Hormonal aspects of reproductive health disorders in women with a history of female sexual dysfunction and early pregnancy loss

Abstract

Objective — to tudy the peculiarities of hormonal background in women with early pregnancy loss and female sexual dysfunction in thepre-pregnancy stage. Materials and methods. A study of steroid and peptide hormones in the first phase of the menstrual cycle (5 — 7 days of the menstrual cycle) in women with a history of female sexual dysfunction and early pregnancy loss at the planning stage of the next pregnancy (69 women, main group). The Control group consisted of 30 women with early pregnancy loss without sexual dysfunction. Results. Women in the surveyed groups had hormonal imbalances before the onset of their pregnancy, women of the main group more often received hormonal therapy of the menstrual cycle and received pre-pregnancy training. Unfortunately, this did not have a positive effect on the progression of the pregnancy. Women with sexual dysfunction showed signs of functional hypogonadism, manifested in the parameters of peptide hormones: the average FSH in the main group I  — 4.46 IU/l, compared to 7.23 in the control group. An average LH indicator was different between the compared groups: 2.77 IU/l in the main group and 6.63 IU/l in the control group. This resulted in the changes in the steroid supply of women: hypoestrogenism, hypoprogesteronemia, hypoandrogenism. In the main group, the level of estradiol was 35.03 [29.69; 40.36] pg/ml vs. 106.87 [95.4; 118.83] in the control group, which led to a violation of proliferative processes in the female body. The progesterone index had an insignificant decrease in main group compared with the control group: 0.27 [0.23; 0.30] nmol/l against 0.40 [0.35; 0.45] nmol/l. The mean value of free testosterone in main group of was 1.08 against 3.38 pkg/ml of the control group. The average DHEA-S in women of main group was 47.67 mg/dl against 351, 92 mg/dl of the control group. The identified differences indicate a greater prognostic value of DHEA-S in violation of ovarian folliculogenesis. Changes in hormonal background in women with early pregnancy and sexual dysfunction indicate a general negative trend of intracranial DHEA-S deficiency to estradiol secretion and steroid deficiency. The study results confirmed the opinion of other scientists about the need to normalize DHEA-S levels to prevent premature atresia of immature follicles. Conclusions. In women with sexual dysfunction and functional hypoandrogenism, there is a significant suppression of LH levels, which in turn makes it impossible to fully recruit preantral follicles from the primordial follicular pool due to deficiency of DHEA-S. In hypoandrogenism, it is the intracrine deficiency of DHEA- S that affects the secretion of estradiol and leads to a lack of steroid supply to the reproductive background of the female body. Restoration of the full gestational capabilities of women with sexual dysfunction and functional hypogonadism depends on a multidisciplinary approach to overcoming of the identified imbalances.