Absatarova Yu S, Evseeva Yu S, Andreeva E N, Sheremetyeva E V, Grigoryan O R, Mikheev R K
Endocrinology Research Centre.
Endocrinology Research Centre; Russian university of medicine.
Probl Endokrinol (Mosk). 2024 Nov 13;71(1):83-91. doi: 10.14341/probl13529.
Functional hypothalamic amenorrhea (FHA) and polycystic ovary syndrome (PCOS) are pathologies most common in women of reproductive age. Menstrual irregularities (oligo/amenorrhea) are the most common symptom of these diseases. FHA develops against the background of stress or excessive physical exertion, and is characterized by inhibition of neuroendocrine regulation of the hypothalamic-pituitary-ovarian axis with a subsequent decrease in the production of sex steroids. For PCOS, the most important pathogenetic links are insulin resistance and hyperandrogenism. The pathology of neuroendocrine regulation in ovarian hyperandrogenism is accompanied by excessive pulsatile secretion of gonadotropin-releasing hormone (GnRH), promoting increased production of luteinizing hormone (LH). Both FHA and PCOS lead to multiple complications from other organs and systems: cardiovascular pathology, decreased bone mineral density with prolonged amenorrhea and contribute to the development of infertility.
To analyze the works studying the problems of differential diagnosis of FHA and PCOS.
Using PubMed, eLibrary, CyberLeninka.ru, a systematic search was conducted for articles published over the past 6 years that met the following criteria: the research that describe methods and develop criteria for the differential diagnosis of FHA and PCOS. Selected impactive publications within 1998-2018 were also included in the review.
This review highlights the differential diagnostic criteria for FHA and PCOS. The features of clinical, laboratory and instrumental studies are also described. Publications describing the coexistence of these pathologies in women are analyzed, and methods that allow differentiating these nosologies are described in detail.
A correct and timely diagnosis facilitates the prescription of appropriate treatment regimens, reduces the incidence of complications and improves the quality of life of women. In light of recent advances in the description of the mechanisms of neuroendocrine regulation of the reproductive system, it is necessary to further conduct research to study the role of neuropeptides in the development of FHA and PCOS, which may serve to create more accurate diagnostic markers of diseases.
功能性下丘脑性闭经（FHA）和多囊卵巢综合征（PCOS）是育龄女性中最常见的病症。月经不规律（月经过少/闭经）是这些疾病最常见的症状。FHA 在压力或过度体力消耗的背景下发生，其特征是下丘脑 - 垂体 - 卵巢轴的神经内分泌调节受到抑制，随后性类固醇生成减少。对于 PCOS，最重要的发病机制联系是胰岛素抵抗和高雄激素血症。卵巢高雄激素血症中神经内分泌调节的病理变化伴有促性腺激素释放激素（GnRH）的过度脉冲式分泌，从而促进黄体生成素（LH）生成增加。FHA 和 PCOS 都会导致其他器官和系统出现多种并发症：心血管疾病、长期闭经导致骨矿物质密度降低，并导致不孕。
分析研究 FHA 和 PCOS 鉴别诊断问题的著作。
使用 PubMed、eLibrary、CyberLeninka.ru，对过去 6 年发表的符合以下标准的文章进行系统检索：描述 FHA 和 PCOS 鉴别诊断方法并制定标准的研究。1998 - 2018 年期间选定的有影响力的出版物也纳入了综述。
本综述重点介绍了 FHA 和 PCOS 的鉴别诊断标准。还描述了临床、实验室和仪器研究的特点。分析了描述这些病症在女性中共存的出版物，并详细描述了区分这些疾病分类的方法。
正确及时的诊断有助于开出适当的治疗方案，降低并发症的发生率，提高女性的生活质量。鉴于生殖系统神经内分泌调节机制描述方面的最新进展，有必要进一步开展研究，以研究神经肽在 FHA 和 PCOS 发病中的作用，这可能有助于创建更准确的疾病诊断标志物。
