Hypothalamic Amenorrhea

Cessation of menstruation due to suppression of GnRH release from the hypothalamus.

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 10, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Hypothalamic Amenorrhea?

Functional hypothalamic amenorrhea (FHA) is menstrual irregularity or absence resulting from suppression of pulsatile GnRH release from the hypothalamus, with low or normal LH and FSH levels, in the absence of structural disease.

Triggering factors include low body weight, insufficient energy intake, intense physical exercise, and psychological stress. The 'female athlete triad' (amenorrhea, low bone mass, and eating disorder) is a commonly seen combination.

Diagnosis is one of exclusion; polycystic ovary syndrome, prolactinoma, thyroid disease, and pituitary insufficiency must be ruled out.

Symptoms

Primary or secondary amenorrhea

Menstrual irregularity and oligomenorrhea

Low body weight and fatigue

Cold intolerance

Decreased libido and vaginal dryness

Decreased bone density

Symptoms of an eating disorder

Risk Factors

Low body mass index (<18.5)

Excessive exercise (>15 hours/week)

Eating disorders (anorexia, bulimia)

Chronic stress and anxiety

Sudden weight loss

Particularly endurance athletes

Long-term dietary restrictions

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

Absence of menstruation for more than 3 months
Menstrual irregularity together with significant weight loss
Amenorrhea in young women undergoing intense exercise
Bone pain and fracture history
If there is an infertility problem

Treatment Methods

Restoring energy balance and weight gain

Reducing exercise intensity

Cognitive behavioral therapy and stress management

Calcium and vitamin D for bone health

Estrogen-progestin therapy (in selected cases)

Pulsatile GnRH or gonadotropin therapy when pregnancy is desired

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Endokrinoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.