Berga S L
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Semin Reprod Endocrinol. 1997 Feb;15(1):47-53. doi: 10.1055/s-2008-1067967.
Behaviors that activate the hypothalamic-pituitary-adrenal (HPA) axis or suppress the hypothalamic-pituitary-thyroidal (HPT) axis can disrupt the hypothalamic-pituitary-gonadal (HPG) axis in women and men. Individuals with functional hypothalamic hypogonadism typically display a combination of behaviors that serve as psychogenic stressors and metabolic challenges. Complete recovery of gonadal function depends upon restoration of the HPA and HPT axes. Hormone replacement strategies have limited benefit, because they do not achieve this objective and they mask deficits that accrue from altered HPA and HPT function. Although fertility can be restored with exogenous administration of gonadotropins or pulsatile gonadoropin-releasing hormone (GnRH), fertility management alone will not permit the HPA and HPT axes to recover. Thus, for complete recovery to ensue, biopsychosocial interventions that address the individual's unique set of psychogenic factors and metabolic challenges must be devised.
激活下丘脑 - 垂体 - 肾上腺（HPA）轴或抑制下丘脑 - 垂体 - 甲状腺（HPT）轴的行为，可扰乱女性和男性的下丘脑 - 垂体 - 性腺（HPG）轴。功能性下丘脑性腺功能减退的个体通常表现出一系列作为心理性应激源和代谢挑战的行为。性腺功能的完全恢复取决于HPA和HPT轴的恢复。激素替代策略的益处有限，因为它们无法实现这一目标，而且会掩盖因HPA和HPT功能改变而产生的缺陷。虽然通过外源性给予促性腺激素或脉冲式促性腺激素释放激素（GnRH）可恢复生育能力，但仅进行生育管理并不能使HPA和HPT轴恢复。因此，为实现完全恢复，必须设计出针对个体独特的心理性因素和代谢挑战的生物心理社会干预措施。
