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

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 16-22 ◽  
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.

The physiology of functional hypothalamic amenorrhea associated with energy deficiency in exercising women and in women with anorexia nervosa

2016 ◽  
Vol 25 (2) ◽  
Author(s):  
Heather C.M. Allaway ◽  
Emily A. Southmayd ◽  
Mary Jane De Souza
Keyword(s):  
Energy Expenditure ◽  
Peptide Yy ◽  
Hormone Secretion ◽  
High Energy ◽  
Drive For Thinness ◽  
Compensatory Mechanisms ◽  
Hypothalamic Amenorrhea ◽  
Menstrual Dysfunction ◽  
Energy Deficiency ◽  
Metabolic Alterations

AbstractAn energy deficiency is the result of inadequate energy intake relative to high energy expenditure. Often observed with the development of an energy deficiency is a high drive for thinness, dietary restraint, and weight and shape concerns in association with eating behaviors. At a basic physiologic level, a chronic energy deficiency promotes compensatory mechanisms to conserve fuel for vital physiologic function. Alterations have been documented in resting energy expenditure (REE) and metabolic hormones. Observed metabolic alterations include nutritionally acquired growth hormone resistance and reduced insulin-like growth factor-1 (IGF-1) concentrations; hypercortisolemia; increased ghrelin, peptide YY, and adiponectin; and decreased leptin, triiodothyronine, and kisspeptin. The cumulative effect of the energetic and metabolic alterations is a suppression of the hypothalamic-pituitary-ovarian axis. Gonadotropin releasing hormone secretion is decreased with consequent suppression of luteinizing hormone and follicle stimulating hormone release. Alterations in hypothalamic-pituitary secretion alters the production of estrogen and progesterone resulting in subclinical or clinical menstrual dysfunction.

scholarly journals Circulating vaspin and visfatin are not affected by acute or chronic energy deficiency or leptin administration in humans

2011 ◽  
Vol 164 (6) ◽  
pp. 911-917 ◽  
Author(s):  
Eun Seok Kang ◽  
Faidon Magkos ◽  
Elizabeth Sienkiewicz ◽  
Christos S Mantzoros
Keyword(s):  
Human Subjects ◽  
Normal Weight ◽  
Hypothalamic Amenorrhea ◽  
Energy Deficiency ◽  
Chronic Energy Deficiency ◽  
Before And After ◽  
Term Energy ◽  
Energy Deprivation

ObjectiveAnimal and in vitro studies indicate that leptin alleviates starvation-induced reduction in circulating vaspin and stimulates the production of visfatin. We thus examined whether vaspin and visfatin are affected by short- and long-term energy deprivation and leptin administration in human subjects in vivo.Design and methodsWe measured circulating levels of vaspin and visfatin i) before and after 72 h of starvation (leading to severe hypoleptinemia) with or without leptin administration in replacement doses in 13 normal-weight subjects, ii) before and after 72 h of starvation with leptin administration in pharmacological doses in 13 lean and obese subjects, iii) during chronic energy deficiency in eight women with hypothalamic amenorrhea on leptin replacement for 3 months, and iv) during chronic energy deficiency in 18 women with hypothalamic amenorrhea on leptin replacement or placebo for 3 months.ResultsAcute starvation decreased serum leptin to 21% of baseline values, (P=0.002) but had no significant effect on vaspin and visfatin concentrations (P>0.05). Nor did normalization of leptin levels affect the concentrations of these two adipokines (P>0.9). Leptin replacement in women with hypothalamic amenorrhea did not significantly alter vaspin and visfatin concentrations, whether relative to baseline or placebo administration (P>0.25). Pharmacological doses of leptin did not affect circulating vaspin and visfatin concentrations (P>0.9).ConclusionsCirculating vaspin and visfatin are not affected by acute or chronic energy deficiency leading to hypoleptinemia and are not regulated by leptin in human subjects, indicating that these adipocyte-secreted hormonal regulators of metabolism are independently regulated in humans.

