Endocrine Abstracts

Introduction/objective: To evaluate the effects of estroprogestagen therapy (EP) on the mineral bone density (BMD) of girls with functional hypothalamic amenorrhea (FHA).

Design: Prospective observation of 78 FHA girls subjected to 4-year EP therapy (Group A) and 50 controls (Group C).

Methods: Anthropometric measurements (height, body weight) were taken for all participants along with baseline values of hormonal parameters and bone turnover markers: serum concentration of the bone fraction of alkaline phosphatase (BALP) and urine concentration of cross-linked n-telopeptide of type I collagen (Ntx), and BMD measurements. Follow-up measurements of hormonal parameters, BALP and Ntx were performed after 6 months of EP treatment in patients belonging to Group A. BMD measurements were carried out on a yearly basis, starting 12 months after the initiation of EP therapy.

Results: Six-month EP treatment resulted in a marked increase in estradiol levels and a significant decrease in BALP and Ntx. The relative increase in BMD was highest after the second year of treatment. Based on the dynamics of BMD changes during the first year of treatment, we identified a Subgroup A1 with no or insignificant reactions to the treatment. It was characterized by significantly higher baseline BMD and markedly lower baseline Ntx compared to the patients who responded to 1-year therapy well (subgroup A2) or extremely well (subgroup A3). Further follow-up proved, however, that subgroup A1 did not differ significantly from the other patients in terms of the long-term prognosis for BMD normalization.

Conclusions: EP therapy is effective in the treatment of BMD disorders associated with FHA.