The LH:FSH Ratio in Functional Hypothalamic Amenorrhea: An Observational Study
Magdalena Boegl1, Didier Dewailly2, Rodrig Marculescu3
1Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria.
Journal of Clinical Medicine
|April 9, 2024
Summary
Most patients with functional hypothalamic amenorrhea (FHA) have a low luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio (≤1). This finding may help differentiate FHA from polycystic ovary syndrome (PCOS).
Area of Science:
- Reproductive Endocrinology
- Gynecology
- Hormone Assays
Background:
- Functional hypothalamic amenorrhea (FHA) diagnosis is complicated by high interindividual variability in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels.
- This variability limits the diagnostic value of LH and FSH in differentiating FHA from polycystic ovary syndrome (PCOS).
Purpose of the Study:
- To profile the LH:FSH ratio in a large cohort of patients with well-defined FHA.
- To assess the potential of the LH:FSH ratio in distinguishing FHA from PCOS.
Main Methods:
- Observational study of consecutive FHA patients (January 2017 - August 2023).
- Analysis of LH levels, FSH levels, and the LH:FSH ratio.
- Subgroup analysis comparing LH:FSH ratio in patients with and without polycystic ovarian morphology (PCOM).
Main Results:
- 135 FHA patients included; few had low FSH (13%) or LH (39%) levels.
- The majority (81.5%) of patients exhibited an LH:FSH ratio ≤ 1.0.
- A minority (2.2%) had an LH:FSH ratio ≥ 2.1; ratio was similar in patients with/without PCOM.
Conclusions:
- In a well-defined FHA cohort, most patients presented with an LH:FSH ratio ≤ 1.
- The LH:FSH ratio shows potential as a diagnostic tool to differentiate FHA from PCOS.
- Further research is warranted to validate the clinical utility of the LH:FSH ratio.
