Волель Б.А., Рагимова А.А., Бурчаков Д.И. и др. Стресс-зависимые нарушения менструального цикла. Consilium Medicum. 2016; 18 (6): 8–13. DOI: 10.26442/2075-1753_2016.6.8-13
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Volel B.A., Ragimova A.A., Burchakov D.I. et al. Stress-related menstrual disorders. Consilium Medicum. 2016; 18 (6): 8–13. DOI: 10.26442/2075-1753_2016.6.8-13
Стресс-зависимые нарушения менструального цикла
Волель Б.А., Рагимова А.А., Бурчаков Д.И. и др. Стресс-зависимые нарушения менструального цикла. Consilium Medicum. 2016; 18 (6): 8–13. DOI: 10.26442/2075-1753_2016.6.8-13
________________________________________________
Volel B.A., Ragimova A.A., Burchakov D.I. et al. Stress-related menstrual disorders. Consilium Medicum. 2016; 18 (6): 8–13. DOI: 10.26442/2075-1753_2016.6.8-13
В статье представлен систематический анализ литературных данных по проблеме нарушений менструального цикла, возникающих в результате психологического стресса. Обобщены данные зарубежных и отечественных публикаций последних 15 лет, проиндексированных в системе цитирования Pubmed. Описаны современные теории механизма развития нарушений менструального цикла психогенного происхождения. Описаны особенности нарушений менструального цикла, развивающихся в результате действия психологического стресса. Проанализированы данные исследований, демонстрирующих отличия стрессовой чувствительности и особенности структуры личности у женщин, отвечающих нарушением менструальной функции на стресс. Описаны методы нефармакологического психотерапевтического лечения.
Ключевые слова: нарушения менструального цикла, ановуляция, аменорея, стресс, тревожность, депрессия.
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In this systematic review of scientific literature on stress-related menstrual disorders we summarize the results presented in papers, published in course of last 15 years and indexed in Pubmed. We describe contemporary theories considering the mechanism of psychogenic menstrual disorders development and review their specific features. We identify certain characteristics of sensitivity to stress and personality traits in women, reacting on stress with menstrual disorder. We also describe certain non-pharmacologic psychotherapeutic approaches to the management of these disorders.
1. Агарков В.А., Бронфман С.А., Кудаева Л.М., Уварова Е.В. Психологические аспекты патогенеза функциональной аменореи. Психическое здоровье. 2012; 7 (74): 70–8. / Agarkov V.A., Bronfman S.A., Kudaeva L.M., Uvarova E.V. Psikhologicheskie aspekty patogeneza funktsional'noi amenorei. Psikhicheskoe zdorov'e. 2012; 7 (74): 70–8. [in Russian]
2. Palm-Fischbacher S, Ehlert J. Dispositional resilience as a moderator of the relationship between chronic stress and irregular menstrual cycle.J Psychosom Obstet Gynaecol 2014; 2 (35): 42–50.
3. Practice Committee of the American Society for Reproductive Medicine. Current evaluation of amenorrhea. Fertil Steril 2006; 86: S148.
4. Williams NI, Berga SL, Cameron JL. Synergismbetweenpsychosocialandmetabolicstressors: impactonreproductivefunction in cynomolgusmonkeys. Am J Physiol Endocrinol Metab 2007; 293: E270–276.
5. Кузнецова И.В., Коновалов В.А. Нарушения менструального цикла и их гормональная коррекция в контексте стрессзависимых, психовегетативных расстройств. Акушерство и гинекология. 2014; 9: 2–6. / Kuznetsova I.V., Konovalov V.A. Narusheniia menstrual'nogo tsikla i ikh gormonal'naia korrektsiia v kontekste stresszavisimykh, psikhovegetativnykh rasstroistv. Akusherstvo i ginekologiia. 2014; 9: 2–6. [in Russian]
6. Meczekalski B, Katulski K. Functional hypothalamic amenorrhea and its influence on women’s health. J Endocrinol Invest 2014; 37: 1049–56.
