Conclusion
Our study suggests that many women with FHA have a typical phenotype of excessive cardiovascular exercise, weight loss, psychological stress and reduced BMD. Psychological comorbidities including EDs, depression and anxiety were moderately prevalent. The most effective parameters distinguishing women with FHA from women with PCOS were low BMI, estradiol, LH and LH:FSH ratio. These data could be utilized to prospectively validate a standardized protocol to optimise the diagnosis and improve the management of women with FHA.