The functional hypothalamic amenorrhea (FHA) often represents a diagnostic and therapeutic challenge and affects the most diverse areas of medical clinics. It underlies diseases and disorders of considerable number, variety and complexity and has gynaecological, neurological, endocrinological, psychological and genetic relevance.
At the basis of this form of hypogonadotropic hypogonadism, there is generally a discomfort of a metabolic, physical or emotional nature which determines, in a reactive way, the exclusion of the reproductive sphere, a kind of functional suppression of the genital axis as a neurobiological response.
In spite of the specific correlation between weight loss, demanding sports activities and FHA, these are not the only causes of amenorrhea. Indeed in a high percentage of amenorrhoeic patients, nutritional pathogenesis or an altered energy balance is not recognizable and the cause of the amenorrhea has been identified in stress. Certainly, CRH inhibits gonadotropin secretion and amenorrhoeic patients are often hypercortisolemic, while in some cases a greater dopaminergic inhibition of pulsatile GnRH secretion can be considered. On the other hand, the contribution of psychological stress in the pathogenesis of FHA is a relevant factor in the diagnosis and treatment of these patients.
Studies in women and primates have suggested that susceptibility to the development of amenorrhea in the presence of stress is related to mutations in the genes involved in the development of neurons that produce GnRH or in the secretion/action of GnRH itself. The same genetic variants involved in the development of idiopathic hypogonadotropic hypogonadism.
The aim of this Research Topic is to highlight the interconnections between the different points of view of the same pathology. We encourage interested scientists to submit mini-reviews, methods papers, review articles, perspectives and original research articles covering this topic in order to investigate the role of the diverse mechanisms behind FHA and to develop an adequate and coherent therapeutic strategy.
We would like to invite researchers to contribute articles on the following themes:
• Genetic basis of congenital isolated hypogonadotropic hypogonadism
• Molecular Etiology of Primary Ovarian Insufficiency
• Genetics of delayed puberty
• Genetic contribution to FHA susceptibility
• Impact of micro RNA on increased GnRH expression during the infantile-to-juvenile transition
• Ceramide Signaling Mediates Obesity-Induced Precocious Puberty
• Epigenetics changes in female puberty
• Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations
• FHA the guidelines
• FHA and bone metabolism
• FHA from diagnosis to therapeutical approach
• FHA and diagnostic overlap with PCOS
• Psychological factors and FHA
The functional hypothalamic amenorrhea (FHA) often represents a diagnostic and therapeutic challenge and affects the most diverse areas of medical clinics. It underlies diseases and disorders of considerable number, variety and complexity and has gynaecological, neurological, endocrinological, psychological and genetic relevance.
At the basis of this form of hypogonadotropic hypogonadism, there is generally a discomfort of a metabolic, physical or emotional nature which determines, in a reactive way, the exclusion of the reproductive sphere, a kind of functional suppression of the genital axis as a neurobiological response.
In spite of the specific correlation between weight loss, demanding sports activities and FHA, these are not the only causes of amenorrhea. Indeed in a high percentage of amenorrhoeic patients, nutritional pathogenesis or an altered energy balance is not recognizable and the cause of the amenorrhea has been identified in stress. Certainly, CRH inhibits gonadotropin secretion and amenorrhoeic patients are often hypercortisolemic, while in some cases a greater dopaminergic inhibition of pulsatile GnRH secretion can be considered. On the other hand, the contribution of psychological stress in the pathogenesis of FHA is a relevant factor in the diagnosis and treatment of these patients.
Studies in women and primates have suggested that susceptibility to the development of amenorrhea in the presence of stress is related to mutations in the genes involved in the development of neurons that produce GnRH or in the secretion/action of GnRH itself. The same genetic variants involved in the development of idiopathic hypogonadotropic hypogonadism.
The aim of this Research Topic is to highlight the interconnections between the different points of view of the same pathology. We encourage interested scientists to submit mini-reviews, methods papers, review articles, perspectives and original research articles covering this topic in order to investigate the role of the diverse mechanisms behind FHA and to develop an adequate and coherent therapeutic strategy.
We would like to invite researchers to contribute articles on the following themes:
• Genetic basis of congenital isolated hypogonadotropic hypogonadism
• Molecular Etiology of Primary Ovarian Insufficiency
• Genetics of delayed puberty
• Genetic contribution to FHA susceptibility
• Impact of micro RNA on increased GnRH expression during the infantile-to-juvenile transition
• Ceramide Signaling Mediates Obesity-Induced Precocious Puberty
• Epigenetics changes in female puberty
• Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations
• FHA the guidelines
• FHA and bone metabolism
• FHA from diagnosis to therapeutical approach
• FHA and diagnostic overlap with PCOS
• Psychological factors and FHA