Changes in reproductive system in Indian female students in middle altitude conditions

OBJECTIVE: This study aimed to examine how altitude hypoxia, climatic conditions, and stress factors influence the reproductive health of Indian female students living in mid-altitude conditions (1600 m above sea level) in Cholpon Ata, Kyrgyzstan. METHODS: A total of 120 Indian female students aged 18-25, residing in the region for at least one year, were assessed through clinical examination, pelvic ultrasound, and hormonal blood tests. Reproductive hormones analyzed included follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol, progesterone, and prolactin. RESULTS: Significant reproductive changes were observed. Elevated FSH and LH levels were found in 35% and 30% of participants, respectively, indicating potential ovarian dysfunction and ovulatory disruption. Decreased oestradiol and progesterone levels were observed in 25% and 10% of students, while prolactin was above normal in 20%, likely due to stress and acclimatisation. Menstrual disorders were prevalent: oligomenorrhoea in 30%, dysmenorrhoea in 25%, and polymenorrhoea in 20% of participants. Ultrasound revealed increased ovarian volume in 20% and reduced endometrial thickness in 15%, reflecting structural alterations potentially caused by chronic hypoxia. A strong positive correlation (r=0.72) was found between the duration of residence and elevated LH levels. CONCLUSIONS: Mid-altitude living conditions appear to significantly affect the reproductive system of young women, likely due to hypoxia, climatic stressors, and psychosocial adaptation. These findings underscore the need for systematic reproductive health monitoring and early intervention strategies for populations residing in elevated environments.