problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl13366problendo-13366Research ArticleРепродуктивная эндокринологияReproductive EndocrinologyЭндокринные и психосоматические нарушения у пациенток с аменореейEndocrine and psychosomatic disorders in patients with amenorrheahttps://orcid.org/0000-0003-0696-5367АбсатароваЮ. С.AbsatarovaYu. S.

Абсатарова Юлия Сергеевна - к.м.н.

117036, Москва, ул. Дмитрия Ульянова, д. 11

Yulia S. Absatarova, MD, PhD.

11 Dm.Ulyanova street, 117036 Moscow

korsil2008@yandex.ruhttps://orcid.org/0000-0001-8425-0020АндрееваЕ. Н.AndreevaE. N.

Андреева Елена Николаевна - д.м.н., профессор.

Москва

Elena N. Andreeva - MD, PhD, professor.

Moscow

endogin@mail.ruhttps://orcid.org/0009-0007-8189-1384ЕвсееваЮ. С.EvseevaYu. S.

Евсеева Юлия Сергеевна

Москва

Yulia S. Evseeva

Moscow

Evseeva.julia09@yandex.ruhttps://orcid.org/0000-0002-9075-8856Зеленкова-ЗахарчукТ. А.Zelenkova-ZakharchukT. A.

Зеленкова-Захарчук Татьяна Анатольевна - к.м.н.Москва

Tatyana A. Zelenkova-Zakharchuk - MD, PhD.

Moscow

tazach@mail.ruhttps://orcid.org/0000-0001-7177-0254ШереметьеваЕ. В.SheremetyevaE. V.

Шереметьева Екатерина Викторовна - к.м.н.

Москва

Ekaterina V. Sheremetyeva - MD, PhD.

Moscow

s1981k@yandex.ruhttps://orcid.org/0000-0003-4979-7420ГригорянО. Р.GrigoryanO. R.

Григорян Ольга Рафаэльевна - д.м.н., профессор.

Москва

Olga R. Grigoryan - MD, PhD, professor.

Moscow

iceberg1995@mail.ruhttps://orcid.org/0000-0001-5826-3186МихеевР. К.MikheevR. K.

Михеев Роберт Константинович

Москва

Robert K. Mikheev - MD, resident.

Moscow

iceberg1995@mail.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian FederationНациональный медицинский исследовательский центр эндокринологии; Московский государственный медико-стоматологический университет им. А.И. Евдокимова Министерства здравоохранения Российской ФедерацииРоссияEndocrinology Research Centre; A.I. Yevdokimov Moscow State University of Medicine and DentistryRussian Federation202324012024696121131Copyright © Абсатарова Ю.С., Андреева Е.Н., Евсеева Ю.С., Зеленкова-Захарчук Т.А., Шереметьева Е.В., Григорян О.Р., Михеев Р.К., 20242024Абсатарова Ю.С., Андреева Е.Н., Евсеева Ю.С., Зеленкова-Захарчук Т.А., Шереметьева Е.В., Григорян О.Р., Михеев Р.К.Absatarova Y.S., Andreeva E.N., Evseeva Y.S., Zelenkova-Zakharchuk T.A., Sheremetyeva E.V., Grigoryan O.R., Mikheev R.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/13366

В статье представлены данные о взаимосвязи патогенетических механизмов развития нарушений менструального цикла функционального и органического происхождения с психическими расстройствами с точки зрения психосоматической концепции. Согласно последней, функциональные нарушения менструального цикла рассматриваются как психосоматические, при которых гинекологическая патология развивается вследствие психопатологических расстройств. Ярким примером такого заболевания является функциональная гипоталамическая аменорея. При этом эндокринопатии, такие как синдром поликистозных яичников и преждевременная недостаточность яичников, также можно рассматривать в парадигме психосоматических нарушений овариальной функции, обусловленных высокой распространенностью тревожных и депрессивных расстройств в этой когорте больных. В данном обзоре подчеркивается важность междисциплинарного сотрудничества гинеколога и психиатра для максимально эффективной репродуктивной реабилитации пациенток с аменореей. Поиск литературы проводили в отечественных (eLibrary, CyberLeninka.ru) и международных (PubMed, Cochrane Library) базах данных на русском и английском языках. Приоритетным являлся свободный доступ к полному тексту статей. Выбор источников был приоритетен периодом с 2018 по 2023 гг. Однако с учетом недостаточной изученности выбранной темы выбор источников датировался с 1985 г.

The article presents data on the relationship of pathogenetic mechanisms for the development of menstrual disorders of functional and organic origin in connection with mental disturbances from the point of view of the psychosomatic concept. According to the latter, functional disorders of the menstrual cycle are considered as psychosomatic, in which gynecological pathology develops as a result of psychopathological illness. A striking example of such a disorder is functional hypothalamic amenorrhea. At the same time, endocrinopathies, such as polycystic ovary syndrome and premature ovarian insufficiency, can also be considered in the paradigm of psychosomatic illnesses of ovarian function due to the high prevalence of anxiety and depressive disorders in this cohort of patients. This review highlights the importance of interdisciplinary collaboration between a gynecologist and a psychiatrist for the most effective reproductive rehabilitation of patients with amenorrhea. Literature search was carried out in national (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The priority was free access to the full text of articles. The choice of sources was prioritized for the period from 2018 to 2023.However, taking into account the insufficient knowledge of the chosen topic, the choice of sources dates back to 1985.

гипогонадизмсиндром поликистозных яичниковгиперандрогенияфункциональная гипоталамическая аменореяпреждевременная недостаточность яичниковhipogonadismpolycystic ovary syndromehyperandrogenismfunctional hypothalamic amenorrheapremature ovarian insufficiencyРабота выполнена в рамках государственного задания №123021300169-4 «Эпигенетические предикторы и метаболомная составляющая аменореи различного генеза у женщин репродуктивного возраста», 2023–2025 гг.ReferencesРоссийское общество акушеров-гинекологов. Клинические рекомендации. Аменорея. — М.: Министерство здравоохранения РФ; 2021.Rossijskoe obshhestvo akusherov-ginekologov. Klinicheskie rekomendacii. Amenoreja. Moscow: Ministerstvo zdravoohranenija RF; 2021. (In Russ.).Gordon CM, Ackerman KE, Berga SL, et al. Functional hypothalamic amenorrhea: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2017;102(5):1413-1439. doi: https://doi.org/10.1210/jc.2017-00131Gordon CM, Ackerman KE, Berga SL, et al. Functional hypothalamic amenorrhea: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2017;102(5):1413-1439. doi: https://doi.org/10.1210/jc.2017-00131Психосоматические расстройства в клинической практике, 2-е изд / Под ред. Смулевича А.Б. — М.: МЕДпресс-информ; 2019.Psikhosomaticheskie rasstroystva v klinicheskoy praktike, 2nd ed. Ed by Smulevich AB. Moscow: MEDpress-inform; 2019. (In Russ.).Berga SL, Marcus MD, 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):976-981. doi: https://doi.org/10.1016/s0015-0282(03)01124-5Berga SL, Marcus MD, 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):976-981. doi: https://doi.org/10.1016/s0015-0282(03)01124-5Volel BA, Ragimova AA, Burchakov DI, et al. Stress-related menstrual disorders. Consilium Medicum. 2016;18(6):8-13. (In Russ.).Volel BA, Ragimova AA, Burchakov DI, et al. Stress-related menstrual disorders. Consilium Medicum. 2016;18(6):8-13. (In Russ.).Prior JC. Adaptive, reversible, hypothalamic reproductive suppression: More than functional hypothalamic amenorrhea. Front Endocrinol (Lausanne). 2022;(13):893889. doi: https://doi.org/10.3389/fendo.2022.893889Prior JC. Adaptive, reversible, hypothalamic reproductive suppression: More than functional hypothalamic amenorrhea. Front Endocrinol (Lausanne). 2022;(13):893889. doi: https://doi.org/10.3389/fendo.2022.893889Nattiv A, Loucks AB, Manore MM, et al. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867-1882. doi: https://doi.org/10.1249/mss.0b013e318149f111Nattiv A, Loucks AB, Manore MM, et al. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867-1882. doi: https://doi.org/10.1249/mss.0b013e318149f111Morrison AE, Fleming S, Levy MJ. A review of the pathophysiology of functional hypothalamic amenorrhoea in women subject to psychological stress, disordered eating, excessive exercise or a combination of these factors. Clin Endocrinol (Oxf). 2021;95(2):229-238. doi: https://doi.org/10.1111/cen.14399Morrison AE, Fleming S, Levy MJ. A review of the pathophysiology of functional hypothalamic amenorrhoea in women subject to psychological stress, disordered eating, excessive exercise or a combination of these factors. Clin Endocrinol (Oxf). 2021;95(2):229-238. doi: https://doi.org/10.1111/cen.14399Pedreira CC, Maya J, Misra M. Functional hypothalamic amenorrhea: Impact on bone and neuropsychiatric outcomes. Front Endocrinol (Lausanne). 2022;(13):953180. doi: https://doi.org/10.3389/fendo.2022.953180Pedreira CC, Maya J, Misra M. Functional hypothalamic amenorrhea: Impact on bone and neuropsychiatric outcomes. Front Endocrinol (Lausanne). 2022;(13):953180. doi: https://doi.org/10.3389/fendo.2022.953180Bonazza F, Politi G, Leone D, et al. Psychological factors in functional hypothalamic amenorrhea: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2023;(14):981491. doi: https://doi.org/10.3389/fendo.2023.981491Bonazza F, Politi G, Leone D, et al. Psychological factors in functional hypothalamic amenorrhea: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2023;(14):981491. doi: https://doi.org/10.3389/fendo.2023.981491Бобров А.Е., Ильина Н.А. Психические расстройства у женщин, страдающих частыми формами вторичной аменореи: нозографическая структура и психологические маркеры // Российский психиатрический журнал. — 2022. — №5. — С. 74-83.Bobrov AE, Il’ina NA. Mental disorders in women suffering from frequent forms of secondary amenorrhea: nosographic structure and psychological markers. Russian Journal of Psychiatry. 