Uterine size and ovarian size in adolescents with functional hypothalamic amenorrhoea

Abstract

IntroductionFunctional hypothalamic amenorrhoea (FHA) is a condition characterised by the absence of menses due to suppression of the hypothalamic-pituitary-ovarian axis.ObjectiveThe purpose of the study was to estimate uterine and ovarian sizes in adolescents with FHA and to compare these results with findings in peers having regular menstrual cycles.DesignProspective case-controlled study.SettingsVilnius University Hospital Santariskiu Klinikos, Lithuania.PatientsLithuanian adolescents—45 with FHA and 40 comparison group participants.Main outcome measuresWe assessed ultrasound measurements of internal reproductive organs, levels of luteinising hormone, follicle-stimulating hormone, prolactin, oestradiol and calculated body mass index (BMI).ResultsThe mean age of the participants was 16.3±1.2 years, the mean age after menarche—3.6 years. In adolescents with FHA the BMI was 17.8±1.8 kg/m2 and 20.4±1.4 kg/m2 in the comparison group, p<0.001. The uterine volume (14.7±6.3 cm3 vs 31.7±10.6 cm3, p<0.001), cervical length (2.3±0.4 cm vs 2.6±0.5 cm, p=0.03), volume of both ovaries (9.3±3.6 cm3 vs 13.8±4.3 cm3, p<0.001) and levels of LH (2.70±2.59 vs 6.01±2.44, p<0.001) were significantly lower in girls with FHA. A significantly positive correlation between volume of uterus and levels of LH (r=0.415; p<0.001) was found. We identified a positive correlation between uterine volume, uterine corpus length, cervical length, ovarian volume and weight, BMI.ConclusionsIn adolescents with FHA the dimensions of uterus and ovaries were smaller than in girls having regular menstrual cycles. Our study confirmed the influence of oestrogen on uterus size: oestrogen deficiency causes a reduction in uterine size. Uterine size and ovarian size correlate positively with BMI.