Current principles of therapy for functional hypothalamic amenorrhea
Objective. To carry out a systems analysis of the information available in modern literature on the principles of therapy for functional hypothalamic amenorrhea (FHA), including innovative treatment options, the use of leptin and kisspeptin in particular.Chernukha G.E., Gusev D.V., Tabeeva G.I., Prilutskaya V.Yu.
Material and methods. The review includes the data of foreign and Russian articles found in Pubmed on this topic.
Results. The paper gives the data available in the literature on drug and non-drug treatment options. It describes the advantages and disadvantages of existing treatment approaches. Taking into account the key role of stress and eating disorders in the pathogenesis of FHA, the review presents the results of studies of cognitive behavioral therapy, the normalization of eating behavior, and the restoration of positive energy balance.
Conclusion. The analysis of the efficiency of FHA therapy modalities shows that to restore regular periods requires that body weight, adipose tissue amount, and leptin level should be normalized, which reflects an energy deficit that occurs in the presence of eating disorders and chronic stress. Management of patients with FHA involves the participation of a gynecologist, a psychotherapist, and a dietitian and the application of approaches aimed at normalizing eating patterns, restoring the mental sphere, and correcting behaviors.
Keywords
amenorrhea
kisspeptin
leptin
hormone therapy
clomiphene citrate
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Received 28.07.2017
Accepted 22.09.2017
About the Authors
Galina E. Chernukha, doctor of medical sciences, professor, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79859996000. E-mail: c-galina1@yandex.ru
Dmitry V. Gusev, graduate student, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79856833884. E-mail: doctor.dgusev@gmail.com
Gyuzyal I. Tabeyeva, Candidate of Medical Science, Senior Researcher, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79031997282. E-mail: doctor.gtab@gmail.com
Viktoriya Y. Prilutskaya, a 6-year student, I.M. Sechenov First Moscow State Medical University.
119991, Russia, Moscow, Trubetskaya, 8, bld. 2. Tel.: +79852419492. E-mail: anturiumvika@mail.ru
For citations: Chernukha G.E., Gusev D.V., Tabeeva G.I., Prilutskaya V.Yu. Current principles of therapy for functional hypothalamic amenorrhea. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (6): 11-7. (in Russian)
https://dx.doi.org/10.18565/aig.2018.6.11-17
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