PDF(Pubmed)
Abstract：
One of the most important and potentially long-lasting detrimental consequences of Functional Hypothalamic Amenorrhoea (FHA) is on skeletal homeostasis. Beyond oestrogen deficiency, FHA is associated with a cascade of additional neuro-endocrine and metabolic alterations, some adaptive, but which combine to disrupt skeletal homeostasis. Ultimately, this leads to a two-fold increased risk of fractures in women with FHA compared to healthy eumenorrhoeic women. Although the cornerstone of management of FHA-related bone loss remains recovery of menses via restoration of metabolic/psychological balance, there is rapidly developing evidence for hormonal manipulations (with a particular emphasis on route of administration) and other pharmacological treatments that can protect or improve skeletal homeostasis in FHA. In this mini-review, we provide an update on the pathophysiology, clinical management and future avenues in the field from a bone perspective.
摘要：
功能性下丘脑闭经(FHA)的最重要且潜在持久的有害后果之一是对骨骼稳态的影响。除了雌激素缺乏,FHA与一系列额外的神经内分泌和代谢改变有关，一些适应性，但是结合起来破坏骨骼稳态。最终,这导致FHA患者的骨折风险比健康的闭经女性增加2倍.尽管FHA相关骨丢失的管理的基石仍然是通过恢复代谢/心理平衡来恢复月经，有迅速发展的证据表明，激素操作（特别强调给药途径）和其他药物治疗可以保护或改善FHA的骨骼稳态。在这个小型审查中，我们提供了病理生理学的最新信息，从骨的角度来看，临床管理和该领域的未来途径。
