Characteristics of patinets with different outcomes of functional hypothalamic amenorrhea: long-term catamnestic follow-up data
Rakhmonova F.S., Ermakova D.M., Dolgushina N.V.
Functional hypothalamic amenorrhea (FHA) is a reversible disorder that causes menstrual irregularity due to energy deficiency as a result of excessive exercise, dietary restrictions, and stress. Despite extensive study of the pathogenesis of FHA, the data on the predictors and timing of restoration of menstrual cycle regularity remain limited. This necessitates an in-depth analysis of clinical and anamnestic characteristics of patients.
Objective: Based on analysis of long-lasting FHA to define particular characteristics of patients, who experienced or not experienced menstrual restoration.
Materials and methods: Analysis included the data of 431 patients with FHA aged 18–35 years, who underwent treatment at V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology from 2015 to 2025. The telephone survey was conducted at the end of 2025 and yielded responses from 123 women. Their data on the cause of the disease and treatment methods were stored in the data matrix. The final statistical sample included 94 patients with a follow-up period of more than one year.
Results: Long-term follow-up showed, that menstrual cycle was restored in most patients with FHA. However, 20% of women still experienced amenorrhea. Poor prognosis was associated with higher age and body mass index (BMI) at the onset of the disorder, as well as profound hypothalamic-pituitary-ovarian axis suppression according to the laboratory test results. Menstrual restoration happened most often in women with reduced BMI as the leading factor in the development of FHA, and with increased energy availability and reduced stress during treatment.
Conclusion: FHA is characterized by clinical heterogeneity. At the same time, restoration of spontaneous menstrual cycle is largely determined by correction of modifiable risk factors. Personalized approach to patient management is necessary taking into account a combination of anthropometric, clinical, anamnestic, and laboratory parameters.
Authors' contributions: Rakhmonova F.S. – analysis of literature data and primary medical documentation, preparation and performance of telephone survey; writing the manuscript; Ermakova D.M. – the study concept, analysis and data systematization of the primary medical documentation and patient feedback, manuscript editing; Dolgushina N.V. - the study concept and design, scientific consulting, analysis and data systematization of the primary medical documentation and patient feedback, critical review of the manuscript, approval of the final version of the manuscript.
Conflicts of interest: The authors confirm that they have no conflict of interest to declare.
Funding: The study was conducted within the framework of dissertation of Rakhmonova F.S. for the degree of candidate of medical sciences “Prediction of the severity of functional hypothalamic amenorrhea and the effectiveness of therapy based on analysis of serum autoantibodies of different specificities, tissue-specific and free mRNA"
Patient Consent for Publication: Before starting telephone survey, oral consent was obtained from patients to process their data for research purposes and publication on the condition of anonymity.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Rakhmonova F.S., Ermakova D.M., Dolgushina N.V. Characteristics of patinets with
different outcomes of functional hypothalamic amenorrhea: long-term catamnestic follow-up data.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (4): 114-120 (in Russian)
https://dx.doi.org/10.18565/aig.2026.100
Keywords
functional hypothalamic amenorrhea
stress
energy deficiency
excessive exercise
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Received 25.03.2026
Accepted 03.04.2026
About the Authors
Farzona S. Rakhmonova, PhD student, obstetrician-gynecologist, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparina str., 4, f_rakhmonova@oparina4.ru, https://orcid.org/0009-0000-6615-9426Daria M. Ermakova, PhD, Senior Researcher, obstetrician-gynecologist, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparina str., 4, d_ermakova@oparina4.ru, https://orcid.org/0000-0002-8558-4687
Nataliya V. Dolgushina, Dr. Med. Sci., Professor, Deputy Director for Research, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparina str., 4, n_dolgushina@oparina4.ru, https://orcid.org/0000-0003-1116-138X
Corresponding author: Farzona S. Rakhmonova, f_rakhmonova@oparina4.ru
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