Introduction: Functional amenorhea can appear due to chemical, emotional of physical chronic stress. It is particular pathology with special issues regagring long therm body sustaiment after the occurence of menses cessation. Material comprise 39 young women, with ages between 17 and 34, (mean age of 24.55±6.09 years), 11 adolescents and 28 adult women, with secondary amenorrhea induced by weight loss, there were addressed to our Endocrine Unit, starting January 2014. Inclusion criteria: spontaneous menarche, regular menses prior to the amenorrhea episode, recent history of weight lost, no hormonal preparation used recently. Exclusion criteria: other central or peripheral causes of secondary amenorheea.
Method: We performed at baseline, and every 2 months in the following 12 months hormonal assays: FSH, LH, estradiol, progesterone, PRL, TSH, Ft4, anti TPO Ab., serum cortisol, midnight salivary cortisol, creatin, GFR, TGP, TGO. Intervention: supplemental therapy with analogues of natural estradiol.
Results: The weight loss responsible for secondary amenorrhea was smaller in adolescents than in adult women: 6.8±1.21 kg vs. 33.5 ±6.1 kg. The mean BMI was lower in adolescents (20.67±2.18 kg/m2sc) than in adult women (24.11±3.9 kg/m2sc). The mean weight loss was 6.5±1.3 kg in adolescents, but 23.4±4.8 kg in adult women. The degree of central suppression was similar: LH 1.15±0.27 mUI/ml, in adolescents, vs. 1.28±0.11 mUI/ml, in adult women P=0.67. Gonadostat disinhibition appeared sooner in weight loos (9.5±2.1 months) compared with a mean of 21.2±4.5 months in stress induced amenorrhea, both in young women and in adolescents.
Conclusion: The vulnerability of gonadostat is higher in adolescents, but the recovery of the function apeeras after a modest weight. Stress induced amenorhea is more resilient to recovery.