Functional hypothalamic amenorrhea remission, with spontaneous pregnancy after behavioral modifications

Functional Hypothalamic Amenorrhea (FHA) is a disorder that generates a state of chronic anovulation due to a low calorie intake and high energy expenditure through intense physical activity. This energy deficit induce several hormonal changes that lead to decreased secretion of gonadotrophin releasing-hormone (GnRH) and luteinizing hormone (LH), resulting in a chronic state of hypoestrogenism and infertility. Loss of bone mineral content and delayed puberty may also arise from such condition depending on patient´s age. Herein we present a case of a patient with HFA that was reversible through behavioral modifications, resulting in spontaneous pregnancy

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Pathophysiological features of development of functional hypothalamic amenorrhea in patients with anorexia nervosa

GYNECOLOGY ◽

10.26442/2079-5696_20.1.16-22 ◽

2018 ◽

Vol 20 (1) ◽

pp. 16-22 ◽

Cited By ~ 1

Author(s):

G E Chernukha ◽

D V Gusev ◽

G I Tabeeva ◽

V Yu Prilutskaia

Keyword(s):

Anorexia Nervosa ◽

Peptide Yy ◽

Hormone Secretion ◽

Metabolic Changes ◽

Energy Deficit ◽

Compensatory Mechanisms ◽

Hypothalamic Amenorrhea ◽

Energy Deficiency ◽

Chronic Energy Deficiency ◽

Functional Hypothalamic Amenorrhea

The energy deficit is the result of insufficient energy intake compared to its high costs. The development of energy deficiency is often associated with the desire to lose weight, a strict diet, as well as the woman's concern about her weight along with a change in eating behavior. The result of eating disorders in combination with a decrease in body weight is anorexia nervosa, accompanied by an energy deficit. Physiological changes occurring against a background of chronic energy deficiency contribute to the inclusion of compensatory mechanisms of energy conservation to provide vital physiological functions. The most frequent metabolic changes include hypoleptinemia in the presence of a decrease in the percentage of fat tissue, a decrease in triiodothyronine, and an increase in the concentrations of ghrelin, peptide YY and neuropeptide Y. The effect of energy and metabolic changes leads to suppression of the hypothalamic-pituitary-ovarian axis, gonadotropin releasing hormone secretion, with the subsequent suppression of the release of luteinizing and follicle stimulating hormones. The suppression of the hypothalamic-pituitary-ovarian axis leads to chronic estrogen deficiency, which is accompanied by the development of functional hypothalamic amenorrhea.

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The Psychoneuroendocrinology of Functional Hypothalamic Amenorrhea

Psychiatric Clinics of North America ◽

10.1016/s0193-953x(18)30454-4 ◽

1989 ◽

Vol 12 (1) ◽

pp. 105-116 ◽

Cited By ~ 53

Author(s):

Sarah L. Berga ◽

Lyda G. Girton

Keyword(s):

Hypothalamic Amenorrhea ◽

Functional Hypothalamic Amenorrhea

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Bone mineral density in girls with functional hypothalamic amenorrhea subjected to estroprogestagen treatment: a 4-year prospective study

Endocrine Abstracts ◽

10.1530/endoabs.35.p100 ◽

2014 ◽

Author(s):

Elzbieta Sowinska-Przepiera ◽

Elzbieta Andrysiak-Mamos ◽

Agnieszka Kazmierczyk-Puchalska ◽

Ewa Wentland-Kotwicka ◽

Anhelli Syrenicz

Keyword(s):

Bone Mineral Density ◽

Prospective Study ◽

Bone Mineral ◽

Mineral Density ◽

Hypothalamic Amenorrhea ◽

Functional Hypothalamic Amenorrhea

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Sepsis as a Pan-Endocrine Illness—Endocrine Disorders in Septic Patients

Journal of Clinical Medicine ◽

10.3390/jcm10102075 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2075

Author(s):

Weronika Wasyluk ◽

Martyna Wasyluk ◽

Agnieszka Zwolak

Keyword(s):

Host Response ◽

Peripheral Resistance ◽

Endocrine System ◽

Endocrine Disorders ◽

Hormonal Changes ◽

Adrenergic Stimulation ◽

Hypothalamic Amenorrhea ◽

Somatotropic Axis ◽

Almost All ◽

Triiodothyronine Concentration

Sepsis is defined as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. One of the elements of dysregulated host response is an endocrine system disorder. Changes in its functioning in the course of sepsis affect almost all hormonal axes. In sepsis, a function disturbance of the hypothalamic–pituitary–adrenal axis has been described, in the range of which the most important seems to be hypercortisolemia in the acute phase. Imbalance in the hypothalamic–pituitary–thyroid axis is also described. The most typical manifestation is a triiodothyronine concentration decrease and reverse triiodothyronine concentration increase. In the somatotropic axis, a change in the secretion pattern of growth hormone and peripheral resistance to this hormone has been described. In the hypothalamic–pituitary–gonadal axis, the reduction in testosterone concentration in men and the stress-induced “hypothalamic amenorrhea” in women have been described. Catecholamine and β-adrenergic stimulation disorders have also been reported. Disorders in the endocrine system are part of the “dysregulated host response to infection”. They may also affect other components of this dysregulated response, such as metabolism. Hormonal changes occurring in the course of sepsis require further research, not only in order to explore their potential significance in therapy, but also due to their promising prognostic value.

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Energy Intakes of Ultraendurance Cyclists During Competition, an Observational Study

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.22.1.19 ◽

2012 ◽

Vol 22 (1) ◽

pp. 19-23 ◽

Cited By ~ 17

Author(s):

Katherine E. Black ◽

Paula M.L. Skidmore ◽

Rachel C. Brown

Keyword(s):

Observational Study ◽

Energy Intake ◽

Energy Requirement ◽

Negative Relationship ◽

Computer Software ◽

High Energy ◽

Energy Deficit ◽

Food Diary ◽

Food And Drink ◽

And Performance

Endurance events >10 hr are becoming increasingly popular but provide numerous physiological challenges, several of which can be attenuated with optimal nutritional intakes. Previous studies in ultraendurance races have reported large energy deficits during events. The authors therefore aimed to assess nutritional intakes in relation to performance among ultraendurance cyclists. This observational study included 18 cyclists in a 384-km cycle race. At race registration each cyclist’s support crew was provided with a food diary for their cyclist. On completion of the race, cyclists were asked to recall their race food and drink intakes. All food and fluids were analyzed using a computer software package. Mean (SD) time to complete the race was 16 hr 21 min (2 hr 2 min). Mean (SD) energy intake was 18.7 (8.6) MJ, compared with an estimated energy requirement for the race of 25.5 (7.4) MJ. There was a significant negative relationship between energy intake and time taken to complete the race (p = .023, r2 = −.283). Mean (SD) carbohydrate, fat, and protein intakes were 52 (27), 15.84 (56.43), and 2.94 (7.25) g/hr, respectively. Only carbohydrate (p = .015, r2 = −.563) and fat intake (p = .037, r2 = −.494) were associated with time taken to complete the race. This study demonstrates the difficulties in meeting the high energy demands of ultraendurance cycling. The relationship between energy intake and performance suggests that reducing the energy deficit may be advantageous. Given the high carbohydrate intakes of these athletes, increasing energy intake from fat should be investigated as a means of decreasing energy deficits.

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