scholarly journals Functional Hypothalamic Amenorrhea: A Stress-Based Disease

Endocrines ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 203-211
Author(s):  
Agnieszka Podfigurna ◽  
Blazej Meczekalski
Keyword(s):  
Lifestyle Modification ◽  
Childbearing Age ◽  
Hypothalamic Amenorrhea ◽  
Excessive Exercise ◽  
Hormonal Function ◽  
Pulsatile Gnrh ◽  
Functional Hypothalamic Amenorrhea ◽  
Short And Long Term ◽  
Negative Impacts

The aim of the study is to present the problem of functional hypothalamic amenorrhea, taking into account any disease and treatment, diagnosis, and consequences of this disease. We searched PubMed (MEDLINE) and included 38 original and review articles concerning functional hypothalamic amenorrhea. Functional hypothalamic amenorrhea is the most common cause of secondary amenorrhea in women of childbearing age. It is a reversible disorder caused by stress related to weight loss, excessive exercise and/or traumatic mental experiences. The basis of functional hypothalamic amenorrhea is hormonal, based on impaired pulsatile GnRH secretion in the hypothalamus, then decreased secretion of gonadotropins, and, consequently, impaired hormonal function of the ovaries. This disorder leads to hypoestrogenism, manifested by a disturbance of the menstrual cycle in the form of amenorrhea, leading to anovulation. Prolonged state of hypoestrogenism can be very detrimental to general health, leading to many harmful short- and long-term consequences. Treatment of functional hypothalamic amenorrhea should be started as soon as possible, and it should primarily involve lifestyle modification. Only then should pharmacological treatment be applied. Importantly, treatment is most often long-term, but it results in recovery for the majority of patients. Effective therapy, based on multidirectional action, can protect patients from numerous negative impacts on fertility, cardiovascular system and bone health, as well as reducing mental morbidity.

scholarly journals Long-Term Follow-Up of Functional Hypothalamic Amenorrhea and Prognostic Factors

2002 ◽  
Vol 87 (2) ◽  
pp. 500-505 ◽  
Author(s):  
Leopoldo Falsetti ◽  
Alessandro Gambera ◽  
Lorena Barbetti ◽  
Cristina Specchia
Keyword(s):  
Prognostic Factors ◽  
Hypothalamic Amenorrhea ◽  
Functional Hypothalamic Amenorrhea ◽  
Long Term Follow Up

scholarly journals Energy Availability in Athletics: Health, Performance, and Physique

2019 ◽  
Vol 29 (2) ◽  
pp. 152-164 ◽  
Author(s):  
Anna K. Melin ◽  
Ida A. Heikura ◽  
Adam Tenforde ◽  
Margo Mountjoy
Keyword(s):  
Body Mass ◽  
Relative Energy ◽  
Track And Field ◽  
Team Approach ◽  
Energy Availability ◽  
Long Distance ◽  
Hypothalamic Amenorrhea ◽  
Stress Injury ◽  
Functional Hypothalamic Amenorrhea

The reported prevalence of low energy availability (LEA) in female and male track and field athletes is between 18% and 58% with the highest prevalence among athletes in endurance and jump events. In male athletes, LEA may result in reduced testosterone levels and libido along with impaired training capacity. In female track and field athletes, functional hypothalamic amenorrhea as consequence of LEA has been reported among 60% of elite middle- and long-distance athletes and 23% among elite sprinters. Health concerns with functional hypothalamic amenorrhea include impaired bone health, elevated risk for bone stress injury, and cardiovascular disease. Furthermore, LEA negatively affects recovery, muscle mass, neuromuscular function, and increases the risk of injuries and illness that may affect performance negatively. LEA in track and field athletes may occur due to intentional alterations in body mass or body composition, appetite changes, time constraints, or disordered eating behavior. Long-term LEA causes metabolic and physiological adaptations to prevent further weight loss, and athletes may therefore be weight stable yet have impaired physiological function secondary to LEA. Achieving or maintaining a lower body mass or fat levels through long-term LEA may therefore result in impaired health and performance as proposed in the Relative Energy Deficiency in Sport model. Preventive educational programs and screening to identify athletes with LEA are important for early intervention to prevent long-term secondary health consequences. Treatment for athletes is primarily to increase energy availability and often requires a team approach including a sport physician, sports dietitian, physiologist, and psychologist.

scholarly journals Has Menstruation Disappeared? Functional Hypothalamic Amenorrhea—What Is This Story about?

