Supervisors info:
Μαστοράκος Γεώργιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πέτρος Δρακάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μιχάλα Σταυρούλα, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
INTRODUCTION
Functional hypothalamic amenorrhea is defined as the amenorrhea which is not due to organic causes but it is due to stress, weight loss, excessive exercise or a combination of the above. The diagnosis is made by the exclusion of other anatomical or organic causes and in order to be confirmed: 1) the duration of menstrual cycle should be consistently more than 45 days 2) and/or patients suffers from amenorrhea for 3 months or more.
Cortisol is the main human endogenous glucocorticoid , and due to the fact that stress is the main cause of functional hypothalamic amenorrhea, it has been observed that patients with functional hypothalamic amenorrhea have increased serum cortisol levels compare to women with normal menstrual cycle. However, it has not yet been investigated the correlation of the salivary cortisol levels among women with functional hypothalamic amenorrhea and women with normal menstrual cycle, that could be a potential useful and valid tool for cortisol levels measurement.
AIM
The aim of this study was to investigate the disturbance of the cortisol secretion levels secretion rate, measured by salivary cortisol.
METHODOS
In order to investigate the cortisol level disturbance, a comparative case-control study was performed using as control group women with normal menstrual cycle and compared their salivary cortisol levels with patients who had functional hypothalamic amenorrhea.
For the salivary cortisol measurements special kits provided to the patients and the control group. The measurements were performed at 08:00, 16:00 and 00:00. Validated questionnaires were used such as EAT-26, the Athens insomnia scale, the International Physical Activity Questionnaire and the HAD scale.
RESULTS
The salivary cortisol levels in the morning measurements were higher in patients with functional hypothalamic amenorrhea compare to women with normal menstrual cycle. On the other hand, the measurements performed at 16:00 (6,09±3,82 vs 7,44±3,72; p=0,65) and at 00:00 (2,76±1,12 vs 2,95±1,8; p=0,70) did not show a statistically significant difference among the two groups.
CONCLUSION
The measurement of salivary cortisol levels could be a promising research tool, and be used as a potential biomarker of recovery of menses. In addition, it could be used as a tool for the management of the disease and follow up of patients suffering from functional hypothalamic amenorrhea. Further studies should be conducted to indicate and clarify the specific cortisol levels associated with the occurrence of the disease or recovery of menses.
Keywords:
Functional hypothalamic amenorrhea, Salivary cortisol, Amenorrhea, Stress
