女性低促性腺激素性性腺功能减退症:从内分泌学到新的临床发现OA

Functional hypothalamic hypogonadism(HH)in women is a common,reversible condition which can lead to infertility.Various stressors,such as excessive exercise,insufficient energy intake,and psychological stress,can suppress the secretion of gonadotropin-releasing hormone(GnRH)from the hypothalamus,thereby triggering HH.Depending on the degree of suppression,the clinical manifestations may range from luteal phase deficiency,anovulation with regular menstruation,oligomenorrhea,to complete amenorrhea.The most recognized presentation of HH is functional hypothalamic amenorrhea(FHA),which has attracted significant attention.However,a larger number of patients exist in an intermediate or transitional state of the disease that often could be undetected referred to as subclinical HH.This review focuses on the identification of subclinical HH,the endocrine mechanisms affecting follicular development,and related clinical treatments.It analyzes the impact of subclinical HH on female infertility,aiming to enhance early recognition and intervention by clinicians and ultimately improve reproductive outcomes of patients by optimizing clinical practice through comprehensive management strategies.