Features of polycystic ovary syndrome (PCOS) in women with functional hypothalamic amenorrhea (FHA) may be reversible with recovery of menstrual function

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Chinese abstract

目的：由于多囊卵巢综合征（PCOS）的特征已被发现在患有功能性下丘脑闭经（FHA）的妇女中普遍存在, 因此我们希望确定FHA者在恢复月经功能后这些特征会发生什么变化。

设计：前瞻性队列研究。研究了28名FHA妇女和30名年龄匹配者的排卵对照。

方法：对28名FHA妇女和30名年龄匹配者的排卵对照进行了研究。我们检测血清雌二醇、LH、FSH、睾酮、DHEAS、抗缪勒氏激素（AMH）、体重指数, 并经阴道超声检查卵巢形态。

结果：在基线时, 28名妇女中的12名（43%）AMH升高（> 4.7 ng/mL）, 与其他16名AMH正常的妇女相比, 睾酮值升高, 卵巢增大。在月经功能恢复1年后, 12名AMH升高的妇女血清AMH、睾酮值下降, 卵巢体积缩小, 而LH和雌二醇升高。在一年中, 高AMH组的12名妇女中只有一名患有PCOS的临床特征。

结论：在大多数具有PCOS样特征的FHA妇女中, 这些特征可能归因于下丘脑状态并且似乎是可逆的。很少有妇女在康复后可能发展成临床PCOS。

Keywords:

• Functional hypothalamic amenorrhea
• PCOS
• AMH
• ovarian morphology
• estradiol
• testosterone

Disclosure statement

There were no real or perceived conflicts of interest for this work.

Additional information

Funding

There was no external funding for this study.