Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline
Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline
复制标题
DOI：
10.1210/jc.2017-00131
复制
发表时间：
2017-05-01
影响因子：
5.8
通讯作者：
Warren, Michelle P.
中科院分区：
文献类型：
--
作者：
Gordon, Catherine M.;Ackerman, Kathryn E.;Warren, Michelle P.
共同赞助协会：美国生殖医学会、欧洲内分泌学会和儿科内分泌学会。本指南由内分泌学会资助。目的：制定功能性下丘脑性闭经（FHA）诊断和治疗的临床实践指南。参与者：参与者包括内分泌学会指定的八名专家，一名方法学家和一名医学作家。证据：该循证指南是使用建议、评估、发展、和评价方法来描述建议的力度和证据的质量。工作组委托进行了两次系统评价，并使用了其他已发表的系统评价和个体研究的最佳证据。共识过程：一次小组会议，几次电话会议和电子邮件通信使共识得以实现。内分泌学会委员会和成员和共同赞助组织审查和评论本guideline.Conclusions的初步草案：FHA是一种形式的慢性无排卵，而不是由于可识别的有机原因，但往往与压力，体重减轻，过度运动，或其组合。检查应包括全身和内分泌病因的评估，因为FHA是一种排除性诊断。多学科治疗方法是必要的，包括医疗，饮食和心理健康支持。医学并发症包括骨质流失和不孕症，适当的治疗方法正在讨论和研究中。
Cosponsoring Associations: The American Society for Reproductive Medicine, the European Society of Endocrinology, and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society.Objective: To formulate clinical practice guidelines for the diagnosis and treatment of functional hypothalamic amenorrhea (FHA).Participants: The participants include an Endocrine Society-appointed task force of eight experts, a methodologist, and a medical writer.Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The task force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies.Consensus Process: One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and cosponsoring organizations reviewed and commented on preliminary drafts of this guideline.Conclusions: FHA is a form of chronic anovulation, not due to identifiable organic causes, but often associated with stress, weight loss, excessive exercise, or a combination thereof. Investigations should include assessment of systemic and endocrinologic etiologies, as FHA is a diagnosis of exclusion. A multidisciplinary treatment approach is necessary, including medical, dietary, and mental health support. Medical complications include, among others, bone loss and infertility, and appropriate therapies are under debate and investigation.