Functional Hypothalamic Amenorrhea and Preclinical Cardiovascular Disease
Authors' conclusion
These results demonstrate endothelial dysfunction in 1 out of 3 young women with FHA. FHA may be a contributor to preclinical CVD, and it is not explained by hypoestrogenemia alone.
Study context
- Population
- Women with functional hypothalamic amenorrhea (FHA), eumenorrheic controls and recently menopausal women, recruited via obstetrics and gynecology referrals, social media advertising and electronic health record review
- Participants
- 30 / 29 / 30
- Exposure
- Women with FHA vs eumenorrheic controls vs recently menopausal women
- FHAn = 30
- Eumenorrheic controlsn = 29reference
- Recently menopausaln = 30
- Outcome
- Endothelial function: reactive hyperemic index (RHI) by EndoPAT 2000; RHI ≤1.67 indicates endothelial dysfunction
Main finding
As reported in the abstract
RHI
FHA
1.8
± 0.5
Eumenorrheic controls
2.2
± 0.5
Recently menopausal
2.2
± 0.6
P = 0.008
- FHA with reactive hyperemic index (RHI) ≤1.67, consistent with endothelial dysfunction
- 35%
Observational data: associations, not effects.
Further findings
Estradiol — FHA vs Eumenorrheic controls · across the three groups
P < 0.0001
- Insulin · FHA vs Eumenorrheic controls · lower with FHA
- P = 0.0095
- Cortisol · FHA vs Eumenorrheic controls · higher with FHA
- P = 0.0004
Original publication
Functional Hypothalamic Amenorrhea and Preclinical Cardiovascular Disease. J Clin Endocrinol Metab. Published 23 August 2023. doi:10.
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