Carmina Enrico, Fruzzetti Franca, Lobo Roger A
a Endocrinology Unit, Department of Health Sciences and Mother and Child Care , University of Palermo , Palermo , Italy.
b Department of Ob/GYN , University of Pisa , Pisa , Italy.
Gynecol Endocrinol. 2018 Apr;34(4):301-304. doi: 10.1080/09513590.2017.1395842. Epub 2017 Oct 27.
Since features of polycystic ovary syndrome (PCOS) have been found to be prevalent in women with functional hypothalamic amenorrhea (FHA), we wished to determine what happens to these features after recovery of menstrual function in FHA Design: Prospective cohort study. Twenty-eight women with FHA and 30 age-matched ovulatory controls were studied.
Twenty-eight women with FHA and 30 age-matched ovulatory controls were studied. We measured serum estradiol, LH, FSH, testosterone, DHEAS, anti-Mullerian hormone (AMH), body mass index, and ovarian morphology on transvaginal ultrasound.
At baseline, 12 of the 28 women (43%) had increased AMH (>4.7 ng/mL), and higher testosterone and larger ovaries compared to the other 16 women with normal AMH. One year after recovery of menstrual function, in the 12 women with increased AMH, serum AMH, testosterone and ovarian size decreased, while LH and estradiol increased. At one year, only one of the 12 women in the high AMH group developed clinical features of PCOS.
In the majority of women with FHA who have PCOS-like features, these features may be due to the hypothalamic state and appear to be reversible. Few women may develop clinical PCOS after recovery.
由于已发现多囊卵巢综合征（PCOS）的特征在功能性下丘脑性闭经（FHA）女性中普遍存在，我们希望确定FHA患者月经功能恢复后这些特征会发生什么变化。设计：前瞻性队列研究。对28名患有FHA的女性和30名年龄匹配的排卵对照者进行了研究。
对28名患有FHA的女性和30名年龄匹配的排卵对照者进行了研究。我们通过经阴道超声测量了血清雌二醇、促黄体生成素（LH）、促卵泡生成素（FSH）、睾酮、硫酸脱氢表雄酮（DHEAS）、抗苗勒管激素（AMH）、体重指数和卵巢形态。
在基线时，28名女性中有12名（43%）的AMH升高（>4.7 ng/mL），与其他16名AMH正常的女性相比，其睾酮水平更高，卵巢更大。月经功能恢复一年后，在12名AMH升高的女性中，血清AMH、睾酮和卵巢大小下降，而LH和雌二醇升高。一年时，高AMH组的12名女性中只有1名出现了PCOS的临床特征。
在大多数具有PCOS样特征的FHA女性中，这些特征可能归因于下丘脑状态，并且似乎是可逆的。恢复后很少有女性会发展为临床PCOS。
