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Daily changes of hormonal status in patients with uterine myoma


D.V. Brunin, I.V. Radysh, S.M. Semyatov

The daily changes of gonadotropin and steroid hormones in the blood serum of healthy and uterine myoma women of reproductive age was study. A total of 68 uterine myoma and 46 healthy women in the follicular phase of 6-8 days of the menstrual cycle aged 20-42 years. Found that in healthy women, the maximum concentration of prolactin, LH, FSH, testosterone was observed in the morning, and estradiol - in the evening. In the patients shifts concentration maxima morning estradiol, progesterone and prolactin and - at night compared to healthy. At the same time 23,5 % of patients showed statistically significant circadian rhythm of secretion of estradiol, progesterone and prolactin. Found that in women with uterine fibroids mean daily concentration of serum prolactin, LH, FSH, estradiol and progesterone significantly increased, and testosterone - reduced compared with healthy (p <0,001). Elevated prolactin levels are usually inhibits the release of gonadotropin-releasing hormone by the pituitary gland that there is more pronounced in patients with uterine myoma in the evening. In this high prolactin very bad for the conception and is one of the leading causes of infertility. Found that 67.3% of the patients present a history of some form of infertility. Comparative analysis showed that the character of the curve of daily secretion of gonadotropin-releasing hormone in patients with uterine myoma shows a lack of evidence of its rhythm, which can be explained by the low-amplitude oscillations of LH (0,13 ± 0,05, mU / l) and FSH (0,15 ± 0,06 mU / L) as compared to healthy (1,07 ± 0,10 and 1,05 ± 0,07), respectively. Thus patients showed simultaneous significant (p <0,001) increase in average daily concentrations of LH and FSH in serum. Thus, the chronobiological approach significantly expand our understanding of the mechanisms of uterine myoma. The results reveal additional possibilities of early diagnosis of uterine fibroids and create preconditions correction therapy based on chronobiological features of homeostasis.

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