy MJ. A review of the pathophysiology of functional hypothalamic amenorrhoea in women subject to psychological stress, disordered eating, excessive exercise or a combination of these factors. Clin Endocrinol (Oxf). 2021;95:229-38. doi: 10.1111/cen.14399
- Laughlin GA, Dominguez CE, Yen SS. Nutritional and endocrine-metabolic aberrations in women with functional hypothalamic amenorrhea. J Clin Endocrinol Metab. 1998;83:25-32. doi: 10.1210/jcem.83.1.4502
- Batury VL, Walton E, Tam F, et al. DNA methylation of ghrelin and leptin receptors in underweight and recovered patients with anorexia nervosa. J Psychiatr Res. 2020;131:271-8. doi: 10.1016/j.jpsychires.2020.08.026
- Nakazato M, Murakami N, Date Y, et al. A role for ghrelin in the central regulation of feeding. Nature. 2001;409:194-8. doi: 10.1038/35051587
- Bernardoni F, Bernhardt N, Pooseh S, et al. Metabolic state and value-based decision-making in acute and recovered female patients with anorexia nervosa. J Psychiatry Neurosci. 2020;45:253-61. doi: 10.1503/jpn.190031
- Barbagallo F, Condorelli RA, Mongioi LM, et al. Molecular mechanisms underlying the relationship between obesity and male infertility. Metabolites. 2021;11:840. doi: 10.3390/metabo11120840
- Болотова Н.В., Тимофеева С.В., Поляков В.К., и др. Роль кисспептина в нарушениях менструальной функции у девочек-подростков. Коррекция клинико-гормональных нарушений. Доктор.Ру. 2020;19(2):13-9 [Bolotova NV, Timofeeva SV, Polyakov VK, et al. The Role of Kisspeptin in Menstrual Disorders in Adolescent Girls. Treatment of Clinically Manifested Endocrine Abnormalities. Doctor.Ru. 2020;19(2):13-9 (in Russian)]. doi: 10.31550/1727-2378-2020-19-2-13-19
- Fontana L, Garzia E, Marfia G, et al. Epigenetics of functional hypothalamic amenorrhea. Front Endocrinol (Lausanne). 2022;13:953431. doi: 10.3389/fendo.2022.953431
- Cao C, Ding Y, Kong X, et al. Reproductive role of miRNA in the hypothalamic-pituitary axis. Mol Cell Neurosci. 2018;88:130-7. doi: 10.1016/j.mcn.2018.01.008
- Lannes J, L’Hôte D, Garrel G, et al. Rapid communication: A microRNA-132/212 pathway mediates GnRH activation of FSH expression. Mol Endocrinol. 2015;29:364-72. doi: 10.1210/me.2014-1390
- Ye RS, Li M, Li CY, et al. miR-361-3p regulates FSH by targeting FSHB in a porcine anterior pituitary cell model. Reproduction. 2017;153:341-9. doi: 10.1530/REP-16-0373
- Calogero AE, Burrello N, Bosboom AM, et al. Glucocorticoids inhibit gonadotropin-releasing hormone by acting directly at the hypothalamic level. J Endocrinol Invest. 1999;22:666-70. doi: 10.1007/BF03343627
- Nappi RE, Petraglia F, Genazzani AD, et al. Hypothalamic amenorrhea: evidence for a central derangement of hypothalamic-pituitary-adrenal cortex axis activity. Fertil Steril. 1993;59:571-6. doi: 10.1016/S0015-0282(16)55802-6
- Lin SH. Prolactin-releasing peptide. Results Probl Cell Differ. 2008;46:57-88. doi: 10.1007/400_2007_048
- Шахтшнейдер Е.В., Иванощук Д.Е., Воевода С.М., Рымар О.Д. Результаты таргетного секвенирования генов PRL, PRLR, PRLHR у молодых женщин с гиперпролактинемией неопухолевого генеза. Сибирский научный медицинский журнал. 2022;42 (4):79-86 [Shakhtshneider EV, Ivanoshchuk DE, Voevoda SM, Rymar OD. Results of targeted sequencing of the PRL, PRLR, PRLHR genes in young women with non-tumor hyperprolactinemia. Sibirskiy nauchnyy meditsinskiy zhurnal = Siberian Scientific Medical Journal. 2022;42(4):79-86 (in Russian)]. doi: 10.18699/SSMJ20220407
- Gala RR. The physiology and mechanisms of the stress-induced changes in prolactin secretion in the rat. Life Sci. 1990;46(20):1407-20. doi: 10.1016/0024-3205(90)90456-2
- Torner L, Toschi N, Pohlinger A, et al. Anxiolytic and anti-stress effects of brain prolactin: improved efficacy of antisense targeting of the prolactin receptor by molecular modeling. J Neurosci. 2001;21(9):3207-14.