2022;(5):74-83. (In Russ.).Pruneti C, Guidotti S. Cognition, behavior, sexuality, and autonomic responses of women with hypothalamic amenorrhea. Brain Sci. 2022;12(11):1448. doi: https://doi.org/10.3390/brainsci12111448Pruneti C, Guidotti S. Cognition, behavior, sexuality, and autonomic responses of women with hypothalamic amenorrhea. Brain Sci. 2022;12(11):1448. doi: https://doi.org/10.3390/brainsci12111448Misra M, Katzman DK, Estella NM, et al. Impact of physiologic estrogen replacement on anxiety symptoms, body shape perception, and eating attitudes in adolescent girls with anorexia nervosa: data from a randomized controlled trial. J Clin Psychiatry. 2013;74(8):e765-e771. doi: https://doi.org/10.4088/JCP.13m08365Misra M, Katzman DK, Estella NM, et al. Impact of physiologic estrogen replacement on anxiety symptoms, body shape perception, and eating attitudes in adolescent girls with anorexia nervosa: data from a randomized controlled trial. J Clin Psychiatry. 2013;74(8):e765-e771. doi: https://doi.org/10.4088/JCP.13m08365Baskaran C, Cunningham B, Plessow F, et al. Estrogen replacement improves verbal memory and executive control in oligomenorrheic/Amenorrheic athletes in a randomized controlled trial. J Clin Psychiatry. 2017;78(5):e490-e497. doi: https://doi.org/10.4088/JCP.15m10544Baskaran C, Cunningham B, Plessow F, et al. Estrogen replacement improves verbal memory and executive control in oligomenorrheic/Amenorrheic athletes in a randomized controlled trial. J Clin Psychiatry. 2017;78(5):e490-e497. doi: https://doi.org/10.4088/JCP.15m10544Baskaran C, Plessow F, Ackerman KE, et al. A cross-sectional analysis of verbal memory and executive control across athletes with varying menstrual status and non-athletes. Psychiatry Res. 2017;(258):605-606. doi: https://doi.org/10.1016/j.psychres.2016.12.054Baskaran C, Plessow F, Ackerman KE, et al. A cross-sectional analysis of verbal memory and executive control across athletes with varying menstrual status and non-athletes. Psychiatry Res. 2017;(258):605-606. doi: https://doi.org/10.1016/j.psychres.2016.12.054Lawson 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(12):4710-4716. doi: https://doi.org/10.1210/jc.2009-1046Lawson 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(12):4710-4716. doi: https://doi.org/10.1210/jc.2009-1046Fontana L, Garzia E, Marfia G, et al. Epigenetics of functional hypothalamic amenorrhea. Front Endocrinol (Lausanne). 2022;(13):953431. doi: https://doi.org/10.3389/fendo.2022.953431Fontana L, Garzia E, Marfia G, et al. Epigenetics of functional hypothalamic amenorrhea. Front Endocrinol (Lausanne). 2022;(13):953431. doi: https://doi.org/10.3389/fendo.2022.953431Bullen BA, Skrinar GS, Beitins IZ, et al. Induction of menstrual disorders by strenuous exercise in untrained women. N Engl J Med. 1985;312(21):1349-1353. doi: https://doi.org/10.1056/NEJM198505233122103Bullen BA, Skrinar GS, Beitins IZ, et al. Induction of menstrual disorders by strenuous exercise in untrained women. N Engl J Med. 1985;312(21):1349-1353. doi: https://doi.org/10.1056/NEJM198505233122103Лазарев А.М., Безуглов Э.Н., Барскова Е.М., Русанов М.О. Влияние интенсивных занятий бегом на менструальную функцию взрослых полупрофессиональных бегуний // Проблемы репродукции. — 2021. — Т. 27. — №4. — С. 91-96. doi: https://doi.org/10.17116/repro20212704191Lazarev AM, Bezuglov EN, Barskova EM, Rusanov MO. Effects of intense running on menstrual function in semi-professional adult runners. Russian Journal of Human Reproduction. 2021;27(4):91-96. (In Russ.). doi: https://doi.org/10.17116/repro20212704191Bethea CL, Phu K, Reddy AP, Cameron JL. The effect of short moderate stress on the midbrain corticotropinreleasing factor system in a macaque model of functional hypothalamic amenorrhea. Fertil Steril. 2013;100(4):1111-1121. doi: https://doi.org/10.1016/j.fertnstert.2013.05.052Bethea CL, Phu K, Reddy AP, Cameron JL. The effect of short moderate stress on the midbrain corticotropinreleasing factor system in a macaque model of functional hypothalamic amenorrhea. Fertil Steril. 2013;100(4):1111-1121. doi: https://doi.org/10.1016/j.fertnstert.2013.05.052Centeno ML, Sanchez RL, Cameron JL, Bethea CL. Hypothalamic gonadotrophin-releasing hormone expression in female monkeys with different sensitivity to stress. J Neuroendocrinol. 