Hormonal and Psychoemotional Status in Uterine Fibroids: Neuroendocrine Mechanisms, Stress Responses, And Changes in Parameters Before and After Surgical Intervention

Current concepts of the pathogenesis of uterine fibroids emphasize the leading role of estrogens and progesterone, local receptor sensitivity of myomatous tissue, growth factors, the extracellular matrix, oxidative stress, and neuroendocrine mechanisms. At the same time, the clinical course of the disease is often accompanied by chronic pelvic pain, heavy menstrual bleeding, anemia, impaired reproductive plans, and reduced sexual and social functioning, which intensify anxiety, depressive manifestations, and the overall stress burden. The aim of this review is to analyze contemporary international data on the hormonal and psychoemotional status of women with uterine fibroids, with an emphasis on neuroendocrine mechanisms, stress responses, and the dynamics of indicators before and after surgical intervention. The article considers the key pathogenetic links of uterine fibroids, the role of the hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal systems, the influence of chronic stress on hormonal status, the significance of anxiety and depression in the clinical course of the disease, as well as changes in psychoemotional status after myomectomy and hysterectomy. The review highlights the need for a comprehensive assessment of patients with uterine fibroids, including not only ultrasound, clinical gynecological, and hormonal parameters, but also psychoemotional status, stress level, quality of life, and adaptive potential.

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