Functional Hypothalamic Amenorrhea and Preclinical Cardiovascular Disease

Area of Science:

• Reproductive Endocrinology
• Cardiovascular Disease Research
• Women's Health

Background:

• Endothelial dysfunction is an early indicator of cardiovascular disease (CVD).
• Functional hypothalamic amenorrhea (FHA) involves neuroendocrine changes and may increase CVD risk in young women.

Purpose of the Study:

• To assess endothelial function in women diagnosed with FHA.
• To compare endothelial function in FHA women with eumenorrheic controls and recently menopausal women.

Main Methods:

• A cross-sectional study included 30 women with FHA, 29 eumenorrheic controls, and 30 menopausal women.
• Endothelial function was measured using the reactive hyperemic index (RHI) via EndoPAT 2000; RHI ≤1.67 signifies dysfunction.
• FHA criteria included amenorrhea ≥3 months, low estradiol, FSH, and LH, excluding other causes.

Main Results:

• Women with FHA exhibited significantly lower RHI (1.8 ± 0.5) compared to controls (2.2 ± 0.5) and menopausal women (2.2 ± 0.6).
• 35% of women with FHA displayed endothelial dysfunction (RHI ≤1.67).
• FHA was associated with lower insulin and higher cortisol levels than controls.

Conclusions:

• Endothelial dysfunction is present in approximately one-third of young women with FHA.
• FHA may contribute to preclinical CVD development in young women.
• The observed endothelial dysfunction in FHA is not solely attributable to hypoestrogenemia.