Uterine size and ovarian size in adolescents with functional hypothalamic amenorrhoea

Abstract

Introduction: Functional hypothalamic amenorrhoea (FHA) is a condition characterised by the absence of menses due to suppression of the hypothalamic-pituitary-ovarian axis.

Objective: The 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.

Design: Prospective case-controlled study.

Settings: Vilnius University Hospital Santariskiu Klinikos, Lithuania.

Patients: Lithuanian adolescents--45 with FHA and 40 comparison group participants.

Main outcome measures: We assessed ultrasound measurements of internal reproductive organs, levels of luteinising hormone, follicle-stimulating hormone, prolactin, oestradiol and calculated body mass index (BMI).

Results: The 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/m(2) and 20.4 ± 1.4 kg/m(2) in the comparison group, p < 0.001. The uterine volume (14.7 ± 6.3 cm(3) vs 31.7 ± 10.6 cm(3), 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 cm(3) vs 13.8 ± 4.3 cm(3), 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.

Conclusions: In 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.

Keywords: Adolescent Health; Imaging.