Osteopenia in women with hypothalamic amenorrhea: a prospective study

Article Abstract:

Hypothalamic amenorrhea, loss of menses caused by decreased thalamic functioning, is frequently seen in young women. It may be brought on by physical or psychological stress and is usually a transient condition. The type of estrogen deficiency associated with hypothalamic amenorrhea is thought to be similar to that associated with anorexia nervosa and other disorders. Osteopenia, loss of bone density, often occurs in women with anorexia. This study examined if women suffering from hypothalamic amenorrhea were also at risk for osteopenia. Bone densities, hormone levels, body fat percentages, and other physiological parameters were measured in 24 women suffering from hypothalamic amenorrhea (HA) and in 31 healthy women. Body fat levels were significantly lower in the HA subjects, while urine free cortisol levels were significantly higher in these women. Twenty of the women with amenorrhea had secondary amenorrhea; weight loss was the cause in 8 women and stress was the cause in 12. The weight loss subjects had significantly lower weights and body fat percentages than did the stress subjects. Trabecular bone density was significantly lower in the HA subjects than in normal subjects, and it was significantly lower in subjects with primary HA than in subjects with secondary HA. Bone density was correlated with the duration of amenorrhea; lower densities were associated with longer durations of amenorrhea. At follow-up examinations, trabecular bone density and spinal bone density decreased significantly in HA women who had fewer than five years of amenorrhea. Decreased bone density was also associated with decreased levels of testosterone. The results indicate that prolonged amenorrhea and osteopenia can occur in women with hypothalamic amenorrhea. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Risk factors, Physiological aspects, Hypothalamus, Amenorrhea

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Osteopenia in men with a history of delayed puberty

Article Abstract:

Boys who experience delayed puberty may have lower bone density and a higher risk for bone fractures later in life. A study of 44 men in their mid-twenties found that the average radial (forearm) bone density of 23 men who had experienced delayed puberty was lower than that of 21 normal men. Men whose puberty had been delayed had a lower average spinal bone density than normal men, and did not have the proportional relationship between radial bone density and spinal bone density found in normal men. In other studies, the incidence of bone fractures in men with similar decreases in bone density was found to be 50 to 100% higher. Approximately 3% of all boys experience delayed puberty, and they may have an increased risk of bone fractures in adulthood. Treating these boys with male hormones may decrease their risk of bone fractures in adulthood, and may prevent the psychological and social consequences of delayed puberty.

Bones, Bone density, Puberty

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Prevention of Estrogen Deficiency-Related Bone Loss With Human Parathyroid Hormone-(1 -34)

Article Abstract:

Long-term use of parathyroid hormone (PTH) may prevent bone loss and even increase bone mass in women who take the drug nafarelin. Nafarelin is used to treat endometriosis, but it suppresses estrogen production. Researchers randomly assigned 43 women with endometriosis to take nafarelin alone or nafarelin plus PTH. After 12 months, the women taking nafarelin alone experienced a loss of bone density in the spine, hip and total body. Women who took nafarelin and PTH had no bone loss in the hip and total body and slightly increased bone mass in the spine.

Prevention, Parathyroid hormone, Parathyroid hormones, Nafarelin

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