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Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline.
Catherine M Gordon1, Kathryn E Ackerman2,3, Sarah L Berga4
1Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229.
The Journal of Clinical Endocrinology and Metabolism
|April 4, 2017
Summary
Functional hypothalamic amenorrhea (FHA) is diagnosed by excluding other causes and often linked to stress or weight loss. Treatment requires a multidisciplinary approach addressing medical, dietary, and mental health needs.
Area of Science:
- Reproductive Endocrinology
- Neuroendocrinology
Background:
- Functional hypothalamic amenorrhea (FHA) is a diagnosis of exclusion characterized by chronic anovulation.
- FHA is frequently associated with psychological stress, significant weight loss, or excessive physical activity.
Framework:
- Guideline development utilized the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
- Evidence was synthesized from two commissioned systematic reviews and existing literature.
Implementation:
- A multidisciplinary task force, including experts, a methodologist, and a medical writer, developed the guideline.
- Consensus was achieved through meetings, calls, and e-mail, with review by Endocrine Society committees and cosponsoring organizations.
Implications:
- Diagnosis requires excluding organic causes and assessing for systemic and endocrinologic etiologies.
- Management necessitates a comprehensive strategy involving medical, nutritional, and psychological interventions.
- Potential complications such as bone loss and infertility require ongoing investigation and therapeutic consideration.