Gordon Catherine M, Ackerman Kathryn E, Berga Sarah L, Kaplan Jay R, Mastorakos George, Misra Madhusmita, Murad M Hassan, Santoro Nanette F, Warren Michelle P
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229.
Boston Children's Hospital, Boston, Massachusetts 02115.
J Clin Endocrinol Metab. 2017 May 1;102(5):1413-1439. doi: 10.1210/jc.2017-00131.
The American Society for Reproductive Medicine, the European Society of Endocrinology, and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society.
To formulate clinical practice guidelines for the diagnosis and treatment of functional hypothalamic amenorrhea (FHA).
The participants include an Endocrine Society-appointed task force of eight experts, a methodologist, and a medical writer.
This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The task force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies.
One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and cosponsoring organizations reviewed and commented on preliminary drafts of this guideline.
FHA is a form of chronic anovulation, not due to identifiable organic causes, but often associated with stress, weight loss, excessive exercise, or a combination thereof. Investigations should include assessment of systemic and endocrinologic etiologies, as FHA is a diagnosis of exclusion. A multidisciplinary treatment approach is necessary, including medical, dietary, and mental health support. Medical complications include, among others, bone loss and infertility, and appropriate therapies are under debate and investigation.
美国生殖医学学会、欧洲内分泌学会和儿科内分泌学会。本指南由内分泌学会资助。
制定功能性下丘脑性闭经（FHA）诊断和治疗的临床实践指南。
参与者包括内分泌学会任命的一个由八名专家组成的特别工作组、一名方法学家和一名医学撰写人。
本循证指南采用推荐分级、评估、制定与评价方法来描述推荐的强度和证据的质量。特别工作组委托进行了两项系统评价，并使用了其他已发表的系统评价和个别研究中可得的最佳证据。
通过一次小组会议、几次电话会议和电子邮件通信达成共识。内分泌学会委员会及成员以及共同主办组织对本指南的初稿进行了审查并提出了意见。
FHA是一种慢性无排卵形式，并非由可识别的器质性原因引起，但常与压力、体重减轻、过度运动或这些因素的组合有关。检查应包括对全身和内分泌病因的评估，因为FHA是一种排除性诊断。需要采取多学科治疗方法，包括医学、饮食和心理健康支持。医学并发症包括骨质流失和不孕等，适当的治疗方法正在讨论和研究中。
