Back to infertility resources
Back to Common cAUSES

What is Hypothalamic Amenorrhea | Advanced Fertility Care

Learn about hypothalamic amenorrhea, which develops when poor nutrition or stress alters your signaling to the brain to regulate the menstrual cycle.

Every Last Wednesday of the month at 6:00 pm | Hosted online

AFC Provider Hosted Monthly Support & Wellness Groups

Participate in our monthly topical support group led by our licensed mental health professional, Morgan Neary, LMSW. These meetings explore diverse facets of the fertility journey, covering topics such as nurturing closeness throughout fertility treatments and navigating grief while cultivating inner strength. Secure your spot today for these supportive sessions, taking place on the second Wednesday of every month.

Fingerprint pattern in teal

What is Secondary Amenorrhea?

Secondary amenorrhea is when a woman who previously menstruated on a regular basis misses her periods for six months, or when a woman who previously experienced irregular periods skips her periods for 12 months. The most common form of secondary amenorrhea is hypothalamic amenorrhea, where the female body reverts to survival mode because it cannot sustain reproductive mode.

What is Hypothalamic Amenorrhea?

Hypothalamic amenorrhea develops when poor nutrition or stress alters your signaling to the brain to regulate the menstrual cycle. Women with this condition may be severely restricting their caloric intake, exercising more than two to three hours a day, or under major psychological stress. It is a common pattern seen in performance athletes and dancers as well as women with anorexia nervosa, with the common denominator of very low body fat levels and significantly low body mass index (BMI). In this situation your brain doesn’t get adequate energy or macronutrients to pulse the hormones that govern follicle ripening and release of eggs.

What are the Symptoms of Hypothalamic Amenorrhea?

The most common symptom of hypothalamic amenorrhea is missing a period, or extremely light bleeding during menstruation. Others include:

  • Low libido
  • Feeling cold often
  • Depression and anxiety
  • Difficulty sleeping
  • Increased hunger
  • Low energy

How Is Hypothalamic Amenorrhea Diagnosed?

To diagnose hypothalamic amenorrhea, Advanced Fertility Care Physicians first try to eliminate some of the basic possibilities of why your periods have stopped. During diagnostic testing, hey check to ensure that you are not pregnant or that you do not have a pituitary problem that’s causing menstruation to stop. They will typically order the following blood tests:

Hormonal Blood Tests

to measure the levels of your key hormones, including FSH (follicle stimulating hormone), LH (luteinizing hormone), E2 (estradiol), HCG (human chorionic gonadotropin) and prolactin. High levels of HCG indicate a pregnancy. Low levels of FSH, LH and E2 may indicate hypothalamic amenorrhea. High levels of prolactin suggest a tumor on the pituitary gland.

Progesterone Challenge

a test that will induce menstrual bleeding in women with some types of amenorrhea, but not in women who have hypothalamic amenorrhea. In general, these women do not have enough estrogen to thicken the uterine lining, and therefore will only bleed if given both estrogen and progesterone, as in the form of a birth control pill.

Can Hypothalamic Amenorrhea Be Treated?

Reversing hypothalamic amenorrhea is possible by examining your lifestyle for unusual stress factors, including extreme diet and exercise habits. These lifestyle changes can be done in conjunction with fertility medications to help you to start ovulating and menstruating again.

What Happens if Hypothalamic Amenorrhea Is Not Treated?

Can amenorrhea lead to infertility? Untreated, hypothalamic amenorrhea can lead to continued problems with infertility as well as osteoporosis and heart disease. If you feel that you have hypothalamic amenorrhea and do not wish to become pregnant, it is still important to seek out medical treatment for your condition. Connect with the Advanced Fertility Care Physicians to know more.

Infertility Resources