7. Berga SL, Loucks TL. Use of cognitive behavior therapy for functional hypothalamic amenorrhea. Ann N Y AcadSci 2006; 1092: 114–29.
8. Podfigurna-Stopa A, Pludowski P, Jaworski M et al. Skeletal status and body composition in young women with functional hypothalamic amenorrhea. Gynecol Endocrinol 2012; 28 (4): 299–304.
9. Berga SL, Loucks TL. Stress and Reproductive Function. Fem Patient 2009; 34: 13–6.
10. Liu JH, Bill AH. Stress-associated or functional hypothalamic amenorrhea in the adolescent. Ann N Y Acad Sci 2008; 1135: 179–984.
11. Parashar R, Bhalla P, Rai NK et al. Migraine: is it related to hormonal disturbances or stress? Int J Women’s Health 2014; 6: 921–5.
12. Gordon C. Functional Hypothalamic Amenorrhea. New Engl J Med 2010; 363 (4): 364–71.
13. Tamura H, Takasaki A, Taketani T et al. Melatonin as a free radical scavenger in the ovarian follicle. Endocr J 2013; 60 (1): 1–13.
14. Bomba M, Gambera A, Bonini L et al. Endocrine profiles and neuropsychologic correlates of functional hypothalamic amenorrhea in adolescents. Fertil Steril 2007; 87 (4): 876–85.
15. Ekbäck M, Lindberg M, Benzein E, Årestedt K. Health-related quality of life, depression and anxiety correlate to the degree of hirsutism. Dermatology 2013; 227: 278–84.
16. Berga SL, Loucks TL. Stress Induced Anovulation. Elsevier 2007; р. 615–31.
17. Allsworth JE, Clarke J, Peipert JF et al. The influence of stress on the cycle among newly incarcerated women. Women’s Health Issues 2007; 17 (4): 202–9.
18. Ulrich-Lai YM, Herman JP. Neural regulation of endocrine and autonomic stress responses. Nature Reviews. Neuroscience 2009; 10: 397–409.
19. Valdes-Socin H, Rubio Almanza M, Tomé Fernández-Ladreda M et al. Reproduction, smell, and neurodevelopmental disorders: genetic defects in different hypogonadotropichypogonadal syndromes. Front Endocrinol (Lausanne) 2014; 5: 109.
20. Koob GF. Brain stress systems in the amygdala and addiction. Brain Research 2009; 1293: 61–75.
21. Uhart M, Wand GS. Stress, alcohol and drug interaction: An update of human research. Addiction Biology 2009; 14: 43–64.
22. Roa J, Tena-Sempere M. KiSS-1 system and reproduction:comparative aspects and roles in the control of female gonadotropic axis in mammals. Gen Comp Endocrinol 2007; 153: 132–40.
23. Fourman LT, Fazeli PK. Neuroendocrine causes of amenorrhea – an update. J Clin Endocrinol Metab 2015; 100 (3): 812–24.
24. Meczekalski B, Genazzani AR, Genazzani AD et al. Clinical evaluation of patients with weight loss-related amenorrhea: neuropeptide Y and luteinizing hormone pulsatility. Gynecol Endocrinol 2006; 22: 239–43.
25. Butera PC. Estradiol and the control of food intake. Physiol Behav 2010; 99: 175–80.
26. McVay MA, Copeland AL, Geiselman PJ. Eating disorder pathology and menstrual cycle fluctuations in eating variables in oral contraceptive users and non-users. Eat Behav 2011; 12: 49–55.
27. Klump KL, Keel PK, Culbert KM, Edler C. Ovarian hormones and binge eating: exploring associations in community samples. Psychol Med 2008; 38: 1749–57.
28. Klump KL, Keel PK, Racine SE et al. The interactive effects of estrogen and progesterone on changes in emotional eating across the menstrual cycle. J Abnorm Psychol 2013; 122: 131–7.
29. Bazarganipour F, Ziaei S, Montazeri A et al. Psychological investigation in patients with polycystic ovary syndrome. Health Qual Life Outcomes 2013; 11: 141.
30. Himelein MJ, Thatcher SS. Polycystic ovary syndrome and mental health: A review. Obstet Gynecol Surv 2006; 61 (11): 723–2.
31. Ching HL, Burke V, Stuckey BGA. Quality of Life and Psychological Morbidity in Women with Polycystic Ovary Syndrome: Body Mass Index, Age and the Provision of Patient Information Are Significant Modifiers. Clin Endocrinol 2007; 66 (3): 373–9.
32. Poyastro Pinheiro A, Thornton LM, Plotonicov KH et al. Patterns of menstrual disturbance in eating disorders. Int J Eat Disord 2007; 40: 424–34.
33. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5. American Psychiatric Publishing; 2013. (DSM-5) ed.
34. Jappe LH, Cao L, Crosby RD et al. Stress and eating disorder behavior in anorexia nervosa as a function of menstrual cycle status. Int J Eat Disord 2014; 47 (2): 181–8.
35. Klump KL, Burt SA, McGue M, Iacono WG. Changes in genetic and environmental influences on disordered eating across adolescence: a longitudinal twin study. Arch Gen Psychiatry 2007; 64: 1409–15.
36. Caronia LM, Martin C, Welt CK. A genetic basis for functional hypothalamic amenorrhea. N Engl J Med 2011; 364 (3): 215–25.
37. Bethea CL, Lima FB, Centeno ML et al. Effects of Citalopram on Serotonin and CRF Systems in the Midbrain of Primates with Differences in Stress Sensitivity. J Chem Neuroanat 2011; 41 (4): 200–18.
38. Bethea CL, Phu K, Reddy AP, Cameron JL. The effect of short moderate stress on the midbrain corticotropin-releasing factor system in amacaque model of functional hypothalamic amenorrhea. Fertil Steril 2013; 100 (4): 1111–21.
39. Кинодо Ж.М. Приручение одиночества: сепарационная тревога в психоанализе М.: Когито-Центр, 2008; с. 254. / Kinodo Zh.M. Priruchenie odinochestva: separatsionnaia trevoga v psikhoanalize M.: Kogito-Tsentr, 2008; s. 254. [in Russian]
40. Van Lieshout R, Boylan K. Increased depressive symptoms in female but not male adolescents born at low birth weight in the offspring of a national cohort. Can J Psychiatry 2010; 55: 422–9.
41. Sandman C, Glynn L, Davis E. Is there a viability-vulnerability tradeoff? Sex differences in fetal programming. J Psychosom Res 2013; 75: 327–35.
42. Claessens SE, Daskalakis NP, van der Veen R et al. Development of individual differences in stress responsiveness: an overview of factors mediating the outcome of early life experiences. Psychopharmacology 2011; 214 (1): 141–54.
43. Scott S. Parenting quality and children's mental health: biological mechanisms and psychological interventions. Curr Opin Psychiatry 2012; 25 (4): 301–6.
44. Горячук И.В., Финогенко Е.И. Профилактика и коррекция дезадаптивных состояний у студентов, формирующихся воздействием информационного стресса. Молодежный вестник ИрГТУ. 2012. / Goriachuk I.V., Finogenko E.I. Profilaktika i korrektsiia dezadaptivnykh sostoianii u studentov, formiruiushchikhsia vozdeistviem informatsionnogo stressa. Molodezhnyi vestnik IrGTU. 2012. [in Russian]
45. Петрова Н.Н., Подольхов Н.Е., Гзгзян А.М. и др. Психические расстройства и личностно-психологические особенности у женщин с бесплодием при лечении ЭКО. Обозрение психиатрии и медицинской психологии. 2013; 2: 42–9. / Petrova N.N., Podol'khov N.E., Gzgzian A.M. i dr. Psikhicheskie rasstroistva i lichnostno-psikhologicheskie osobennosti u zhenshchin s besplodiem pri lechenii EKO. Obozrenie psikhiatrii i meditsinskoi psikhologii. 2013; 2: 42–9. [in Russian]
46. Bomba M, Corbetta F, Bonini L et al. Psychopathological traits of adolescents with functional hypothalamic amenorrhea: a comparison with anorexia nervosa. Eat Weight Disord 2013; 19: 41–8.
47. McEwen BS, Akama KT, Spencer-Segal JL et al. Estrogen effects on the brain: actions beyond the hypothalamus via novel mechanisms. Behav Neurosci 2012; 126: 4–16.
48. Kormos V, Gaszner B. Role of neuropeptides in anxiety, stress, and depression: from animals to humans. Neuropeptides 2013; 47: 401–19.
49. Lawson EA, Donoho D, Miller KK et al. Hypercortisolemia is associated with severity of bone loss and depression in hypothalamic amenorrhea and anorexia nervosa. J Clin Endocrinol Metab 2009; 94: 4710–16.
50. Toufexis D, Rivarola MA, Lara H, Viau V. Stress and the reproductive axis. J Neuroendocrinol 2014; 26 (9): 573–86.
51. Berga S, Marcus M, Loucks TL et al. Recovery of ovarian activity in women with functional hypothalamic amenorrhea who were treated with cognitive behavior therapy.Fertil Steril 2003; 80 (4): 976–81.
52. Michopoulos V, Mancini F, Loucks TL, Bergs SL. Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial. Fertil Steril 2013; 99 (7): 2084–91.
53. Tschugguel W, Berga SL. Treatment of functional hypothalamic amenorrhea with hypnotherapy.Fertil Steril 2003; 80
________________________________________________
1. Agarkov V.A., Bronfman S.A., Kudaeva L.M., Uvarova E.V. Psikhologicheskie aspekty patogeneza funktsional'noi amenorei. Psikhicheskoe zdorov'e. 2012; 7 (74): 70–8. [in Russian]
2. Palm-Fischbacher S, Ehlert J. Dispositional resilience as a moderator of the relationship between chronic stress and irregular menstrual cycle.J Psychosom Obstet Gynaecol 2014; 2 (35): 42–50.
3. Practice Committee of the American Society for Reproductive Medicine. Current evaluation of amenorrhea. Fertil Steril 2006; 86: S148.
4. Williams NI, Berga SL, Cameron JL. Synergismbetweenpsychosocialandmetabolicstressors: impactonreproductivefunction in cynomolgusmonkeys. Am J Physiol Endocrinol Metab 2007; 293: E270–276.
5. Kuznetsova I.V., Konovalov V.A. Narusheniia menstrual'nogo tsikla i ikh gormonal'naia korrektsiia v kontekste stresszavisimykh, psikhovegetativnykh rasstroistv. Akusherstvo i ginekologiia. 2014; 9: 2–6. [in Russian]
6. Meczekalski B, Katulski K. Functional hypothalamic amenorrhea and its influence on women’s health. J Endocrinol Invest 2014; 37: 1049–56.
7. Berga SL, Loucks TL. Use of cognitive behavior therapy for functional hypothalamic amenorrhea. Ann N Y AcadSci 2006; 1092: 114–29.
8. Podfigurna-Stopa A, Pludowski P, Jaworski M et al. Skeletal status and body composition in young women with functional hypothalamic amenorrhea. Gynecol Endocrinol 2012; 28 (4): 299–304.
9. Berga SL, Loucks TL. Stress and Reproductive Function. Fem Patient 2009; 34: 13–6.
10. Liu JH, Bill AH. Stress-associated or functional hypothalamic amenorrhea in the adolescent. Ann N Y Acad Sci 2008; 1135: 179–984.
11. Parashar R, Bhalla P, Rai NK et al. Migraine: is it related to hormonal disturbances or stress? Int J Women’s Health 2014; 6: 921–5.
12. Gordon C. Functional Hypothalamic Amenorrhea. New Engl J Med 2010; 363 (4): 364–71.
13. Tamura H, Takasaki A, Taketani T et al. Melatonin as a free radical scavenger in the ovarian follicle. Endocr J 2013; 60 (1): 1–13.
14. Bomba M, Gambera A, Bonini L et al. Endocrine profiles and neuropsychologic correlates of functional hypothalamic amenorrhea in adolescents. Fertil Steril 2007; 87 (4): 876–85.
15. Ekbäck M, Lindberg M, Benzein E, Årestedt K. Health-related quality of life, depression and anxiety correlate to the degree of hirsutism. Dermatology 2013; 227: 278–84.
16. Berga SL, Loucks TL. Stress Induced Anovulation. Elsevier 2007; р. 615–31.
17. Allsworth JE, Clarke J, Peipert JF et al. The influence of stress on the cycle among newly incarcerated women. Women’s Health Issues 2007; 17 (4): 202–9.
18. Ulrich-Lai YM, Herman JP. Neural regulation of endocrine and autonomic stress responses. Nature Reviews. Neuroscience 2009; 10: 397–409.
19. Valdes-Socin H, Rubio Almanza M, Tomé Fernández-Ladreda M et al. Reproduction, smell, and neurodevelopmental disorders: genetic defects in different hypogonadotropichypogonadal syndromes. Front Endocrinol (Lausanne) 2014; 5: 109.
20. Koob GF. Brain stress systems in the amygdala and addiction. Brain Research 2009; 1293: 61–75.
21. Uhart M, Wand GS. Stress, alcohol and drug interaction: An update of human research. Addiction Biology 2009; 14: 43–64.
22. Roa J, Tena-Sempere M. KiSS-1 system and reproduction:comparative aspects and roles in the control of female gonadotropic axis in mammals. Gen Comp Endocrinol 2007; 153: 132–40.
23. Fourman LT, Fazeli PK. Neuroendocrine causes of amenorrhea – an update. J Clin Endocrinol Metab 2015; 100 (3): 812–24.
24. Meczekalski B, Genazzani AR, Genazzani AD et al. Clinical evaluation of patients with weight loss-related amenorrhea: neuropeptide Y and luteinizing hormone pulsatility. Gynecol Endocrinol 2006; 22: 239–43.
25. Butera PC. Estradiol and the control of food intake. Physiol Behav 2010; 99: 175–80.
26. McVay MA, Copeland AL, Geiselman PJ. Eating disorder pathology and menstrual cycle fluctuations in eating variables in oral contraceptive users and non-users. Eat Behav 2011; 12: 49–55.
27. Klump KL, Keel PK, Culbert KM, Edler C. Ovarian hormones and binge eating: exploring associations in community samples. Psychol Med 2008; 38: 1749–57.
28. Klump KL, Keel PK, Racine SE et al. The interactive effects of estrogen and progesterone on changes in emotional eating across the menstrual cycle. J Abnorm Psychol 2013; 122: 131–7.
29. Bazarganipour F, Ziaei S, Montazeri A et al. Psychological investigation in patients with polycystic ovary syndrome. Health Qual Life Outcomes 2013; 11: 141.
30. Himelein MJ, Thatcher SS. Polycystic ovary syndrome and mental health: A review. Obstet Gynecol Surv 2006; 61 (11): 723–2.
31. Ching HL, Burke V, Stuckey BGA. Quality of Life and Psychological Morbidity in Women with Polycystic Ovary Syndrome: Body Mass Index, Age and the Provision of Patient Information Are Significant Modifiers. Clin Endocrinol 2007; 66 (3): 373–9.
32. Poyastro Pinheiro A, Thornton LM, Plotonicov KH et al. Patterns of menstrual disturbance in eating disorders. Int J Eat Disord 2007; 40: 424–34.
33. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5. American Psychiatric Publishing; 2013. (DSM-5) ed.
34. Jappe LH, Cao L, Crosby RD et al. Stress and eating disorder behavior in anorexia nervosa as a function of menstrual cycle status. Int J Eat Disord 2014; 47 (2): 181–8.
35. Klump KL, Burt SA, McGue M, Iacono WG. Changes in genetic and environmental influences on disordered eating across adolescence: a longitudinal twin study. Arch Gen Psychiatry 2007; 64: 1409–15.
36. Caronia LM, Martin C, Welt CK. A genetic basis for functional hypothalamic amenorrhea. N Engl J Med 2011; 364 (3): 215–25.
37. Bethea CL, Lima FB, Centeno ML et al. Effects of Citalopram on Serotonin and CRF Systems in the Midbrain of Primates with Differences in Stress Sensitivity. J Chem Neuroanat 2011; 41 (4): 200–18.
38. Bethea CL, Phu K, Reddy AP, Cameron JL. The effect of short moderate stress on the midbrain corticotropin-releasing factor system in amacaque model of functional hypothalamic amenorrhea. Fertil Steril 2013; 100 (4): 1111–21.
39. Kinodo Zh.M. Priruchenie odinochestva: separatsionnaia trevoga v psikhoanalize M.: Kogito-Tsentr, 2008; s. 254. [in Russian]
40. Van Lieshout R, Boylan K. Increased depressive symptoms in female but not male adolescents born at low birth weight in the offspring of a national cohort. Can J Psychiatry 2010; 55: 422–9.
41. Sandman C, Glynn L, Davis E. Is there a viability-vulnerability tradeoff? Sex differences in fetal programming. J Psychosom Res 2013; 75: 327–35.
42. Claessens SE, Daskalakis NP, van der Veen R et al. Development of individual differences in stress responsiveness: an overview of factors mediating the outcome of early life experiences. Psychopharmacology 2011; 214 (1): 141–54.
43. Scott S. Parenting quality and children's mental health: biological mechanisms and psychological interventions. Curr Opin Psychiatry 2012; 25 (4): 301–6.
44. Goriachuk I.V., Finogenko E.I. Profilaktika i korrektsiia dezadaptivnykh sostoianii u studentov, formiruiushchikhsia vozdeistviem informatsionnogo stressa. Molodezhnyi vestnik IrGTU. 2012. [in Russian]
45. Petrova N.N., Podol'khov N.E., Gzgzian A.M. i dr. Psikhicheskie rasstroistva i lichnostno-psikhologicheskie osobennosti u zhenshchin s besplodiem pri lechenii EKO. Obozrenie psikhiatrii i meditsinskoi psikhologii. 2013; 2: 42–9. [in Russian]
46. Bomba M, Corbetta F, Bonini L et al. Psychopathological traits of adolescents with functional hypothalamic amenorrhea: a comparison with anorexia nervosa. Eat Weight Disord 2013; 19: 41–8.
47. McEwen BS, Akama KT, Spencer-Segal JL et al. Estrogen effects on the brain: actions beyond the hypothalamus via novel mechanisms. Behav Neurosci 2012; 126: 4–16.
48. Kormos V, Gaszner B. Role of neuropeptides in anxiety, stress, and depression: from animals to humans. Neuropeptides 2013; 47: 401–19.
49. Lawson EA, Donoho D, Miller KK et al. Hypercortisolemia is associated with severity of bone loss and depression in hypothalamic amenorrhea and anorexia nervosa. J Clin Endocrinol Metab 2009; 94: 4710–16.
50. Toufexis D, Rivarola MA, Lara H, Viau V. Stress and the reproductive axis. J Neuroendocrinol 2014; 26 (9): 573–86.
51. Berga S, Marcus M, Loucks TL et al. Recovery of ovarian activity in women with functional hypothalamic amenorrhea who were treated with cognitive behavior therapy.Fertil Steril 2003; 80 (4): 976–81.
52. Michopoulos V, Mancini F, Loucks TL, Bergs SL. Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial. Fertil Steril 2013; 99 (7): 2084–91.
53. Tschugguel W, Berga SL. Treatment of functional hypothalamic amenorrhea with hypnotherapy.Fertil Steril 2003; 80
1 ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2;
2 ФГБНУ Научный центр психического здоровья. 115522, Россия, Москва, Каширское шоссе, д. 34;
3 АНО ВО Московский гуманитарный университет. 111395, Россия, Москва, ул. Юности, д. 5
*dr.burchakov@yandex.ru
1 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2;
2 Mental Health Research Center. 115522, Russian Federation, Moscow, Kashirskoe shosse, d. 34
3 111395, Russian Federation, Moscow, ul. Iunosti, d. 5
*dr.burchakov@yandex.ru