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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2022№5
Functional hypothalamic amenorrhea in clinical...

Functional hypothalamic amenorrhea in clinical practice: medical and diagnostic features

DOI
https://dx.doi.org/10.18565/aig.2022.5.149-156

Bondarenko K.R., Kazantseva V.D., Dobrokhotova Yu.E.

Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
The paper presents the current data on the epidemiology, causes, and pathogenesis of functional hypothalamic amenorrhea (FHA). The authors highlight the current therapeutic approaches aimed at eliminating the cause of the disease and at preventing long-term consequences associated with hypoestrogenism in the presence of hypogonadotropic hypogonadism in FHA. The paper describes a clinical case that is used by the authors to analyze the most common diagnostic and therapeutic errors in the management of patients with FHA. The patients with this disease may be effectively treated provided that there is interdisciplinary involvement by professions in mental health and in dietology to normalize eating behavior and to ensure a positive energy balance. According to international and Russian clinical practice guidelines, to restore and maintain bone mineral density, patients with FHA require hormone replacement therapy with transdermal estrogens (for example, as a patch, 0.1% estradiol gel (Divigel), and others) in combination with progestins to protect the endometrium.
Conclusion: Implementation of consistent diagnostic measures, adherence to the clear algorithms that can timely verify FHA, and correctly selected hormone replacement therapy with transdermal estrogens will be able to level off the symptoms of the disease and to prevent long-term complications as osteoporosis and cardiovascular diseases.

Keywords

amenorrhea
functional hypothalamic amenorrhea
replacement hormone therapy
transdermal estrogens
Full text (in Russian)

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Received 26.04.2022

Accepted 06.05.2022

About the Authors

Karina R. Bondarenko, Dr. Med. Sci., Associate Professor at the Department of Obstetrics and Gynecology of the Faculty of Medicine, Pirogov Russian National Research Medical University, Ministry of Health of Russia, karinabond@mail.ru , https://orcid.org/0000-0003-4147-1151 , SPIN code: 9976-0735, AuthorID: 798660, 117997, Russia, Moscow, Ostrovityanova str., 1.
Valeria D. Kazantseva, PhD student of the Department of Obstetrics and Gynecology of the Faculty of Medicine, Pirogov Russian National Research Medical University, Ministry of Health of Russia, shapee08@mail.ru, https://orcid.org/0000-0002-4011-3195, 117997, Russia, Moscow, Ostrovityanova str., 1.
Yulia E. Dobrokhotova, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology of the Faculty of Medicine, Pirogov Russian National Research Medical University, Ministry of Health of Russia, pr.dobrohotova@mail.ru, https://orcid.org/0000-0002-7830-2290, SPIN-code: 2925-9948, AuthorID: 312767,
117997, Russia, Moscow, Ostrovityanova str., 1.
Corresponding author: Karina R. Bondarenko, karinabond@mail.ru

Authors' contributions: Bondarenko K.R. – development of the idea of the article, writing the article, development of the diagnostic algorithm; Dobrokhotova Yu.E., Kazantseva V.D. – information collection, writing the article.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Bondarenko K.R., Kazantseva V.D., Dobrokhotova Yu.E. Functional hypothalamic amenorrhea in clinical practice: medical and diagnostic features.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 5: 149-156 (in Russian)
https://dx.doi.org/10.18565/aig.2022.5.149-156

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