Functional Hypothalamic Amenorrhea

Publication Date: March 22, 2017

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

...gnosis

...crine Society (ES) suggests that clinicians ma...


...nostic evaluation for FHA in adolesc...


...eening patients with FHA for psychological str...


...s establish the diagnosis of FHA,...


...tial Etiologies of AmenorrheaHaving trouble viewi...


...Common Causes of Anovulation and Accompanyin...


Evaluation

Evaluat...

...with suspected FHA, ES recommends obtaining a det...


...a patient with suspected FHA, ES recommends excl...


...dolescents and women with suspected FHA,...


...itial endocrine evaluation for patients...


...pregnancy, ES suggests administering a...


...nds a brain magnetic resonance imaging (MRI) (with...


...gests that clinicians obtain a baseline...


...ases of primary amenorrhea, ES sugge...


...baseline BMD measurement by DXA in those with ...

clinical monitoring for hyperrespons...


Treatment

Treatm...

...ecommends that clinicians evaluate pat...


...escents and women with FHA, ES recommend...


...adolescents and women with FHA, ES s...


...suggests against patients with FHA using oral con...


...ients with FHA using OCPs for contracepti...


...suggests short-term use of transderma...


...s against using bisphosphonates, denosumab, te...


...adult FHA cases, ES suggests that short-term u...


...reatment with pulsatile gonadotropin-rel...

...tious use of gonadotropin therapy. (2-VL)699...

...trial of treatment with clomiphene citrate for...

...the use of kisspeptin and leptin for...

...here is only a single, small study...


...that clinicians should induce ovulation...