Highlights
- •Women with HA that responded to leptin treatment, i.e. ovulated and restored menstruation, show a distinct hormonal profile compared to non-responders.
- •This hormonal profile is characterized by higher LH/FSH ratio and higher circulating levels/peak values of Inhibin A and E2 compared to non-responders.
- •AMH may serve as a marker of ovarian recovery under HA treatment.
Abstract
Background
Chronic energy deficiency observed in women that exercise strenuously affects reproductive
function, often leading to hypothalamic amenorrhea (HA). In such conditions, hypoleptinemia
and robust changes in the Activin-Follistatin-Inhibin Axis (AFI) are observed. Treatment
with leptin restores menstruation in many (60% responders) but not all (40% non-responders)
women, suggesting that leptin is not the only regulator of reproductive function related
to energy balance. In this work, we aimed to identify differences in hormonal profiles
between leptin responders and non-responders among women with HA, with particular
focus on the AFI axis.
Methods
AFI axis and reproductive hormones (LH, FSH, Estradiol, ΑΜΗ) were measured in blood
in: a) An open-label interventional study, b) a randomized placebo-controlled trial,
both investigating responders versus non-responders/women with HA treated with leptin.
Results
Women with HA that responded to leptin treatment have higher circulating levels/peak
values of Inhibin A, Estradiol (E2), higher LH/FSH ratio and a trend to lower AMH
compared with non-responders.
Conclusions
Components of the AFI axis are associated with improvement of reproductive function
in women with HA treated with leptin. ΑΜΗ may serve as a marker of ovarian recovery
under HA treatment.
Keywords
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- (Available from:)
Article info
Publication history
Published online: October 09, 2020
Accepted:
October 7,
2020
Received:
September 8,
2020
Footnotes
☆Clinical Trial Information: ClinicalTrials.gov no., NCT00130117.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
