Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
Faculty of Medicine Henri Warembourg, University of Lille, Lille Cedex, France.
Reprod Biol Endocrinol. 2023 May 11;21(1):42. doi: 10.1186/s12958-023-01095-5.
Women with functional hypothalamic amenorrhea (FHA) reveal polycystic ovarian morphology (PCOM) in up to 50%. If stress sensitivity in women with polycystic ovary syndrome (PCOS) is the reason why PCOS women are prone to develop FHA, patients with FHA caused by stress should reveal PCOM more often.
In a retrospective cohort study, 38 stress-associated and 38 excessive exercise-induced FHA women were included. The main outcome parameter was PCOM. In addition, the focus was on general patient characteristics as well as on prolactin, dehydroepiandrosterone-sulphate (DHEAS), and anti-Mullerian hormone (AMH).
PCOM was found in 34/76 patients (44.7%). The stress group showed a higher prevalence of PCOM than the excessive exercise group (57.9% versus 31.6%, p = 0.019) as well as higher prolactin levels (median 13.2ng/mL versus 11.7ng/mL, p = 0.008) and a trend towards higher DHEAS levels (p = 0.058).
In FHA women, the PCOM prevalence was significantly higher in the stress-group than in the excessive exercise-group. The well-known stress sensitivity in women with PCOS might explain why PCOS women are prone to develop FHA as well as the high PCOM prevalence in FHA women.
多达 50%的功能性下丘脑性闭经（FHA）女性存在多囊卵巢形态（PCOM）。如果多囊卵巢综合征（PCOS）女性的应激敏感性是导致其易发生 FHA 的原因，那么由应激引起的 FHA 患者应该更频繁地出现 PCOM。
在一项回顾性队列研究中，纳入了 38 例应激相关和 38 例过度运动诱导的 FHA 女性。主要观察指标为 PCOM。此外，还关注了一般患者特征以及催乳素、脱氢表雄酮硫酸酯（DHEAS）和抗苗勒管激素（AMH）。
在 76 例患者中，有 34 例（44.7%）发现 PCOM。应激组的 PCOM 患病率高于过度运动组（57.9%比 31.6%，p=0.019），催乳素水平更高（中位数 13.2ng/mL 比 11.7ng/mL，p=0.008），DHEAS 水平也有升高的趋势（p=0.058）。
在 FHA 女性中，应激组的 PCOM 患病率明显高于过度运动组。PCOS 女性中众所周知的应激敏感性可能解释了为什么 PCOS 女性容易发生 FHA，以及 FHA 女性中 PCOM 高患病率的原因。
