en زنان و زایمان Obstetrics & Gynecology نامه به سر دبیر Letter to Editor <div style="text-align: justify;">Abnormal uterine bleeding (AUB) is a common gynecological condition that significantly impacts women&#39;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.</div> Hysterectomy, Uterine Bleeding, Stress 127 128 http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-437-1&slc_lang=en&sid=1 Marzieh Bagherinia mar65m3@gmail.com 100319475328460010651 100319475328460010651 No Clinical Research Development Center, Motazedi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Farzaneh Safajou fsafajou@bums.ac.ir 100319475328460010652 100319475328460010652 Yes Department of Midwifery, Qaen Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran. Zahra Amouzeshi amouzeshiz9039@gmail.com 100319475328460010653 100319475328460010653 No Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran