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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 ...
Secondary amenorrhea's most common and most easily diagnosable causes are pregnancy, thyroid disease, and hyperprolactinemia. [50] A pregnancy test is a common first step for diagnosis. [50] Similar to primary amenorrhea, evaluation of secondary amenorrhea also begins with a pregnancy test, prolactin, FSH, LH, and TSH levels. [13]
However, if no bleeding occurs after progesterone withdrawal, then the patient's amenorrhea is likely to be due to either a) low serum estradiol (i.e. premature ovarian failure), b) hypothalamic-pituitary axis dysfunction (such as low GNRH or low FSH that lead to low estrogen level ), c) a nonreactive endometrium, or d) a problem with the ...
Starvation from anorexia nervosa or bulimia causes the HPG axis to deactivate causing women's ovarian and uterine cycles to stop. Stress, physical exercise, and weight loss have been correlated with oligomenorrhea and secondary amenorrhea. [29] Similarly environmental factors can also affect men such as stress causing impotence. Prenatal ...
FHA accounts for around 10–15% of all cases of anovulation. Weight loss or anorexia can lead to FHA by causing a hormonal imbalance, leading to irregular ovulation (dysovulation). It is possible that this mechanism evolved to protect the mother's health. A pregnancy where the mother is weak could pose a risk to the baby's and mother's health.
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 ...
It begins with the main symptom, which is amenorrhea, where there is an irregular or no menstrual period at all. Other symptoms are related to ovarian cysts, and more common ones are also listed below. A variation of symptoms can occur together, however, that depends on the person and the severity of the disease. Primary amenorrhea
The history of a pregnancy event followed by a D&C leading to secondary amenorrhea or hypomenorrhea is typical. Hysteroscopy is the gold standard for diagnosis. [18] Imaging by sonohysterography or hysterosalpingography will reveal the extent of the scar formation. Ultrasound is not a reliable method of diagnosing Asherman's Syndrome.