Impact of Estrogen Replacement on Endothelial Dysfunction and Psychological Health in Women With Hypothalamic Amenorrhea
Authors' conclusion
In women with FHA, 12 weeks of transdermal E2 increased serum E2 levels but did not improve vascular or psychological health measures. Further studies with larger sample sizes and longer follow-up are needed to explore the long-term effects of E2 therapy on cardiovascular and mental health outcomes in this population.
Study context
- Population
- Women with functional hypothalamic amenorrhea (amenorrhea ≥3 consecutive months, E2 < 50 pg/mL, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) <10 mIU/L, LH:FSH <1, other etiologies excluded); mean age 26.2 ± 6.3 years, BMI 21.5 ± 3.3 kg/m², 63% non-Hispanic White
- Participants
- 29 women
- Comparison
- Transdermal E2 0.1 mg/day vs placebo patch for 12 weeks
- E2n = 14
- Placebon = 15reference
Methodological detailsdouble-blind, placebo-controlled
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Vascular, hormonal and psychological outcomes (endothelial dysfunction: reactive hyperemic index ≤ 1.67) · week 12
- No significant differences in vascular, hormonal, or psychological outcomes between E2 and placebo at week 12
Further findings
Serum E2 levels · 12 weeks
P = 0.0002
µg/dL
| Outcome | E2 | Placebo | P value |
|---|---|---|---|
| Change in cortisol levels · 12 weeksNear-significant decrease with E2 vs increase with placebo | −.4 | 3.1 | P = 0.05 |
Original publication
Impact of Estrogen Replacement on Endothelial Dysfunction and Psychological Health in Women With Hypothalamic Amenorrhea. J Clin Endocrinol Metab. Published 18 June 2025. doi:10.
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