Characteristics of disorders of reproductive function in women of fertile age with Cushing syndrome in the Republic of Uzbekistan
O. Irgasheva*a (Mrs), Z. Khalimovab (Prof)
a Republican Specialized Scientific Practical Medical Center of Endocrinology of Public Health Ministry named by acad. Ya.Kh. Turakulov,, Tashkent, UZBEKISTAN ; b Tashkent Pediatric, Tashkent, UZBEKISTAN
Introduction.Cushing's syndrome (CS) is a serious neuro -endocrine disease that has been under the close attention of many different specialists . Hyperandrogenia and menstrual irregularities, such as amenorrhea and oligomenorrhea, complement the clinical picture of Cushing's syndrome. Infertility occurs relatively often, including complex pathogenetic mechanisms that differ depending on the cause of hypercorticism .
Observation. In the period from 2000 to the present, 158 women with CS of fertile age are registered. The average age was 27.58 ± 3.4 years. 20 healthy women of the appropriate age made up the control group. All female patients with CS were distributed by etiology as follows: 1 group - patients with ACTH-dependent CS- 115 (72.7%), 2 group - with ACTH-independent CS - 40 (25.3%) and 3 group - patients with ACTH-ectopic CS - 2 (1.3%) and 1 patient with cyclic CS (0,6%).
Discussion. Various reproductive disorders were observed in patients with CS, among which dominated: menstrual cycles disorders (MCD) - 32.9%, secondary amenorrhea - 20.4%. Most of the cycle disorders were observed in 1 gr. with ACTH-DCS. MCDs were 80% and appeared as oligomenorrhea in 30% of cases, amenorrhea in 35%, polymenorrhea in 7.5%, and the variable cycle in 7.5%. On the 14th day of the cycle, only 1 gr. patients showed decrease in basal levels of LH and FSH, a decrease in ovarian hormones (estradiol, progesterone) against the background of hyperandrogenemia (free testosterone, DHEA), a significant increase in blood cortisol with hypercorticotropinemia. In 2 and 3 gr. on the 14th day of the cycle, an unreliable decrease in basal levels of LH, FSH and ovarian hormones was characteristic (p> 0.05) against the background of a significant increase in blood cortisol with normocorticotropenemia and hyperandrogenemia (p <0.05).
Bibliography 1.Cyranska-Chyrek Ewa , Filipowicz Dorota , Szczepanek-Parulska Ewelina , Nowaczyk Marta et all. Primary Pigmented Nodular Adrenocortical Disease (PPNAD) as an Underlying Cause of Symptoms in a Patient Presenting With Hirsutism and Secondary Amenorrhea //Gynecol Endocrinol, 34 (12), 1022-1026 Dec 2018. 2.Szczepanek-Parulska E. , Cyranska-Chyrek E., Nowaczyk M. , Kamiński Grzegorz 2, Diagnostic Difficulties In a Young Women With Symptoms of Cushing Syndrome Endocr Pract, 24 (8), 766 Aug 2018 ,
The author has declared no conflict of interest.