Functional hypothalamic and drug-induced amenorrhea: an overview
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Functional hypothalamic amenorrhea (FHA) is a form of chronic anovulation not due to identifiable organic causes and with adverse health consequences. The identification of women with this disorder or the precocious identification of women at risk is based on the knowledge of lifestyle risk factors or behaviors such as stress, weight loss, and excessive physical exercise that are known to negatively impact gonadal axis activity.
In this overview, we described the most common forms of FHA, in particular stress-induced amenorrhea and overtraining-induced amenorrhea. In addition, although its mechanisms can differ from those involved in FHA, we reviewed the available literature on drug-induced amenorrhea, highlighting the clear connection between this condition and psychoactive drugs such as antipsychotics, antidepressants and anti-epilectics thus raising concern about the role that the abuse of substances such as opioids or alcohol can possibly have on the growing unexplained infertility of the female population.
KeywordsFunctional amenorrhea Hypothalamic amenorrhea Drug-induced amenorrhea Hypoestrogenism Opiates Alcohol
The authors acknowledge Mrs. Racca Anna (email@example.com) for her contribution to this paper.
None of the authors received funding for the realization of this paper.
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Conflict of interest
The authors declare that they have no conflict of interest.
This is a review paper, therefore, no ethical approval was necessary.
This is a review paper, therefore, no informed consent was necessary.
- 2.Sowińska-Przepiera E, Andrysiak-Mamos E, Jarząbek-Bielecka G et al (2014) Functional hypothalamic amenorrhoea—diagnostic challenges, monitoring, and treatment. Endokrynol Polska 66(5):252–260Google Scholar
- 4.Genazzani AD, Chierchia E, Santagni S et al (2010) Hypothalamic amenorrhea: from diagnosis to therapeutical approach. Ann Endocrinol 71:163–169Google Scholar
- 14.Wahab F, Atika B, Ullah F et al (2018) Metabolic impact on the hypothalamic kisspeptin-kiss1r signaling pathway. Front Endocrinol 9:123Google Scholar
- 27.Ruegsegger GN, Booth FW (2017) Running from disease: molecular mechanisms associating dopamine and leptin signaling in the brain with physical inactivity, obesity, and type 2 diabetes. Front Endocrinol 8(109):1–8Google Scholar
- 42.Montejo ÁL, Arango C, Bernardo M, Carrasco JL, Crespo-Facorro B, Cruz JJ, Del Pino-Montes J, García-Escudero MA, García-Rizo C, González-Pinto A, Hernández AI, Martín-Carrasco M, Mayoral-Cleries F, Mayoral-van Son J, Mories MT, Pachiarotti I, Pérez J, Ros S, Vieta E (2017) Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics. Front Neuroendocrinol 45:25–34PubMedGoogle Scholar
- 49.International Narcotics Control Board (INCB). Narcotic drugs technical report: Estimates world requirements for 2018—statistics for 2016. https://www.incb.org/documents/Narcotic-Drugs/Technical-Publications/2017/Narcotic_drugs_technical_publication_2017.pdf. Accessed 29 August 2018
- 50.Berterame S, Erthal J, Thomas J, Fellner S, Vosse B, Clare P, Hao W, Johnson DT, Mohar A, Pavadia J, Samak AK, Sipp W, Sumyai V, Suryawati S, Toufiq J, Yans R, Mattick RP (2016) Use of and barriers to access to opioid analgesics: a worldwide, regional, and national study. Lancet 387(10028):1644–1656PubMedGoogle Scholar
- 52.European Drug Report 2017: trends and developments; EMCDDA, Lisbon, June 2017. http://www.emcdda.europa.eu/publications/edr/trends-developments/2017. Accessed 29 August 2018
- 61.GBD Alcohol Collaborators (2018) Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 10152:1015–1035Google Scholar
- 62.Rachdaoui N, Sarkar DK (2013) Effects of alcohol on the endocrine system. Endocrinol Metab Clin N Am 42(3):593–615Google Scholar
- 68.Block GD, Yamamoto ME, Mallick A, Styche A (1993) Effects on pubertal hormones by ethanol abuse in adolescents. Alcohol Clin Exp Res 17:505Google Scholar