role of chronic stress in abnormal uterine bleeding leading to hysterectomy

Abnormal uterine bleeding (aub) is a common gynecological condition that significantly impacts women’s quality of life and often necessitates surgical intervention, including hysterectomy. while aub is multifactorial in origin, emerging evidence suggests that chronic stress may play a critical role in its pathogenesis and progression. this letter highlights the potential link between chronic stress and aub, emphasizing the need for further research to explore this association and its implications for clinical management. chronic stress, characterized by prolonged activation of the hypothalamic-pituitary-adre nal (hpa) axis, has been implicated in various reproductive health disorders. stress-induced hormonal dysregulation, particularly elevated cortisol levels, can disrupt the delicate balance of reproductive hormones, leading to menstrual irregularities and aub. additionally, chronic stress is associated with systemic inflammation and immune dysregulation, which may exacerbate endometrial dysfunction and contribute to abnormal bleeding patterns.