Pharmacological interventions to improve bone density in functional hypothalamic amenorrhea: a systematic review and network meta-analysis of randomized clinical trials
Authors' conclusion
Transdermal HRT and teriparatide improve LS BMD in women with FHA, with transdermal HRT also improving FN BMD.
Study context
- Population
- Women with functional hypothalamic amenorrhea (FHA)
- Participants
- 897 women13 RCTs
- Comparison
- Pharmacological interventions vs control and each other
- Outcome
- BMD at lumbar spine (LS), femoral neck (FN) or total hip (TH), as SMD
Methodological detailsrandom-effects network meta-analysis (NMA), CINeMA certainty assessment
- Random-effects NMA
- CINeMA certainty assessment
Pooled result
As reported in the abstract
SMD (95% CI)
Transdermal HRTvs ControlLS BMD
0.34(0.03–0.64)
Transdermal HRTvs ControlFN BMD
0.57(0.04–1.10)
Teriparatidevs Transdermal HRTLS BMD
1.48(0.38–2.59)
Teriparatidevs COCPLS BMD
1.75(0.66–2.83)
Original publication
Pharmacological interventions to improve bone density in functional hypothalamic amenorrhea: a systematic review and network meta-analysis of randomized clinical trials. J Clin Endocrinol Metab. Published 8 January 2026. doi:10.
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