2007;19(8):594-604. doi: https://doi.org/10.1111/j.1365-2826.2007.01566.xCenteno ML, Sanchez RL, Cameron JL, Bethea CL. Hypothalamic gonadotrophin-releasing hormone expression in female monkeys with different sensitivity to stress. J Neuroendocrinol. 2007;19(8):594-604. doi: https://doi.org/10.1111/j.1365-2826.2007.01566.xDelaney A, Burkholder AB, Lavender CA, et al. Increased burden of rare sequence variants in GnRH-associated genes in women with hypothalamic amenorrhea. J Clin Endocrinol Metab. 2021;106(3):e1441-e1452. doi: https://doi.org/10.1210/clinem/dgaa609Delaney A, Burkholder AB, Lavender CA, et al. Increased burden of rare sequence variants in GnRH-associated genes in women with hypothalamic amenorrhea. J Clin Endocrinol Metab. 2021;106(3):e1441-e1452. doi: https://doi.org/10.1210/clinem/dgaa609Cangiano B, Swee DS, Quinton R, Bonomi M. Genetics of congenital hypogonadotropic hypogonadism: peculiarities and phenotype of an oligogenic disease. Hum Genet. 2021;140(1):77-111. doi: https://doi.org/10.1007/s00439-020-02147-1Cangiano B, Swee DS, Quinton R, Bonomi M. Genetics of congenital hypogonadotropic hypogonadism: peculiarities and phenotype of an oligogenic disease. Hum Genet. 2021;140(1):77-111. doi: https://doi.org/10.1007/s00439-020-02147-1Oyola MG, Handa RJ. Hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes: sex differences in regulation of stress responsivity. Stress. 2017;20(5):476-494. doi: https://doi.org/10.1080/10253890.2017.1369523Oyola MG, Handa RJ. Hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes: sex differences in regulation of stress responsivity. Stress. 2017;20(5):476-494. doi: https://doi.org/10.1080/10253890.2017.1369523Gan Y, Chen Y, Han X, et al. Neuropeptide Y Gene × Environment Interaction Predicts Resilience and Positive Future Focus. Appl Psychol Health Well Being. 2019;11(3):438-458. doi: https://doi.org/10.1111/aphw.12162Gan Y, Chen Y, Han X, et al. Neuropeptide Y Gene × Environment Interaction Predicts Resilience and Positive Future Focus. Appl Psychol Health Well Being. 2019;11(3):438-458. doi: https://doi.org/10.1111/aphw.12162Meczekalski 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(5):239-243. doi: https://doi.org/10.1080/14767050600761992Meczekalski 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(5):239-243. doi: https://doi.org/10.1080/14767050600761992Miranda M, Morici JF, Zanoni MB, Bekinschtein P. Brain-derived neurotrophic factor: A key molecule for memory in the healthy and the pathological brain. Front Cell Neurosci. 2019;(13):363. doi: https://doi.org/10.3389/fncel.2019.00363Miranda M, Morici JF, Zanoni MB, Bekinschtein P. Brain-derived neurotrophic factor: A key molecule for memory in the healthy and the pathological brain. Front Cell Neurosci. 2019;(13):363. doi: https://doi.org/10.3389/fncel.2019.00363Podfigurna-Stopa A, Casarosa E, Luisi M, et al. Decreased plasma concentrations of brain-derived neurotrophic factor (BDNF) in patients with functional hypothalamic amenorrhea. Gynecol Endocrinol. 2013;29(9):817-820. doi: https://doi.org/10.3109/09513590.2013.813472Podfigurna-Stopa A, Casarosa E, Luisi M, et al. Decreased plasma concentrations of brain-derived neurotrophic factor (BDNF) in patients with functional hypothalamic amenorrhea. Gynecol Endocrinol. 2013;29(9):817-820. doi: https://doi.org/10.3109/09513590.2013.813472Koysombat K, Dhillo WS, Abbara A. Assessing hypothalamic pituitary gonadal function in reproductive disorders. Clin Sci (Lond). 2023;137(11):863-879. doi: https://doi.org/10.1042/CS20220146Koysombat K, Dhillo WS, Abbara A. Assessing hypothalamic pituitary gonadal function in reproductive disorders. Clin Sci (Lond). 2023;137(11):863-879. doi: https://doi.org/10.1042/CS20220146Argente J, Dunkel L, Kaiser UB, et al. Molecular basis of normal and pathological puberty: from basic mechanisms to clinical implications. Lancet Diabetes Endocrinol. 2023;11(3):203-216. doi: https://doi.org/10.1016/S2213-8587(22)00339-4Argente J, Dunkel L, Kaiser UB, et al. Molecular basis of normal and pathological puberty: from basic mechanisms to clinical implications. Lancet Diabetes Endocrinol. 