Dysfunctional uterine bleeding and the stress axis

Aim: The aim of this study is to determine the autonomic nervous system activity by measuring heart rate variability with electrocardiography in patients diagnosed with dysfunctional uterine bleeding (DUB) and to obtain basic data on the role of stress in the etiology of DUB. Material and Method: This was a prospective case-control study that included patients admitted to the Inonu University School of Medicine Department of Obstetrics and Gynecology between 15.09.2018-15.09.2021 due to abnormal uterine bleeding and was diagnosed with DUB. DUB was classified according to the International Gynecology and Obstetrics Federation classification. During the study period, 34 women diagnosed with DUB formed the study group, while 36 volunteers with age and body mass index-matched healthy and regular menstrual cycles (every 27-32 days) constituted the control group. All volunteers included in the study were questioned symptoms of autonomic nervous system dysfunction, and detailed cardiac and neurological examinations were performed. Baseline electrocardiograms were obtained from all volunteers, and women with abnormal baseline electrocardiography were excluded from the study. Electrocardiography was performed for 5 minutes to analyze heart rate variability during the intensive period of the menstrual cycle (2-3 days). Results: A total of 70 women; 36 healthy women (control group), and 34 women diagnosed with DUB (study group) were included in this study. The mean age of the control group was 33.28 ± 6.91 years, and the DUB group was 35.32 ± 6.32 years, and there was no significant difference in terms of age between the groups. Also, no significant difference was found between the control group and the DUB group in terms of weight and body mass index ( p = 0.311). There was no significant difference in follicle stimulating hormone, luteinizing hormone, estriol, testosterone, and thyroid stimulating hormone between the groupsWhen women with DUB and controls were compared using frequency-dependent heart rate variability parameters, there was no statisyically significant difference in HR, RR min, RR max, RRNN, SDNN, RMSSD, pNN50, CV, RM min, RM max, RR-avg min, and RR-avg max parameters was observed. Conclusion: No significant difference was found between the menstrual cycle and electrocardiogram stress parameters of patients with DUB compared with the control group. Keywords: Dysfunctional uterine bleeding; Electrocardiogram; Heart rate; Menstruation; Autonomic nervous system; Parasympathetic nervous system; Sympathetic nervous system