Imperial College London
Alternate

ProfessorWaljitDhillo

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Endocrinology & Metabolism
 
 
 
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Contact

 

+44 (0)20 7594 3487w.dhillo Website

 
 
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Assistant

 

Ms Suzanne Wheeler +44 (0)20 7594 3487

 
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Location

 

6N6ECommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Phylactou:2021:10.1111/cen.14402,
author = {Phylactou, M and Clarke, S and Patel, B and Baggaley, C and Jayasena, C and Kelsey, T and Comninos, A and Dhillo, W and Abbara, A},
doi = {10.1111/cen.14402},
journal = {Clinical Endocrinology},
pages = {239--252},
title = {Clinical and biochemical discriminants between functional hypothalamic amenorrhoea (FHA) and polycystic ovary syndrome (PCOS)},
url = {http://dx.doi.org/10.1111/cen.14402},
volume = {95},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundSecondary oligo/amenorrhoea occurs in 3%–5% of women of reproductive age. The two most common causes are polycystic ovary syndrome (PCOS) (2%–13%) and functional hypothalamic amenorrhoea (FHA) (1%–2%). Whilst both conditions have distinct pathophysiology and their diagnosis is supported by guidelines, in practice, differentiating these two common causes of menstrual disturbance is challenging. Moreover, both diagnoses are qualified by the need to first exclude other causes of menstrual disturbance.AimTo review clinical, biochemical and radiological parameters that could aid the clinician in distinguishing PCOS and FHA as a cause of menstrual disturbance.ResultsFHA is uncommon in women with BMI > 24 kg/m2, whereas both PCOS and FHA can occur in women with lower BMIs. AMH levels are markedly elevated in PCOS; however, milder increases may also be observed in FHA. Likewise, polycystic ovarian morphology (PCOM) is more frequently observed in FHA than in healthy women. Features that are differentially altered between PCOS and FHA include LH, androgen, insulin, AMH and SHBG levels, endometrial thickness and cortisol response to CRH. Other promising diagnostic tests with the potential to distinguish these two conditions pending further study include assessment of 5alphareductase activity, leptin, INSL3, kisspeptin and inhibin B levels.ConclusionFurther data directly comparing the discriminatory potential of these markers to differentiate PCOS and FHA in women with secondary amenorrhoea would be of value in defining an objective probability for PCOS or FHA diagnosis.
AU  - Phylactou,M
AU  - Clarke,S
AU  - Patel,B
AU  - Baggaley,C
AU  - Jayasena,C
AU  - Kelsey,T
AU  - Comninos,A
AU  - Dhillo,W
AU  - Abbara,A
DO  - 10.1111/cen.14402
EP  - 252
PY  - 2021///
SN  - 0300-0664
SP  - 239
TI  - Clinical and biochemical discriminants between functional hypothalamic amenorrhoea (FHA) and polycystic ovary syndrome (PCOS)
T2  - Clinical Endocrinology
UR  - http://dx.doi.org/10.1111/cen.14402
UR  - https://onlinelibrary.wiley.com/doi/10.1111/cen.14402
UR  - http://hdl.handle.net/10044/1/86305
VL  - 95
ER  -
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