Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial Vasiliki.

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Presentation transcript:

Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial Vasiliki Michopoulos, Ph.D., Fulvia Mancini, M.D., Tammy L. Loucks, M.P.H., D.P.H., Sarah L. Berga, M.D. Fertility and Sterility Volume 99, Issue 7, Pages 2084-2091.e1 (June 2013) DOI: 10.1016/j.fertnstert.2013.02.036 Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Circulatory cortisol with cognitive behavioral therapy in an individual. (A) Circulatory concentrations of cortisol in 15-minute intervals over 24 hours in a woman with FHA before (pre) and after (post) CBT. Meals are indicated by arrows. (B) Circulatory concentrations of cortisol displayed as 8-hour mean in the same woman before (pre) and after (post) CBT. Fertility and Sterility 2013 99, 2084-2091.e1DOI: (10.1016/j.fertnstert.2013.02.036) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Cortisol levels with cognitive behavioral therapy (CBT) versus observation. Mean ± standard error of the mean levels of nocturnal (2400–0745 hours) cortisol levels by treatment arm (observation vs. CBT) and before (pre) and after (post) treatment. The CBT reduced cortisol levels (P=.006). ∗P<.01. Fertility and Sterility 2013 99, 2084-2091.e1DOI: (10.1016/j.fertnstert.2013.02.036) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Mean ± standard error of the mean of (A) BMI, (B) leptin (∗P=.09), (C) TSH (∗∗P<.01), and (D) free T3 in women who underwent observation or cognitive behavioral therapy (CBT) before (pre) and after (post) treatment. The CBT increased leptin levels (B: P=.09) and increased TSH levels (C: P=.009). Fertility and Sterility 2013 99, 2084-2091.e1DOI: (10.1016/j.fertnstert.2013.02.036) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions