THE PATTERN OF HYPOTHALAMIC-PITUITARY GONADAL RELATIONSHIPS IN DIFFERENT CLINICAL TYPES OF PUBERTAL UTERINE BLEEDING

Objective. To study the hormonal profile, the level of biogenic amines, and their effect on target organs in female adolescents with pubertal uterine bleeding (PUB) in relation to its clinical type. Subject and methods. The study enrolled 145 girls with new-onset bleeding (Group 1), 48 adolescents with remitting bleeding (Group 2), and 153 patients with recurrent disease (Group 3); a comparison group consisted of 25 normal menstruating peers. The serum levels of serotonin, luteinizing hormone, follicle-stimulating hormone, prolactin, estradiol, estriol, thyroxin, and cortisol were measured; the excretion of dihydroxyphenylalanine, dopamine, noradrenaline, and adrenaline was determined in 24-hour urine samples; small pelvic ultrasonography was performed. Results. Multiple regression analysis revealed the specific features of relationships between the levels of gonadotropins and catecholamines, as well as the selectivity of tropic hormones on the production of sex steroids and steroid hormones on target organs (uterus and ovaries) that depended on the clinical type of PUB. Conclusion. PUB features a wide variety of its pathogenesis. Each clinical type has its own features in relationships between the central and peripheral components of menstrual cycle regulation.

pubertal uterine bleeding, biologically active substances, hormones, small pelvic ultrasonography, relationships