MD are the most frequent complaint of women with Cushing Syndrome at the time of diagnosis.
Objective: To study the frequency of occurrence of MD in patients with Syndrome Cushing and to characterize their clinical and hormonal parallels. We investigated 34 women (average age of 27 years, variation in age from 18 to 30 years) with a newly identified ACTHA. The patients were divided into 4 groups: (1) the normal cycle is 2631 days; (2) oligomenorrhea 32120 days; (3) amenorrhea -more than 120 days, and (4) polymenorrhea- when the cycle was shortened to less than 26 days. The following hormonal studies were carried out: at 9:00 am on an empty stomach, blood was taken to determine the level of LH, FSN, PRL, test, androstenedione, DEAS, SSSG and ACTH. Cortisol blood was determined at 9:00; 18:00; and 24:00. Statistics processing of the results was performed by the package.
Results: Only 6 women (17.6%) had a normal cycle, 9- (26.5%) oligomenorrhea, 12-(35.3) amenorrhea and 7- (20.6%) polymenorrhea. Comparative analysis of clinical and hormonal parameters reveal is the following: in the group of patients with amenorrhea, there is a significant decrease in the level of estradiol 104 nmol/e compared with oligomenorrhea (217±12 pool/l+0.05) and patients with a normal menstrual cycle (246±22,6 pmol/l P<0.05). The average indices of cortisol level were significantly higher than in the compared groups and accordingly, amounted to 9:00 841±11.2 nmol/l, 701±472 and 560.6±18.2 nmol/l, P<0.05) and at 18:00 (926±31.2 versus 620±18.4, 681.4±18.4 pmol/l P<0.05). The correlation analysis showed an inverse relationship between the level of estradiol and cortisol at 9:00 in the whole group of patients,regardless of the type of MD (r=−0.40; P< 0.01) and at 18:00 (r=−0.51; P<0.01). There was no connection between androgens and estradiol or cortisol.
Conclusion: In our study, 82.4% of patients with ACTG dependent Cushing Syndrome had menstrual dysfunctional that were highly dependent on cortisol and had. Androgenov. Significantly high levels of cortisol contribute to the development of amenorrhea combined with low estradiol levels. We believe that MD in Cushing develop possible due to the inhibition of gonadotropins by hypercortisolemia and not by levels of circulating androgens.
18 - 21 May 2019
European Society of Endocrinology