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2827
Author(s):  
Karina Ryterska ◽  
Agnieszka Kordek ◽  
Patrycja Załęska
Keyword(s):  
Current Knowledge ◽  
Therapeutic Interventions ◽  
Macronutrient Intake ◽  
Review Of The Literature ◽  
Hypothalamic Amenorrhea ◽  
Main Determinant ◽  
Complex Disorder ◽  
Functional Hypothalamic Amenorrhea ◽  
Regeneration Processes

Functional hypothalamic amenorrhea (FHA) is a very common condition affecting women of procreative age. There are many reasons for this disorder, including a low availability of energy in the diet, low micro- and macronutrient intake, overly intensive physical activity, disturbed regeneration processes, sleep disorders, stress, and psychological disorders. The main determinant is long-term stress and an inability to handle the effects of that stress. FHA is a very complex disorder and often goes undiagnosed. Moreover, therapeutic interventions do not address all the causes of the disorder, which could have implications for women’s health. As shown by scientific reports, this condition can be reversed by modifying its causes. This review of the literature aims to update the current knowledge of functional hypothalamic amenorrhea and underscores the complexity of the disorder, with particular emphasis on the nutritional aspects and potential interventions for restoring balance.

scholarly journals The Short and Long-term Effects of Pregnancy on Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis

2018 ◽  
Author(s):  
Pamela McCombe
Keyword(s):  
Multiple Sclerosis ◽  
Long Term Effects ◽  
Childbearing Age ◽  
Autoimmune Encephalomyelitis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Beneficial Effects ◽  
Maternal Immune System ◽  
Short And Long Term

The role of pregnancy in multiple sclerosis (MS) is of importance because many patients with MS are young women in the childbearing age who require information to inform their reproductive decisions. Pregnancy is now well-known to be associated with fewer relapses of MS and reduced activity of autoimmune encephalomyelitis (EAE). However, in women with multiple sclerosis, this benefit is not always sufficient to protect against a rebound of disease activity if disease modulating therapy is ceased for pregnancy. There is reason to be concerned that use of assisted reproductive therapies can be associated with relapses of MS. It is thought that the beneficial effects of pregnancy are due to the pregnancy-associated changes in the maternal immune system. There is some evidence of this in human studies and studies of EAE. There is also evidence that having been pregnant leads to better long-term outcome of MS. The mechanism for this is not fully understood but it could result from epigenetic changes resulting from pregnancy or parenthood. Further studies of the mechanisms of the beneficial effects of pregnancy could provide information that might be used to produce new therapies.

scholarly journals The Short and Long-Term Effects of Pregnancy on Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis

2018 ◽  
Vol 7 (12) ◽  
pp. 494 ◽  
Author(s):  
Pamela McCombe
Keyword(s):  
Multiple Sclerosis ◽  
Long Term Effects ◽  
Childbearing Age ◽  
Autoimmune Encephalomyelitis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Beneficial Effects ◽  
Maternal Immune System ◽  
Short And Long Term

The role of pregnancy in multiple sclerosis (MS) is of importance because many patients with MS are young women in the childbearing age who require information to inform their reproductive decisions. Pregnancy is now well-known to be associated with fewer relapses of MS and reduced activity of autoimmune encephalomyelitis (EAE). However, in women with multiple sclerosis, this benefit is not always sufficient to protect against a rebound of disease activity if disease-modulating therapy is ceased for pregnancy. There is concern that use of assisted reproductive therapies can be associated with relapses of MS, but more data are required. It is thought that the beneficial effects of pregnancy are due to the pregnancy-associated changes in the maternal immune system. There is some evidence of this in human studies and studies of EAE. There is also evidence that having been pregnant leads to better long-term outcome of MS. The mechanism for this is not fully understood but it could result from epigenetic changes resulting from pregnancy or parenthood. Further studies of the mechanisms of the beneficial effects of pregnancy could provide information that might be used to produce new therapies.

Boreal forest sensitivity to global warming: Implications for forest management in western interior Canada

1991 ◽  
Vol 67 (4) ◽  
pp. 342-348 ◽  
Author(s):  
T. Singh ◽  
E. E. Wheaton
Keyword(s):  
Global Warming ◽  
Forest Management ◽  
Boreal Forest ◽  
Climatic Changes ◽  
Rate Of Change ◽  
Western Canada ◽  
Highly Sensitive ◽  
Short And Long Term ◽  
Negative Impacts

Unmitigated global warming due to the enhanced greenhouse effect could have significant impacts on the boreal forest in interior western Canada. Increases in annual temperature of 3 to 7 °C are projected for Alberta under a 2 × CO2 scenario by 2030 – 2050 A.D. Such an unprecedented rate of change has many short- and long-term implications for forest management and for industries. As the boreal forest is highly sensitive to climatic changes, foresters need to develop a set of safe strategies to minimize the negative impacts and maximize the benefits of these changes.

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