КЛИНИЧЕСКИЕ ПРОЯВЛЕНИЯ ВЕГЕТАТИВНОЙ ДИСРЕГУЛЯЦИИ У ДЕВУШЕК С НАРУШЕНИЕМ МЕНСТРУАЛЬНОГО ЦИКЛА: НЕЙРОЭНДОКРИННЫЕ МЕХАНИЗМЫ, ДИАГНОСТИЧЕСКИЕ КРИТЕРИИ И ПЕРСПЕКТИВЫ ФУНКЦИОНАЛЬНОГО МОНИТОРИНГА

Abstract

Background. Menstrual cycle disorders during adolescence represent an important clinical problem involving reproductive, endocrine, cardiovascular, and neurological regulatory systems. In some patients, menstrual irregularities coexist with headaches, dizziness, orthostatic intolerance, palpitations, excessive sweating, sleep disturbances, and emotional instability. Interactions between the hypothalamic–pituitary–ovarian axis, autonomic nervous system, and stress-response mechanisms may contribute to these manifestations. However, physiological menstrual cycle-related autonomic fluctuations must be distinguished from established autonomic disorders and symptoms caused by coexisting medical conditions.

Materials and Methods. A narrative analytical review of clinical studies, systematic reviews, meta-analyses, and international recommendations was conducted. The main topics included adolescent menstrual disorders, cardiovascular autonomic regulation, heart rate variability, dysmenorrhea, orthostatic intolerance, and premenstrual disorders.

Results. Clinical patterns of autonomic symptoms accompanying menstrual disturbances were systematically characterized. The diagnostic roles and limitations of orthostatic testing, heart rate variability analysis, clinical questionnaires, and endocrine assessment were examined. An original conceptual framework, ADOLESCENT-AUTO-CYCLE, was developed to integrate menstrual characteristics, autonomic symptoms, physiological reactivity, and comorbid conditions.

Conclusion. Evaluation of autonomic manifestations in adolescent girls with menstrual cycle disorders requires an interdisciplinary approach involving neurology, adolescent gynecology, and endocrinology. Longitudinal symptom assessment and standardized autonomic monitoring may improve clinical characterization and support individualized follow-up.