Functional hypothalamic amenorrhea: gut microbiota composition and the effects of exogenous estrogen administration

Am J Physiol Endocrinol Metab. 2023 Nov 29. doi: 10.1152/ajpendo.00281.2023. Online ahead of print.ABSTRACTFunctional hypothalamic amenorrhea (FHA) is characterized by estrogen deficiency that significantly impacts on metabolic, bone, cardiovascular, mental, and reproductive health. Given the importance of environmental factors such as stress, and body composition, and particularly considering the importance of estrogens in regulating the gut microbiota, some changes in the intestinal microenvironment are expected when all of these factors occur simultaneously. We aimed to assess whether the gut microbiota composition is altered in FHA and to determine the potential impact of hormonal replacement therapy (HRT) on the gut microbiota. This prospective observational study included 33 patients aged 18-34 years with FHA and 10 age-matched healthy control women. Clinical, hormonal, and metabolic evaluations were performed at baseline for the FHA group only, while gut microbiota profile was assessed by 16S rRNA gene amplicon sequencing for both groups. All measurements were repeated in patients with FHA after receiving HRT for 6 months. Gut microbiota alpha diversity at baseline was significantly different between patients with FHA and healthy controls (p<0.01). At the phylum level, the relative abundance of Fusobacteria was higher in FHA patients after HRT (p<0.01), as was that of Ruminococcus and Eubacterium at the genus level (p<0.05), which correlated with a decrease in...
Source: American Journal of Physiology. Endocrinology and Metabolism - Category: Physiology Authors: Source Type: research