2023;11(3):203-216. doi: https://doi.org/10.1016/S2213-8587(22)00339-4Teles MG, Bianco SD, Brito VN, et al. A GPR54-activating mutation in a patient with central precocious puberty. N Engl J Med. 2008;358(7):709-715. doi: https://doi.org/10.1056/NEJMoa073443Teles MG, Bianco SD, Brito VN, et al. A GPR54-activating mutation in a patient with central precocious puberty. N Engl J Med. 2008;358(7):709-715. doi: https://doi.org/10.1056/NEJMoa073443Podfigurna A, Maciejewska-Jeske M, Meczekalski B, Genazzani AD. Kisspeptin and LH pulsatility in patients with functional hypothalamic amenorrhea. Endocrine. 2020;70(3):635-643. doi: https://doi.org/10.1007/s12020-020-02481-4Podfigurna A, Maciejewska-Jeske M, Meczekalski B, Genazzani AD. Kisspeptin and LH pulsatility in patients with functional hypothalamic amenorrhea. Endocrine. 2020;70(3):635-643. doi: https://doi.org/10.1007/s12020-020-02481-4Meczekalski B, Niwczyk O, Bala G, Szeliga A. Stress, kisspeptin, and functional hypothalamic amenorrhea. Curr Opin Pharmacol. 2022;(67):102288. doi: https://doi.org/10.1016/j.coph.2022.102288Meczekalski B, Niwczyk O, Bala G, Szeliga A. Stress, kisspeptin, and functional hypothalamic amenorrhea. Curr Opin Pharmacol. 2022;(67):102288. doi: https://doi.org/10.1016/j.coph.2022.102288Jayasena CN, Nijher GM, Chaudhri OB, et al. Subcutaneous injection of kisspeptin-54 acutely stimulates gonadotropin secretion in women with hypothalamic amenorrhea, but chronic administration causes tachyphylaxis. J Clin Endocrinol Metab. 2009;94(11):4315-4323. doi: https://doi.org/10.1210/jc.2009-0406Jayasena CN, Nijher GM, Chaudhri OB, et al. Subcutaneous injection of kisspeptin-54 acutely stimulates gonadotropin secretion in women with hypothalamic amenorrhea, but chronic administration causes tachyphylaxis. J Clin Endocrinol Metab. 2009;94(11):4315-4323. doi: https://doi.org/10.1210/jc.2009-0406Jayasena CN, Nijher GM, Abbara A, et al. Twice-weekly administration of kisspeptin-54 for 8 weeks stimulates release of reproductive hormones in women with hypothalamic amenorrhea. Clin Pharmacol Ther. 2010;88(6):840-847. doi: https://doi.org/10.1038/clpt.2010.204Jayasena CN, Nijher GM, Abbara A, et al. Twice-weekly administration of kisspeptin-54 for 8 weeks stimulates release of reproductive hormones in women with hypothalamic amenorrhea. Clin Pharmacol Ther. 2010;88(6):840-847. doi: https://doi.org/10.1038/clpt.2010.204Jayasena CN, Abbara A, Veldhuis JD, et al. Increasing LH pulsatility in women with hypothalamic amenorrhoea using intravenous infusion of Kisspeptin-54. J Clin Endocrinol Metab. 2014;99(6):E953-961. doi: https://doi.org/10.1210/jc.2013-1569Jayasena CN, Abbara A, Veldhuis JD, et al. Increasing LH pulsatility in women with hypothalamic amenorrhoea using intravenous infusion of Kisspeptin-54. J Clin Endocrinol Metab. 2014;99(6):E953-961. doi: https://doi.org/10.1210/jc.2013-1569Abbara A, Eng PC, Phylactou M, et al. Kisspeptin receptor agonist has therapeutic potential for female reproductive disorders. J Clin Invest. 2020;130(12):6739-6753. doi: https://doi.org/10.1172/JCI139681Abbara A, Eng PC, Phylactou M, et al. Kisspeptin receptor agonist has therapeutic potential for female reproductive disorders. J Clin Invest. 2020;130(12):6739-6753. doi: https://doi.org/10.1172/JCI139681Бондаренко К.Р., Казанцева В.Д., Доброхотова Ю.Э. Функциональная гипоталамическая аменорея в практике клинициста: лечебно-диагностические особенности // Акушерство и гинекология. — 2022. — №5. — С. 149-156. doi: https://doi.org/10.18565/aig.2022.5.149-156Bondarenko KR, Kazantseva VD, Dobrokhotova YuYe. Functional hypothalamic amenorrhea in clinical practice: medical and diagnostic features. Obstetrics and gynecology. 2022;(5):149-156. (In Russ.). doi: https://doi.org/10.18565/aig.2022.5.149-156Padda J, Khalid K, Hitawala G, et al. Depression and its effect on the menstrual cycle. Cureus. 2021;13(7):e16532. doi: https://doi.org/10.7759/cureus.16532Padda J, Khalid K, Hitawala G, et al. Depression and its effect on the menstrual cycle. Cureus. 2021;13(7):e16532. doi: https://doi.org/10.7759/cureus.16532Чернуха Г.Е., Гусев Д.В., Табеева Г.И., Прилуцкая В.Ю. Современные принципы терапии функциональной гипоталамической аменореи // Акушерство и гинекология. — 2018. — №6. — С. 11-17. doi: https://doi.org/10.18565/aig.2018.6.11-17Chernukha GE, Gusev DV, Tabeeva GI, Prilutskaya PYu. Current principles of therapy for functional hypothalamic amenorrhea. Obstetrics and gynecology. 