Functional Hypothalamic Amenorrhea
Key Points
Key Points
- Functional hypothalamic amenorrhea (FHA) is a form of chronic anovulation, not due to identifiable organic causes, but often associated with stress, weight loss, excessive exercise, or a combination thereof.
- Investigations should include assessment of systemic and endocrinologic etiologies, since FHA is a diagnosis of exclusion.
- A multidisciplinary treatment approach is necessary, including medical, dietary, and mental health support.
- Medical complications include, among others, bone loss and infertility.
- Appropriate therapies are under debate and investigation.
Diagnosis
...iagnosi...
...y (ES) suggests that clinicians make the diagnosis...
...ests diagnostic evaluation for FHA in ado...
...suggests screening patients with F...
...clinicians establish the diagnosis of FH...
.... Potential Etiologies of AmenorrheaHaving troub...
...n Causes of Anovulation and Accomp...
Evaluation
Evaluat...
...ith suspected FHA, ES recommends obtaining a...
...a patient with suspected FHA, ES recommends e...
...nts and women with suspected FHA, ES reco...
...of an initial endocrine evaluation for p...
...ing pregnancy, ES suggests administering a...
...brain magnetic resonance imaging (MRI) (wit...
...gests that clinicians obtain a base...
...ary amenorrhea, ES suggests evaluating Müller...
...measurement by DXA in those with ≥6...
...cal monitoring for hyperresponse in thos...
Treatment
...atment...
...recommends that clinicians evaluate p...
...nts and women with FHA, ES recommends correcti...
...ts and women with FHA, ES suggests psycholog...
...gainst patients with FHA using ora...
In patients with FHA using OCPs for contraception,...
...short-term use of transdermal E2 therapy with cy...
...ts against using bisphosphonates, den...
...FHA cases, ES suggests that short-ter...
...ment with pulsatile gonadotropin-releasin...
...se of gonadotropin therapy. (2-VL)699...
...rial of treatment with clomiphene citrate fo...
...he use of kisspeptin and leptin fo...
...at there is only a single, small study su...
...suggests that clinicians should i...