Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline

Autor: Sarah L. Berga, M. Hassan Murad, Jay R. Kaplan, Nanette Santoro, Madhusmita Misra, Michelle P. Warren, Catherine M. Gordon, George Mastorakos, Kathryn E. Ackerman
Rok vydání: 2017
Předmět:
Zdroj: The Journal of Clinical Endocrinology & Metabolism. 102:1413-1439
ISSN: 1945-7197
0021-972X
DOI: 10.1210/jc.2017-00131
Popis: Cosponsoring associations The American Society for Reproductive Medicine, the European Society of Endocrinology, and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. Objective To formulate clinical practice guidelines for the diagnosis and treatment of functional hypothalamic amenorrhea (FHA). Participants The participants include an Endocrine Society-appointed task force of eight experts, a methodologist, and a medical writer. Evidence This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The task force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies. Consensus process One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and cosponsoring organizations reviewed and commented on preliminary drafts of this guideline. Conclusions FHA is a form of chronic anovulation, not due to identifiable organic causes, but often associated with stress, weight loss, excessive exercise, or a combination thereof. Investigations should include assessment of systemic and endocrinologic etiologies, as FHA is a diagnosis of exclusion. A multidisciplinary treatment approach is necessary, including medical, dietary, and mental health support. Medical complications include, among others, bone loss and infertility, and appropriate therapies are under debate and investigation.
Databáze: OpenAIRE