2018;(6):11-17. (In Russ.). doi: https://doi.org/10.18565/aig.2018.6.11-17Chernukha GE, Gusev DV, Tabeeva GI, Prilutskaya PVu. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. doi: https://doi.org/10.1016/j.fertnstert.2003.10.004Chernukha GE, Gusev DV, Tabeeva GI, Prilutskaya PVu. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. doi: https://doi.org/10.1016/j.fertnstert.2003.10.004Zaks N, Batuure A, Lin E, et al. Association between mental health and reproductive system disorders in women: A systematic review and meta-analysis. JAMA Netw Open. 2023;6(4):e238685. doi: https://doi.org/10.1001/jamanetworkopen.2023.8685Zaks N, Batuure A, Lin E, et al. Association between mental health and reproductive system disorders in women: A systematic review and meta-analysis. JAMA Netw Open. 2023;6(4):e238685. doi: https://doi.org/10.1001/jamanetworkopen.2023.8685Ушакова В.М., Морозова А.Ю., Резник А.М., и др. Молекулярнобиологические аспекты депрессивных состояний: современный взгляд на проблему // Молекулярная биология. — 2020. — Т. 54. — №5. — С. 725-749. doi: https://doi.org/10.31857/S0026898420050110Ushakova VM, Morozova AYu, Reznik AM, et al. Molekulyarno-biologicheskie aspekty depressivnykh sostoyaniy: sovremennyy vzglyad na problem. Molekulyarnaya biologiya. 2020;54(5):725-749. (In Russ.)]. doi: https://doi.org/10.31857/S0026898420050110Hu R, Geng Y, Huang Y, et al. New insights into the interaction between polycystic ovary syndrome and psychiatric disorders: A narrative review. Int J Gynecol Obstet. 2023;54(5):725-749. doi: https://doi.org/10.1002/ijgo.14988Hu R, Geng Y, Huang Y, et al. New insights into the interaction between polycystic ovary syndrome and psychiatric disorders: A narrative review. Int J Gynecol Obstet. 2023;54(5):725-749. doi: https://doi.org/10.1002/ijgo.14988Wallen K. Hormonal influences on sexually differentiated behavior in nonhuman primates. Front Neuroendocrinol. 2005;26(1):7-26. doi: https://doi.org/10.1016/j.yfrne.2005.02.001Wallen K. Hormonal influences on sexually differentiated behavior in nonhuman primates. Front Neuroendocrinol. 2005;26(1):7-26. doi: https://doi.org/10.1016/j.yfrne.2005.02.001Moore AM, Campbell RE. Polycystic ovary syndrome: Understanding the role of the brain. Front Neuroendocrinol. 2017;46(5):1-14. doi: https://doi.org/10.1016/j.yfrne.2017.05.002Moore AM, Campbell RE. Polycystic ovary syndrome: Understanding the role of the brain. Front Neuroendocrinol. 2017;46(5):1-14. doi: https://doi.org/10.1016/j.yfrne.2017.05.002Teede HJ, Tay CT, Laven J, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertil Steril. 2023;120(4):767-793. doi: https://doi.org/10.1016/j.fertnstert.2023.07.025Teede HJ, Tay CT, Laven J, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertil Steril. 2023;120(4):767-793. doi: https://doi.org/10.1016/j.fertnstert.2023.07.025Rempert AN, Sarria I, Standeven LR, et al. A systematic review of the psychosocial impact of polycystic ovarian syndrome before and after treatment. Reprod Sci. 2023;120(4):767-793. doi: https://doi.org/10.1007/s43032-023-01285-xRempert AN, Sarria I, Standeven LR, et al. A systematic review of the psychosocial impact of polycystic ovarian syndrome before and after treatment. Reprod Sci. 2023;120(4):767-793. doi: https://doi.org/10.1007/s43032-023-01285-xAdamczak A, Płotek W, Głowińska A, et al. Time perspective as a mediator of depressive symptoms in patients with polycystic ovary syndrome. Healthcare (Basel). 2023;11(7):993. doi: https://doi.org/10.3390/healthcare11070993Adamczak A, Płotek W, Głowińska A, et al. Time perspective as a mediator of depressive symptoms in patients with polycystic ovary syndrome. Healthcare (Basel). 2023;11(7):993. doi: https://doi.org/10.3390/healthcare11070993Brutocao C, Zaiem F, Alsawas M, et al. Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine. 2018;62(2):318-325. doi: https://doi.org/10.1007/s12020-018-1692-3Brutocao C, Zaiem F, Alsawas M, et al. Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine. 2018;62(2):318-325. doi: https://doi.org/10.1007/s12020-018-1692-3Majidzadeh S, Mirghafourvand M, Farvareshi M, Yavarikia P. The effect of cognitive behavioral therapy on depression and anxiety of women with polycystic ovary syndrome: a randomized controlled trial. BMC Psychiatry. 