US EPA

7432986 

Journal Article 

Physiopathology, Diagnosis, and Treatment of Secondary Female Hypogonadism 

Antoniou-Tsigkos, A; Macut, D; Mastorakos, G; , 

2018 

1-41 

10.1007/978-3-319-38681-2_9-1 

http://link.springer.com/10.1007/978-3-319-38681-2_9-1
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Female hypogonadism is a state characterized by absent or decreased ovarian function. It results from a gonadal (primary hypogonadism) or an extragonadal (secondary hypogonadism) princeps defect. In secondary hypogonadism, hypothalamic gonadotropin-releasing hormone or/and pituitary-secreted gonadotropins (follicle-stimulating hormone, luteinizing hormone) are either deficient or inactive leading to decreased secretion of gonadal steroids and subsequent amenorrhea. In certain conditions, both hypothalamic and pituitary dysfunctions are present. The genetic causes of secondary hypogonadism manifest mainly as congenital genetic syndromes (i.e., Kallmann syndrome) while some of them have been attributed to recognized single gene mutations and others have been characterized as idiopathic forms. Acquired causes of secondary hypogonadism include reversible causes such as functional hypothalamic amenorrhea, drugs, chronic illnesses, and irreversible causes such as central nervous system insults (trauma, irradiation, and intracranial tumors). Diagnosis should take in consideration the age at the clinical presentation (prepubertal or postpubertal), the physical findings as well as biochemical and imaging findings. Genetic investigation can be employed for more precise diagnosis. Finally, treatment should focus upon the treatment of the causal factor wherever possible and the hormone replacement therapy. The latter is adapted to the age of diagnosis of secondary female hypogonadism (prepubertal vs. postpubertal).