Pulsatile gonadotropin-releasing hormone therapy in persistent amenorrheic weight-recovered anorexia nervosa patients

Abstract

This study showed increased gonadal status and higher E response to pulsatile GnRH therapy in persistent amenorrheic weight-recovered AN compared with HA from other causes. It suggests that their individual set-point of body weight allowing a fully functional gonadal axis is not reached yet. Specific factors of gonadal inertia in Rec-AN still remain unclear.

Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews

“…To date, no systematic review concerning endocrine medications exists, but we found a few recent, innovative studies on promising hormone treatments conducted among female AN patients: one study concerned recombinant human growth hormone (rhGH) replacement among adult AN women [150], one study concerned rhGH treatment among AN children [151], one study concerned oestrogen replacement among adolescent AN girls [152], one study concerned GnRH among weight-recovered AN [153] and one study concerned recombinant human leptin among underweight women [154]. We report these five studies on these innovative hormone medications in the following sections, and they are summarized in Table S1.…”

“…One retrospective observational monocentric study reported by Germain et al [153], compared response to gonadotropin-releasing hormone therapy (GnRH) with 20 µg/90 min/four weeks induction cycles (repeated if there was no pregnancy) administered by a sub-cutaneous infusion pump to 19 weight-recovered AN patients (Rec-AN) (BMI > 18.5) and to patients with other causes of hypothalamic amenorrhea, including primary hypothalamic amenorrhea patients (PHA) and secondary hypothalamic amenorrhea patients (SHA). The study results reported higher estradiol and LH levels during induction cycles among Rec-AN patients than in the PHA and SHA groups; follicular recruitment and the ovulation rate were higher among Rec AN patients than among PHA patients, but similar to SHA patients; the cumulate pregnancy rate was 74 % for Rec-An (vs 73% for SHA et 14% for PHA).…”

Amenorreia secundária: revisão das etiologias / Secondary amenorrhea: etiologies review

“…Um dispositivo intravenoso/subcutâneo é instalado para fornecer doses pulsáteis de GnRH a cada 90 minutos, semelhante à fisiologia normal, permitindo a maturação fisiológica dos folículos ovarianos (GERMAIN et al, 2017).…”

Resistance to lean mass gain in constitutional thinness in free‐living conditions is not overpassed by overfeeding

“…2 Indeed, this low bodyweight condition [body mass index (BMI) < 17.5 kg/m 2 ] also called constitutional thinness (CT) is a state without any sign of undernutrition as observed through normal nutritional biomarkers and gonadal function and low but not blunted leptin plasma levels. [1][2][3][4][5] CT also present with less psychological dietary restriction behaviours compared with normal-weight women. 2 CT individuals have a steady bodyweight in the lower population-wide percentiles adjusted for age, gender, and ethnicity, 2,3 suggestive of a genetic determination of this underweight state consistent with previous reports on the heritability of thinness.…”

“…A recent cohort publication showed the difference of naturally underweight women from anorexia nervosa . Indeed, this low bodyweight condition [body mass index (BMI) < 17.5 kg/m 2 ] also called constitutional thinness (CT) is a state without any sign of undernutrition as observed through normal nutritional biomarkers and gonadal function and low but not blunted leptin plasma levels . CT also present with less psychological dietary restriction behaviours compared with normal‐weight women .…”