2023;23(1):332. doi: https://doi.org/10.1186/s12888-023-04814-9Majidzadeh S, Mirghafourvand M, Farvareshi M, Yavarikia P. The effect of cognitive behavioral therapy on depression and anxiety of women with polycystic ovary syndrome: a randomized controlled trial. BMC Psychiatry. 2023;23(1):332. doi: https://doi.org/10.1186/s12888-023-04814-9Dema H, Videtič Paska A, Kouter K, et al. Effects of mindfulness-based therapy on clinical symptoms and DNA methylation in patients with polycystic ovary syndrome and high metabolic risk. Curr Issues Mol Biol. 2023;45(4):2717-2737. doi: https://doi.org/10.3390/cimb45040178Dema H, Videtič Paska A, Kouter K, et al. Effects of mindfulness-based therapy on clinical symptoms and DNA methylation in patients with polycystic ovary syndrome and high metabolic risk. Curr Issues Mol Biol. 2023;45(4):2717-2737. doi: https://doi.org/10.3390/cimb45040178Santos IK, Pichini GS, Daniel d. Ferreira C, et al. Effects of highintensity interval training in combination with detraining on mental health in women with polycystic ovary syndrome: A randomized controlled trial. Front Physiol. 2022;13(2):318-325. doi: https://doi.org/10.3389/fphys.2022.948414Santos IK, Pichini GS, Daniel d. Ferreira C, et al. Effects of highintensity interval training in combination with detraining on mental health in women with polycystic ovary syndrome: A randomized controlled trial. Front Physiol. 2022;13(2):318-325. doi: https://doi.org/10.3389/fphys.2022.948414Patten RK, McIlvenna LC, Moreno-Asso A, et al. Efficacy of highintensity interval training for improving mental health and healthrelated quality of life in women with polycystic ovary syndrome. Sci Rep. 2023;13(1):3025. doi: https://doi.org/10.1038/s41598-023-29503-1Patten RK, McIlvenna LC, Moreno-Asso A, et al. Efficacy of highintensity interval training for improving mental health and healthrelated quality of life in women with polycystic ovary syndrome. Sci Rep. 2023;13(1):3025. doi: https://doi.org/10.1038/s41598-023-29503-1Greenwood EA, Pasch LA, Cedars MI, et al. Insulin resistance is associated with depression risk in polycystic ovary syndrome. Fertil Steril. 2018;110(1):27-34. doi: https://doi.org/10.1016/j.fertnstert.2018.03.009Greenwood EA, Pasch LA, Cedars MI, et al. Insulin resistance is associated with depression risk in polycystic ovary syndrome. Fertil Steril. 2018;110(1):27-34. doi: https://doi.org/10.1016/j.fertnstert.2018.03.009Irandoust K., Taheri M. Effect of a high intensity interval training (HIIT) on serotonin and cortisol levels in obese women with sleep disorders. Women Health Bull. 2018;(6):1-5. doi: https://doi.org/10.5812/whb.83303Irandoust K., Taheri M. Effect of a high intensity interval training (HIIT) on serotonin and cortisol levels in obese women with sleep disorders. Women Health Bull. 2018;(6):1-5. doi: https://doi.org/10.5812/whb.83303Li X, Wang S, Zhang L, et al. Amitriptyline plays important roles in modifying the ovarian morphology and improving its functions in rats with estradiol valerate-induced polycystic ovary. Arch Pharm Res. 2019;42(4):344-358. doi: https://doi.org/10.1007/s12272-015-0573-zLi X, Wang S, Zhang L, et al. Amitriptyline plays important roles in modifying the ovarian morphology and improving its functions in rats with estradiol valerate-induced polycystic ovary. Arch Pharm Res. 2019;42(4):344-358. doi: https://doi.org/10.1007/s12272-015-0573-zAlkan I, Kaplan S. An investigation of the potential effects of amitriptyline on polycystic ovary syndrome induced by estradiol valerate. Histochem Cell Biol. 2023;160(1):27-37. doi: https://doi.org/10.1007/s00418-023-02188-3Alkan I, Kaplan S. An investigation of the potential effects of amitriptyline on polycystic ovary syndrome induced by estradiol valerate. Histochem Cell Biol. 2023;160(1):27-37. doi: https://doi.org/10.1007/s00418-023-02188-3Rebar RW, Keator CS. Expanding our knowledge of premature ovarian insufficiency. Fertil Steril. 2021;115(2):328-329. doi: https://doi.org/10.1016/j.fertnstert.2020.09.145Rebar RW, Keator CS. Expanding our knowledge of premature ovarian insufficiency. Fertil Steril. 2021;115(2):328-329. doi: https://doi.org/10.1016/j.fertnstert.2020.09.145Li M, Zhu Y, Wei J, et al. The global prevalence of premature ovarian insufficiency: a systematic review and meta-analysis. Climacteric. 