A study on hypothalamic amenorrhea (Doctoral thesis)

Κουτουλάκης, Ιωάννης


Hypothalamic amenorrhea, is characterized by the absence of menstrual cycles for three months, low estrogen levels and low/normal levels of gonadotrophins. Functional Hypothalamic Amenorrhea is a commonest cause of primary and secondary amenorrhea, it accounts for over thirty percent of cases of amenorrhea in women of reproductive age and may lead infertility and bone loss. Functional Hypothalamic Amenorrhea occurs when a relative energy deficit (owing eating disorders, excessive exercise) disrupt the secretion of hypothalamic Gonadotrophins Releasing Hormone (GnRH). There are three main types of FHA, all of which are commonly interrelated: stress related amenorrhea, weight loss related amenorrhea and excessive exercise related amenorrhea.The association between low levels of estrogens (disease such as Premature Ovarian Failure) and cardiovascular disease has been suggested in several studies, but hasn’t been investigated in cases of FHA. Cardiovascular disease, including coronary artery disease, stroke and peripheral vascular disease is the leading cause of death among women. Vascular endothelial dysfunction is an early marker of arteriosclerosis. Women with FHA present an increased risk for cardiovascular disease, which might be attributed to the early onset of vascular endothelial dysfunction associated with sex steroid deficiency. This thesis will constitute a prospective study of patient with FHA who admitted at the Unit of Gynaecological Endocrinology, at the University Hospital of Ioannina, under the main purpose to evaluation of endothelium function by assessment of the Flow Mediated Dilation of brancial artery and correlate to controls group. The secondary objective of this study is to determinate the levels of hormones and lipid acids in women with hypothalamic amenorrhea and controls group. Also, in this study, the efficacy (through the menstrual period recovery and gonadotrophines levels improvement) of the treatment (including hormone replacement treatment along with weight gain, either reduction in physical exercise or psychotherapy), was observed.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Subject classification: Αμηνόρροια
Keywords: Υποθαλαμική αμηνόρροια,Αμηνόρροια,Ανορεξία,Καρδιαγγειακός κίνδυνος,Hypothalamic amenorrhea,Amenorrhea,Anorexia,Risk for cardiovascular disease
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/28131
Appears in Collections:Διδακτορικές Διατριβές

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