Functional hypothalamic amenorrhea in clinical practice: medical and diagnostic features


Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

The paper presents the current data on the epidemiology, causes, and pathogenesis of functional hypothalamic amenorrhea (FHA). The authors highlight the current therapeutic approaches aimed at eliminating the cause of the disease and at preventing long-term consequences associated with hypoestrogenism in the presence of hypogonadotropic hypogonadism in FHA. The paper describes a clinical case that is used by the authors to analyze the most common diagnostic and therapeutic errors in the management of patients with FHA. The patients with this disease may be effectively treated provided that there is interdisciplinary involvement by professions in mental health and in dietology to normalize eating behavior and to ensure a positive energy balance. According to international and Russian clinical practice guidelines, to restore and maintain bone mineral density, patients with FHA require hormone replacement therapy with transdermal estrogens (for example, as a patch, 0.1% estradiol gel (Divigel), and others) in combination with progestins to protect the endometrium. Conclusion: Implementation of consistent diagnostic measures, adherence to the clear algorithms that can timely verify FHA, and correctly selected hormone replacement therapy with transdermal estrogens will be able to level off the symptoms of the disease and to prevent long-term complications as osteoporosis and cardiovascular diseases

Толық мәтін

Рұқсат жабық

Авторлар туралы

Karina Bondarenko

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: karinabond@mail.ru
Dr. Med. Sci., Associate Professor at the Department of Obstetrics and Gynecology of the Faculty of Medicine

Valeria Kazantseva

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: shapee08@mail.ru
PhD student of the Department of Obstetrics and Gynecology of the Faculty of Medicine

Yulia Dobrokhotova

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: pr.dobrohotova@mail.ru
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology of the Faculty of Medicine

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