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Functional hypothalamic amenorrhea (FHA) is a form of amenorrhea and chronic anovulation [1] and is one of the most common types of secondary amenorrhea. [2] It is classified as hypogonadotropic hypogonadism. [3] It was previously known as "juvenile hypothalamosis syndrome," prior to the discovery that sexually mature females are equally ...
Laboratory findings of low serum estradiol and low FSH are associated with the decrease in hypothalamic secretion of GnRH. [3] A rare form of HA that presents as primary amenorrhea can be due to a congenital deficiency of GnRH knows as idiopathic hypogonadotropic hypogonadism or, Kallmann syndrome if it is associated with anosmia. [3]
Functional hypothalamic amenorrhoea is typically treated by weight gain through increased calorie intake and decreased expenditure. [7] Multidisciplinary treatment with monitoring from a physician, dietitian , and mental health counselor is recommended, along with support from family, friends, and coaches. [ 7 ]
Hypoestrogenism is typically found in menopause and aids in diagnosis of other conditions such as POI and functional amenorrhea. [17] [24] Estrogen levels can be tested through several laboratory tests: vaginal maturation index, [clarification needed] progestogen challenge test, and vaginal swabs for small parabasal cells. [19]
In the case of RED-S, the majority of secondary amenorrhea cases are attributed to functional hypothalamic amenorrhea (FHA), an adaptive mechanism to preserve energy for survival and vital processes rather than reproduction when energy balance is low. [17] [18] Primary amenorrhea is characterized by delayed menarche (the onset of menses during ...
In patients with functional hypothalamic amenorrhea due to physical or psychological stress, non-pharmacological options include weight gain, resolution of emotional issues, or decreased intensity of exercise. Patients experiencing amenorrhea due to hypothyroidism may be started with thyroid replacement therapy.
KS/HH is most often present from birth but adult onset versions are found in both males and females. In those cases, the hypothalamic-pituitary-gonadal axis (HPG axis) functions normally at birth and well into adult life, giving normal puberty and normal reproductive function. The HPG axis then either fails totally or is reduced to a very low ...
Hypothalamic disorders result from a deficiency in the release of gonadotropic releasing hormone , while pituitary gland disorders are due to a deficiency in the release of gonadotropins from the anterior pituitary. [1] GnRH is the central regulator in reproductive function and sexual development via the HPG axis.