Specific Features in the Development of the Reproductive System in Girls with Hypothalamic Dysfunction
Study Objective: To investigate specific features in the development of the reproductive system in girls with hypothalamic dysfunction (HD) during puberty. Materials and Methods: The main group consisted of 124 girls with HD, and the control group consisted of 20 girls without endocrine disorders. The study participants had clinical examinations, laboratory tests, and pelvic ultrasound. Ultrasound examination assessed the uterine size, endometrial thickness and structure, and ovarian volume and structure. At the same time, color flow Doppler mapping was done to measure blood-flow velocity in the basal arteries. Results: The study showed that in 37.1% of girls going through puberty HD was accompanied by metabolic syndrome; and another 62.9% of study participants had HD and were developing metabolic syndrome. Other findings included low progesterone levels and reduced blood supply to the endometrium via the basal arteries. These changes were caused by metabolic disorders and by alterations in the hypothalamic-pituitary system. As a result, endometrial function was suppressed due to a reduction of glycodelin levels in menstrual blood. Conclusion: These results suggest that a comprehensive assessment of hypothalamic dysfunction including the evaluation of metabolic disorders and their timely correction may help improve the prevention of reproductive health problems.