Stress-induced amenorrhea – possibilities for non-hormonal correction

Background. Menstrual cycle disorders associated with stress, particularly functional hypothalamic amenorrhea, are a common condition among women of reproductive age in the context of martial law. Stress-induced amenorrhea not only causes reduced fertility and quality of life for women but also poses a future risk due to related general health disorders among the female population of Ukraine. There are reports in the literature about the effectiveness of etiological treatment for these disorders in the form of psychological counseling with additional supplementation, which prompted us to explore the possibilities of non-hormonal correction of stress-induced amenorrhea. Objective of the study: to optimize the treatment of stress-induced amenorrhea by non-hormonal medication therapy combined with phytotherapy alongside psychological counseling.Materials and methods. A total of 106 women of reproductive age with stress-induced amenorrhea were examined, receiving psychological counseling and medication therapy. The patients were randomized into three groups: 34 patients received Vitex agnus castus extract BNO 1095, 35 women were prescribed a preparation containing magnesium citrate and vitamin B6, and 37 participants received a combination of both treatments for six months.Results. After six months menstrual cycles were restored in 22 (64.71%) women who received Vitex agnus castus, in 19 (55.88%) patients who received magnesium citrate, and in 29 (78.4%) patients who received combined treatment. This was accompanied by the normalization of gonadotropic function of the pituitary gland, steroidogenic function of the ovaries, and endometrial thickness. Conclusions. Stabilization of the mental state and reduction of anxiety levels are key etiological interventions and essential conditions for restoring menstrual cycle regularity in patients with stress-induced amenorrhea. The mild dopaminergic support in the form of standardized Vitex agnus castus extract BNO 1095 (Cyclodynon) helps to restore hormonal balance and the menstrual cycle in women with stress-induced amenorrhea, especially when combined with magnesium supplements and psychological counseling. The obtained data allow to recommend this treatment regimen as first-line therapy for women with stress-induced amenorrhea to preserve and restore reproductive function that is especially relevant in the conditions of the military conflict in Ukraine.