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Leptin Therapy in Women with Hypothalamic Amenorrhea

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Leptin

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Abstract

Hypothalamic amenorrhea is caused by dysfunction of the hypothalamic–pituitary–gonadal axis associated with chronic energy deficiency from excessive exercise, psychological stress, or insufficient nutritional intake. In addition to amenorrhea, these women are also noted to have abnormalities in other neuroendocrine axes (e.g., cortisol excess, decreased thyroid hormones, growth hormone resistance), low bone turnover and bone mineral density, and low lymphocyte counts. Hypoleptinemia in these women has been proposed to signal a state of energy deficiency and set off these energy-conserving processes. In the context of two clinical trials studying the effects of recombinant leptin in women with HA, leptin administration in replacement doses has been shown to restore reproductive function, decrease cortisol levels, increase triiodothyronine levels, increase insulin-growth factor-1 levels, improve bone mineral density, and increase CD4+ and CD8+ T-cell counts. If circulating leptin reaches supraphysiological levels in response to leptin administration, loss of weight and fat mass ensues; this is reversible however by decreasing the dose to achieve physiological levels. The potential use of leptin in HA needs to be further studied.

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Authors and Affiliations

  1. Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, The University of Chicago, 5841 S. Maryland Avenue, MC 1027, Chicago, IL, 60637, USA

    Sharon H. Chou M.D.

  2. Section of Endocrinology, Boston VA Healthcare System, Jamaica Plain, MA, USA

    Christos Mantzoros M.D., D.Sc.

  3. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School and Boston Medical Center, Boston, MA, 02215, USA

    Christos Mantzoros M.D., D.Sc.

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  1. Sharon H. Chou M.D.
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  2. Christos Mantzoros M.D., D.Sc.
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Correspondence to Christos Mantzoros M.D., D.Sc. .

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  1. Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, Tennessee, USA

    Sam Dagogo-Jack, MD

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Chou, S.H., Mantzoros, C. (2015). Leptin Therapy in Women with Hypothalamic Amenorrhea. In: Dagogo-Jack, MD, S. (eds) Leptin. Springer, Cham. https://doi.org/10.1007/978-3-319-09915-6_19

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