Functional Hypothalamic Amenorrhea

Functional Hypothalamic Amenorrhea (FHA) is a condition where the brain's hypothalamus temporarily stops sending signals to the ovaries, causing a woman to stop having menstrual periods. This condition affects the reproductive system and is often triggered by stress, significant weight loss, or excessive exercise. The lack of menstrual periods can lead to problems with fertility and bone health due to decreased hormone production. FHA is not caused by structural damage but by a disruption in the normal hormonal signals that regulate the menstrual cycle. It is a reversible condition once the underlying causes are addressed. The main health impact is the absence of ovulation and reduced levels of estrogen.

Functional Hypothalamic Amenorrhea is defined as the reversible absence of menstrual periods due to decreased pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus. This leads to reduced secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), resulting in anovulation and hypoestrogenism. The condition is typically caused by psychological stress, energy deficit from low caloric intake or excessive physical activity, and/or significant weight loss. It is characterized by the absence of organic or structural hypothalamic-pituitary disease. Clinically, patients present with amenorrhea, low serum gonadotropins, and low estradiol levels. FHA is important to recognize because prolonged hypoestrogenism can cause osteopenia and infertility.