Как связаны питание, стресс и физическая нагрузка с развитием аменореи?

Аменорея — отсутствие или ненормальное прекращение менструального цикла. Функциональная гипоталамическая аменорея (ФГА), одна из наиболее распространенных и наименее изученных форм вторичной (гипоталамической) аменореи, возникает вследствие срыва адаптации женского организма к комплексному воздействию психосоциальных и метаболических раздражителей. На сегодняшний день не существует общепринятых методов измерения пороговой величины потенциальных раздражителей и маркеров эффективности коррекции данного состояния у женщин, в связи с чем диагностика, лечение и профилактика ФГА пока имеют эмпирический характер. Наиболее перспективным направлением в свете данной проблемы является разработка разнонаправленных подходов к персонализированному ведению пациенток с ФГА, включающих коррекцию нутритивного и психоэмоционального статуса. Особые надежды возлагаются на поиск и применение омиксных (геномных, эпигеномных, транскриптомных, протеомных и метаболомных) маркеров нарушения работы гипоталамо-гипофизарно-гонадной оси в научно-практических интересах. В данном обзоре литературы показана связь возникновения аменореи со стрессом, изменениями в питании и весе, чрезмерными физическим нагрузками, а также пандемией COVID-19. Поиск литературы проводился на русском и английском языках в базах данных eLibrary, MEDLINE и Scopus преимущественно за период последних 5–10 лет. Ввиду недостаточной изученности выбранной темы также выбирались источники, датированные 1990-ми годами.

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