New opportunities of clomiphene citrate treatment for functional hypothalamic amenorrhea
Objective. To evaluate the efficiency of clomiphene citrate (CC) therapy for functional hypothalamic amenorrhea (FHA).Chernukha G.E., Gusev D.V., Tabeeva G.I., Marchenko L.A.
Subjects and methods. A total of 84 patients with FHA underwent clinical and laboratory examinations. The patients received down-step therapy with CC, by reducing its cycle dose and use duration. The response to CC was rated as complete, partial, or absent in terms of the presence of menses and their preservation after therapy discontinuation.
Results. Menses were observed to appear in 76.2% of the patients during the therapy; these preserved in 23.8% after its discontinuation. The predictors of response to therapy as recovery of the intrinsic rhythm of menstruation included LH levels > 2.71 IU/l, estradiol > 106.5 nmol/l, LH/FSH > 0.88, and BMI > 20.6 kg/m2.
Conclusion. Down-step CС therapy may contribute to sensitization of the hypothalamic-pituitary-ovarian axis, to the appearance of menstruations in 76.2% of the patients, and to their subsequent preservation in every three of them.
Keywords
functional hypothalamic amenorrhea
clomiphene citrate
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Received 19.06.2018
Accepted 22.06.2018
About the Authors
Chernukha, Galina E., MD, professor, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79859996000. E-mail: c-galina1@yandex.ru ORCID ID 0000-0002-9065-5689Gusev, Dmitry V., postgraduate student, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +7 9856833884. E-mail: doctor.dgusev@gmail.com ORCID ID 0000-0001-7661-3389
Tabeeva, Guzyal I., PhD, senior researcher, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79031997282. E-mail: doctor.gtab@gmail.com ORCID ID 0000-0002-3833-532X
Marchenko, Larisa A., MD, professor, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79035476058. E-mail l_marchenko@yandex.ru
For citation: Chernukha G.E., Gusev D.V., Tabeeva G.I., Marchenko L.A. New opportunities of clomiphene citrate treatment for functional hypothalamic amenorrhea. Akusherstvo i Ginekologiya/Obstetrics and Gynecology.2019; (3): 84-90. (in Russian)
https://dx.doi.org/10.18565/aig.2019.3.84-90
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