月经都去哪儿了？功能性下丘脑性闭经的评估与管理
Where Have the Periods Gone? The Evaluation and Management of Functional Hypothalamic Amenorrhea.
作者信息
Sophie Gibson Marie Eve, Fleming Nathalie, Zuijdwijk Caroline, Dumont Tania
机构信息
University of Ottawa, Children’s Hospital of Eastern Ontario, Division of Gynecology, Ottawa, Canada
University of Ottawa, Children’s Hospital of Eastern Ontario, Division of Endocrinology and Metabolism, Ottawa, Canada
出版信息
J Clin Res Pediatr Endocrinol. 2020 Feb 6;12(Suppl 1):18-27. doi: 10.4274/jcrpe.galenos.2019.2019.S0178.
Functional hypothalamic amenorrhea (FHA) is a common cause of amenorrhea in adolescent girls. It is often seen in the setting of stress, weight loss, or excessive exercise. FHA is a diagnosis of exclusion. Patients with primary or secondary amenorrhea should be evaluated for other causes of amenorrhea before a diagnosis of FHA can be made. The evaluation typically consists of a thorough history and physical examination as well as endocrinological and radiological investigations. FHA, if prolonged, can have significant impacts on metabolic, bone, cardiovascular, mental, and reproductive health. Management often involves a multidisciplinary approach, with a focus on lifestyle modification. Depending on the severity, pharmacologic therapy may also be considered. The aim of this paper is to present a review on the pathophysiology, clinical findings, diagnosis, and management approaches of FHA in adolescent girls.
功能性下丘脑性闭经（FHA）是青春期女孩闭经的常见原因。它常出现在压力、体重减轻或过度运动的情况下。FHA是一种排除性诊断。在做出FHA诊断之前，原发性或继发性闭经患者应评估闭经的其他原因。评估通常包括全面的病史和体格检查以及内分泌和影像学检查。如果FHA持续时间较长，会对代谢、骨骼、心血管、心理和生殖健康产生重大影响。管理通常采用多学科方法，重点是改变生活方式。根据严重程度，也可考虑药物治疗。本文旨在对青春期女孩FHA的病理生理学、临床表现、诊断和管理方法进行综述。
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