- Characteristic features of puberty in adolescent girls from the Precarpathian region and the main factors of reproductive potential decline.
Characteristic features of puberty in adolescent girls from the Precarpathian region and the main factors of reproductive potential decline.
HEALTH OF WOMAN. 2017.7(123):77–80
Dziombak V. B., Makarchuk O. M.
Ivano-Frankivsk National Medical University
Reproductive capacity significantly depends on the period of puberty of a woman-to-be, as well as on the so-called «intrauterine childhood».
The objective: to determine the peculiarities of the development of a girl during her puberty, to evaluate the causes of the menstrual function disturbances and to identify the main factors of the reproductive potential decline.
Patients and methods. The medical and social audit was conducted by interviewing, questioning and studying the medical documentation (clinical symptoms of extragenital pathology, duration of the disease, state of menstrual function, heredity, lifestyle and bad habits) in 264 girls in order to evaluate the probable factors of the development of menstrual function disturbance and ovarian-menstrual cycle disorders.
Results. The period of «intrauterine childhood» was in the context of a complicated gestation period: the threat of abortion, preeclampsia of varying degrees of severity, perinatal infections, preterm labour, fetal hypotrophy, harmful parenting habits, fetal distress during childbirth. More than two thirds of girls have chronic diseases of the internal organs, 24,2% of patients have the comorbidity of gynaecological pathology and extragenital diseases. Menstrual disorders predominate by type of algodismenorrhea, premenstrual syndrome and juvenile uterine bleeding. In sexually active adolescents the inflammatory processes of the genitals have been revealed in 46.2% of cases, undoubtedly the number of girls with absolute or relative risk of infertility is increasing. Dyshormonal diseases of the mammary glands were noted in 16.7% of cases, in girls with gynaecological pathology – twice as often, and in patients with menstrual function disturbances – 53.4%. The comparative analysis indicated the most obvious negative effect on the reproductive capacity, ovarian reserve of ovarian operations and hereditary predisposition to the disturbed reproductive function (OR=19.3; 95%: 3.1–92.6).
Conclusion. The obtained results help in classifying the risk factors of reduced reproductive potential for female adolescents and girls, which allows to optimize the formation of risk groups, to predict and monitor the reduction of the ovarian reserve and to develop preventive measures for improvement of the reproductive capacity. The most significant causes that reduce the reproductive potential of girls in the period of «intrauterine childhood» are: complicated pregnancy (severe gestosis, complicated childbirth), maternal perinatal infections (especially in the early stages), and in the adolescence – ovarian surgery, childhood infections, hypothyroidism and bad habits (smoking).
Key words: puberty, main causes of menstrual disturbances, reproductive potential.
1. Andreyeva VO, Gerasimova IA, Mashtalova AA. 2013. Sostoyaniye ovarial’nogo rezerva u devochek-podrostkov s autoimmunnym ooforitom. State of ovarian reserve in adolescent girls with autoimmune oophoritis. Reproduktivnoye zdorov’ye detey i podrostkov 1:35–43 .
2. Aronskind AV, Kovtun OP, Kabdrakhmanova OT. 2010. Sravnitel’nyye rezul’taty katamnesticheskogo nablyudeniya detey, perenesshikh kriticheskiye sostoyaniya neonatal’nogo perioda. Comparative results of follow-up observation of children who underwent critical states of the neonatal period. Pediatriya 89(5):47–50.
3. Burlakina NA, Uvarova YeV. 2009. Vliyaniye somaticheskoy patologii na nekotoryye parametry fizicheskogo razvitiya devochek v vozraste 10–14 let. The influence of somatic pathology on some parameters of the physical development of girls aged 10–14 years. Reproduktivnoye zdorov’ye detey i podrostkov. 4:78–84.
4. Parashchuk YuS, Tuchkina IA. 2005. Negormonal’noye lecheniye devochek-podrostkov s patologiyey pubertatnogo perioda v komplekse etapnoy reabilitatsii. Non-hormonal treatment of adolescent girls with pathology of the pubertal period in the complex of stage rehabilitation. Eksperymental’na i klinichna medytsyna. 2:144–147.
5. Radzinskiy VYe, Khamoshina MB, Lebedeva MG. 2010. Devushki-podrostki: sovremennyye tendentsii formirovaniya reproduktivnogo potentsiala (obzor literatury). Adolescent girls: current trends in the formation of reproductive potential (review of literature). Sib. med. zhurn. 25(4–2):9–14.
6. Tsysar YuV, Andriyets’ OA. 2011. Vplyv patolohiyi shchytopodibnoyi zalozy na menstrual’nu funktsiyu u divchat pubertatnoho viku. Influence of the thyroid gland pathology on menstrual function in girls of puberty age. Bukovyns’kyy medychnyy visnyk. 15(2,58):130–132.
7. Yakovlyeva EB, Serhiyenko MYu, Kas’yanova NV, Loskutova OV. 2011. Suchasni pohlyady na problemu pubertatnoho period. Modern approach to the problem of puberty period. Novosti meditsiny i farmatsii. Akusherstvo, ginekologiya, reproduktologiya 369:3–4.
8. Agarwal A, Verma A, Agarwal S. 2014. Antral follicle count in normal (fertility-proven) and infertile Indian women. Indian J. Radiol. Imaging. 24(3):297–302. https://doi.org/10.4103/0971-3026.137061; PMid:25114395 PMCid:PMC4126147