2023;26(2):95-102. doi: https://doi.org/10.1080/13697137.2022.2153033Li M, Zhu Y, Wei J, et al. The global prevalence of premature ovarian insufficiency: a systematic review and meta-analysis. Climacteric. 2023;26(2):95-102. doi: https://doi.org/10.1080/13697137.2022.2153033Hu M, Yeh YH, Munakata Y, et al. PRC1-mediated epigenetic programming is required to generate the ovarian reserve. Nat Commun. 2022;13(1):4510. doi: https://doi.org/10.1038/s41467-022-31759-6Hu M, Yeh YH, Munakata Y, et al. PRC1-mediated epigenetic programming is required to generate the ovarian reserve. Nat Commun. 2022;13(1):4510. doi: https://doi.org/10.1038/s41467-022-31759-6Xi D, Chen B, Tao H, et al. The risk of depressive and anxiety symptoms in women with premature ovarian insufficiency: a systematic review and meta-analysis. Arch Womens Ment Health. 2023;26(1):1-10. doi: https://doi.org/10.1007/s00737-022-01289-7Xi D, Chen B, Tao H, et al. The risk of depressive and anxiety symptoms in women with premature ovarian insufficiency: a systematic review and meta-analysis. Arch Womens Ment Health. 2023;26(1):1-10. doi: https://doi.org/10.1007/s00737-022-01289-7Ventura JL, Fitzgerald OR, Koziol DE, et al. Functional well-being is positively correlated with spiritual well-being in women who have spontaneous premature ovarian failure. Fertil Steril. 2007;87(3):584-590. doi: https://doi.org/10.1016/j.fertnstert.2006.07.1523Ventura JL, Fitzgerald OR, Koziol DE, et al. Functional well-being is positively correlated with spiritual well-being in women who have spontaneous premature ovarian failure. Fertil Steril. 2007;87(3):584-590. doi: https://doi.org/10.1016/j.fertnstert.2006.07.1523Chu K, Wang Y, He Y, et al. The psychosocial impact of premature ovarian insufficiency on male partners and their perceptions of the disease. Psychol Health Med. 2021;26(10):1248-1257. doi: https://doi.org/10.1080/13548506.2020.1810717Chu K, Wang Y, He Y, et al. The psychosocial impact of premature ovarian insufficiency on male partners and their perceptions of the disease. Psychol Health Med. 2021;26(10):1248-1257. doi: https://doi.org/10.1080/13548506.2020.1810717Gordon JL, Eisenlohr-Moul TA, Rubinow DR, et al. Naturally occurring changes in estradiol concentrations in the menopause transition predict morning cortisol and negative mood in perimenopausal depression. Clin Psychol Sci. 2016;4(5):919-935. doi: https://doi.org/10.1177/2167702616647924Gordon JL, Eisenlohr-Moul TA, Rubinow DR, et al. Naturally occurring changes in estradiol concentrations in the menopause transition predict morning cortisol and negative mood in perimenopausal depression. Clin Psychol Sci. 2016;4(5):919-935. doi: https://doi.org/10.1177/2167702616647924Liu J, Huang X, Cao X, et al. Serum biomarker analysis in patients with premature ovarian insufficiency. Cytokine. 2020;126(2):154876. doi: https://doi.org/10.1016/j.cyto.2019.154876Liu J, Huang X, Cao X, et al. Serum biomarker analysis in patients with premature ovarian insufficiency. Cytokine. 2020;126(2):154876. doi: https://doi.org/10.1016/j.cyto.2019.154876Yusuf L. Depression, anxiety and stress among female patients of infertility; A case control study. Pak J Med Sci. 2016;32(6):1340-1343. doi: https://doi.org/10.12669/pjms.326.10828Yusuf L. Depression, anxiety and stress among female patients of infertility; A case control study. Pak J Med Sci. 2016;32(6):1340-1343. doi: https://doi.org/10.12669/pjms.326.10828Golezar S, Keshavarz Z, Ramezani Tehrani F, Ebadi A. An exploration of factors affecting the quality of life of women with primary ovarian insufficiency: a qualitative study. BMC Womens Health. 2020;20(1):163. doi: https://doi.org/10.1186/s12905-020-01029-yGolezar S, Keshavarz Z, Ramezani Tehrani F, Ebadi A. An exploration of factors affecting the quality of life of women with primary ovarian insufficiency: a qualitative study. BMC Womens Health. 2020;20(1):163. doi: https://doi.org/10.1186/s12905-020-01029-yZefferino R, Di Gioia S, Conese M. Molecular links between endocrine, nervous and immune system during chronic stress. Brain Behav. 2021;11(2):e01960. doi: https://doi.org/10.1002/brb3.1960Zefferino R, Di Gioia S, Conese M. Molecular links between endocrine, nervous and immune system during chronic stress. Brain Behav. 2021;11(2):e01960. doi: https://doi.org/10.1002/brb3.1960

The authors declare that there are no conflicts of interest present.