- Torner L, Toschi N, Nava G, et al. Increased hypothalamic expression of prolactin in lactation: involvement in behavioral and neuroendocrine stress responses. Eur J Neurosci. 2002;15:1381-9. doi: 10.1046/j.1460-9568.2002.01965.x
- Faron-Górecka A, Kuśmider M, Solich J, et al. Involvement of prolactin and somatostatin in depression and the mechanism of action of antidepressant drugs. Pharmacol Rep. 2013;65(6):1640-6. doi: 10.1016/S1734-1140(13)71525-1
- Подзолкова Н.М., Полетова Т.Н., Глазкова О.Л., Созаева Л.Г. Клиническая оценка негормональной монотерапии при нарушениях менструальной функции. Вопросы гинекологии, акушерства и перинатологии. 2009;8(3):33-6 [Podzolkova NM, Poletova TN, Glazkova OL, et al. A clinical evaluation of nonhormonal monotherapy in disorders of the menstrual function. Vopr. ginekol. akus. perinatol./Gynecology, Obstetrics and Perinatology. 2009;8(3):33-6 (in Russian)].
- Артымук Н.В., Зотова О.А. Влияние препарата «Циклодинон» на сексуальную функцию у пациенток с бесплодием и нарушениями менструального цикла. Акушерство и гинекология. 2023;(11):158-68 [Artymuk NV, Zotova OA. The effect of the Cyclodynon drug on sexual function in patients with infertility and menstrual disorders. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023;(11):158-68 (in Russian)]. doi: 10.18565/aig.2023.1939
- Shahnazi M, Khalili AF, Hamdi K, Ghahremaninasab P. The Effects of Combined Low-Dose Oral Contraceptives and Vitex Agnus on the Improvement of Clinical and Paraclinical Parameters of Polycystic Ovarian Syndrome: A Triple-Blind, Randomized, Controlled Clinical Trial. Iran Red Crescent Med J. 2016;18(12):e37510. doi: 10.5812/ircmj.37510
- Уварова Е.В. Эффективность и безопасность применения растительного лекарственного препарата Циклодинон® для лечения нарушений менструального цикла у девочек-подростков: обзор опыта клинического применения. Репродуктивное здоровье детей и подростков. 2021;17(2):51-6 [Uvarova EV. Effectiveness and safety of herbal medicinal product Cyclodinone® in treatment of menstrual irregularities in adolescent girls: a review of clinical usage. Reproduktivnoe zdorov’e detey i podrostkov. 2021;17(2):51-64 (in Russian)]. doi: 10.33029/1816-2134-2020-17-2-51-64
- Вуттке В., Ярри Г., Зайдлова-Вуттке Д., и др. Терапевтические возможности экстрактов из Авраамова дерева (Vitex Agnus castus) в гинекологической практике. Проблемы репродукции. 2009;(4):53-8 [Vuttke V, Iarri G, Zaidlova-Vuttke D, et al. Terapevticheskie vozmozhnosti ekstraktov iz Avraamova dereva (Vitex Agnus castus) v ginekologicheskoi praktike. Problemy reproduktsii. 2009;(4):53-8 (in Russian)].
- Кузнецова И.В., Успенская Ю.Б., Диль В.В., Гринева А.М. Использование растительных дофаминомиметиков у подростков и молодых женщин с нарушенным менструальным циклом. Акушерство и гинекология. 2015;(11):70-7 [Kuznetsova IV, Uspenskaya YuB, Dil VV, Grineva AM. Use of herbal dopamine mimetics in adolescents and young women with menstrual irregularities. Akusherstvo i ginekologiya/Obstetrics and Gynecology. 2015;(11):70-7 (in Russian)].
- Яворская С.Д. Место фитотерапии в лечении пациенток с гиперпролактинемией. Гинекология. 2013;15(4):28-30 [Yavorskaya SD. Herbal medicine in the treatment of hyperprolactinemia patients. Gynecology. 2013;15(4):28-30 (in Russian)].
- Брюхина Е.В., Окраинская О.А., Усольцева Е.Н. Опыт использования препарата циклодинон при лечении нарушений менструального цикла у подростков. Репродуктивное здоровье детей и подростков. 2008;3:37-40 [Bryukhina EV, Okrainskaya OA, Usoltseva EN. Experience of using the drug cyclodynone in the treatment of menstrual disorders in adolescents. Reproductive health of children and adolescents. 2008;3:37-40 (in Russian)].
Supplementary files
