Some features of hormonal profile in adolescent girls with urinary tract infections
BACKGROUND. Currently, adolescent girls with recurrent urinary tract infection (UTI) have a high incidence of reproductive disorders. THE AIM: to study the features of the hormonal profile of adolescent girls with urinary tract infections, depending on the frequency of relapses. PATIENTS AND METHODS. A prospective controlled randomized study was conducted in 156 adolescent girls aged 15-17 years and 11 months 29 days, including 1 group (n=41) - patients with acute urinary tract infection; 2 group (n=43) - with rare relapses of chronic urinary tract infection; 3 group (n=42) - with frequent recurrence of urinary tract infection; 4 group (n=30) - healthy girls of similar age without urinary tract infection. The concentrations of gonadotropic (luteinizing hormone, follicle-stimulating hormone, prolactin) and steroid (estradiol, testosterone, dehydroepiandrosterone sulfate, cortisol) hormones were studied. All studies were performed on the 5-7 day of the menstrual cycle, progesterone - on the 22-24 day by enzyme immunoassay. RESULTS. Patients of the 3rd group with often recurrent UTI, compared with patients of groups 1 and 2, showed a significant increase in the levels of luteinizing hormone, testosterone, cortisol, dehydroepiandrosterone sulfate, with a decrease in estradiol concentrations. Progesterone levels determined on days 22-24 from the onset of menstruation in patients with frequent recurrences of UTI were significantly lower than in patients of the 1st, 2nd, 3rd, and control groups. In patients with acute UTI in the presence of the ovulatory cycle, the hormonal status was similar with the control group. At the same time, in terms of anovulation, an increase in luteinizing hormone, cortisol, was observed against the background of a tendency to a decrease in follicle-stimulating hormone. In patients of group 2 with rare recurrences of UTI in the presence of the ovulatory cycle, the hormonal status was similar with the control group (p> 0.1), in anovulation conditions, in comparison with the control, there was a significant increase in cortisol and luteinizing hormone. In 90.5% of patients of the 3rd group with frequent recurrences of UTI there was no ovulatory cycles. CONCLUSION. In adolescent girls with frequent relapses of UTI, there are marked disorders of hormonal status in the form of hypoprolactinemia, increase the level of cortisol and testosterone. The basis of the development of reproductive disorders is the formation of chronic anovulation, which requires a pathogenetic correction.