ReviewFrontiers in endocrinology2025
Functional hypothalamic amenorrhea in adolescent athletes impairs bone accrual and increases fracture risk.
Review in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Physiological mechanisms and organism response in youth sports activities-related musculoskeletal injuries.Frontiers in physiology · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Functional hypothalamic amenorrhea (FHA) is a reversible neuroendocrine condition prevalent among adolescent female athletes that often results from energy deficiency, reflecting an imbalance between energy intake and expenditure due to factors such as disordered eating, psychological stress, and excessive physical activity. By disrupting hypothalamic-pituitary-ovarian (HPO) axis signaling, FHA in adolescence typically leads to hypoestrogenism and subsequent impairment of bone mineral accrual during a crucial period of skeletal development. This review synthesizes current evidence on the pathophysiology of FHA in relation to bone health, emphasizing the impact of altered estrogen, IGF-1, leptin, and cortisol levels. We further summarize the main risk factors of FHA and examine their effect on reduced bone mineral density (BMD), compromised bone microarchitecture, and increased fracture risk. Studies emphasize the high risk of osteopenia, osteoporosis, and stress fractures in female athletes with FHA. Diagnosis of FHA requires exclusion of organic pathology and a multidisciplinary evaluation of orthopedic, nutritional, endocrinological, psychological, and exercise-related contributors. Evidence-based management prioritizes lifestyle modification, nutritional rehabilitation, and psychological support, with transdermal estrogen therapy as a promising treatment for refractory cases. Ongoing controversies include the limited skeletal benefits of oral contraceptives versus growing evidence for transdermal estrogen, and the paradoxical effects of exercise as both protective and harmful under energy-deficient conditions. Additionally, persistent clinical challenges are highlighted, such as underdiagnosis of menstrual dysfunction and lasting microarchitectural deficits despite weight restoration. Ultimately, early identification and intervention are essential to optimize long-term skeletal and reproductive outcomes for adolescent female athletes affected by FHA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.