Functional hypothalamic amenorrhea (FHA), a common cause of secondary amenorrhea driven by stress, weight loss, or excessive exercise, is associated with estrogen deficiency and a high risk of low bone mineral density and fractures. When lifestyle measures fail to restore menses, pharmacological therapies are used to protect bone health, yet their relative effectiveness remains uncertain. To address this gap, a study compared the efficacy of available pharmacological interventions in improving bone mineral density in women with FHA, including hormone-based and non-hormonal therapies, involving 897 women.
The study found that, compared with placebo or no intervention, transdermal hormone replacement therapy (HRT) was associated with significant improvements in lumbar spine bone mineral density (BMD) (standardized mean difference (SMD) 0.34) and femoral neck BMD (SMD 0.57). In contrast,…