Heart rate variability in adolescents with functional hypothalamic amenorrhea and anorexia nervosa

2014 ◽  
Vol 215 (2) ◽  
pp. 406-409 ◽  
Author(s):  
Monica Bomba ◽  
Fabiola Corbetta ◽  
Alessandro Gambera ◽  
Franco Nicosia ◽  
Luisa Bonini ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Anorexia Nervosa ◽  
Hypothalamic Amenorrhea ◽  
Functional Hypothalamic Amenorrhea

Estriol administration modulates luteinizing hormone secretion in women with functional hypothalamic amenorrhea

2012 ◽  
Vol 97 (2) ◽  
pp. 483-488 ◽  
Author(s):  
Alessandro D. Genazzani ◽  
Blazej Meczekalski ◽  
Agnieszka Podfigurna-Stopa ◽  
Susanna Santagni ◽  
Erica Rattighieri ◽  
...  
Keyword(s):  
Luteinizing Hormone ◽  
Hormone Secretion ◽  
Luteinizing Hormone Secretion ◽  
Hypothalamic Amenorrhea ◽  
Functional Hypothalamic Amenorrhea

scholarly journals Functional hypothalamic amenorrhea remission, with spontaneous pregnancy after behavioral modifications

2020 ◽  
Vol 6 (6) ◽  
pp. 162-163
Author(s):  
Maria Thereza Campagnolo ◽  
Marcio Luis Duarte ◽  
Lucas Ribeiro dos Santos
Keyword(s):  
Mineral Content ◽  
High Energy ◽  
Energy Deficit ◽  
Delayed Puberty ◽  
Calorie Intake ◽  
Hormonal Changes ◽  
Hypothalamic Amenorrhea ◽  
Spontaneous Pregnancy ◽  
Functional Hypothalamic Amenorrhea ◽  
Gonadotrophin Releasing Hormone

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

Psychopathological traits of adolescents with functional hypothalamic amenorrhea: a comparison with anorexia nervosa

2013 ◽  
Vol 19 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Monica Bomba ◽  
Fabiola Corbetta ◽  
Luisa Bonini ◽  
Alessandro Gambera ◽  
Lucio Tremolizzo ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Hypothalamic Amenorrhea ◽  
Functional Hypothalamic Amenorrhea

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN KEKURANGAN ENERGI KRONIS PADA IBU HAMIL

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Febriyeni Febriyeni
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Negative Impact ◽  
Univariate Analysis ◽  
Good Condition ◽  
Health Centers ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Energy Deficiency ◽  
Chronic Energy Deficiency

<pre>Chronic Energy Deficiency is a situation where the nutritional status someone is on the Less Good Condition. Among the 22 health centers in the district of Lima Puluh Kota, CED highest coverage at the health center are Banja Laweh Namely Case 17 (16.50%) of 103 pregnant mothers. Preliminary Survey of 10 pregnant women at health centers Banja Laweh, note 4 people (40%) of them suffered CED. Based on the findings of interviews stating Not pregnant women know the importance of the size upper arm circumference on Against her pregnancy, in addition to pregnant women consume no food Diversified, because lust Eating Less and Economics not sufficient. Objectives for review determine factors related to the occurrence of Chronic energy deficiency on pregnant women. Methods descriptive analytic with cross sectional approach. Data collection is done on Date in January-February 2017. CASE is a whole population of pregnant women in the region are working Health Center Banja Laweh Year 2017, amounted to 55 people, with sampling total sampling. Operating data analysis using univariate and bivariate statistical test Chi Square. Results of univariate analysis 87,3% of respondents experienced Genesis not CED, (60,0%) High Knowledge, (56,4%) Economy High, and 61,8% of Eating Well. Bivariate analysis known Relationship of Knowledge (p = 0.013 and OR = 12,000, Economics (p = 0.035 and OR = 10,000), and Diet (p = 0.019 and OR = 13,200) with the Genesis CED pregnant women. Can be concluded that the factors related to the occurrence of CED pregnant women is Science, Economics and the Diet. Expected to conduct monitoring of the health center and Supervision of pregnant women at risk Against The Genesis CED, so the negative impact of the CED can be addressed early on.</pre>

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