Hypothalamic Amenorrhea: Symptoms And Management

Hypothalamic amenorrhea is a condition in which the periods or the menstrual cycle in a female stops due to a problem in the hypothalamus gland. Hypothalamic amenorrhea can also occur due to stress and poor nutrition.

Stress leads to altering of the signals to the brain, which regulate the menstrual cycle. Due to this, the hypothalamus stops producing signals to the pituitary gland. The hormone used for sending the signal is gonadotropin-releasing hormone GnRH. The pituitary gland in hypothalamic amenorrhea then fails to produce FSH (follicle stimulating hormone), LH (luteinizing hormone) and prolactin, which further leads to a fall in the level of estrogen, progesterone and testosterone hormone. The females who are mostly seen undergoing hypothalamic amenorrhea condition are the ones who are restricting their calorie intake, exercise more than required or are under some psychological stress.

Apart from missing periods or getting very low flow during menstruation, the symptoms of hypothalamic amenorrhea are as follows:

• Low libido is a symptom of hypothalamic amenorrhea.
• Difficulty in sleeping is a symptom of hypothalamic amenorrhea
• Depression also occurs in hypothalamic amenorrhea.
• Hypothalamic amenorrhea can also produce anxiety as its symptom.
• Fatigue can occur in hypothalamic amenorrhea.
• Increased appetite can also occur as a symptom of hypothalamic amenorrhea.
• Feeling chilly is a symptom of hypothalamic amenorrhea.
• Cystic acne is a symptom of hypothalamic amenorrhea.
• Failure to ovulate is a symptom of hypothalamic amenorrhea.

Other symptoms of hypothyroidism, such as brittle nails and hair are also seen in women suffering from hypothalamic amenorrhea.

Diagnosis of hypothalamic amenorrhea involves first eliminating other causes of amenorrhea. The doctor enquires whether the patient is pregnant or is whether she is suffering from any other disorder. The medical history of the patient is taken and a pelvic examination is also performed. To further confirm the diagnosis of hypothalamic amenorrhea, the following tests are done.

Hormonal Tests. A blood test is performed to check the levels of hormones like FSH, LH, HCG, and prolactin, which indicate.

• Low FSH and LH level indicate hypothalamic amenorrhea.
• If the prolactin level is raised it might indicate a benign tumor in the pituitary gland.
• The HCG levels eliminate the possibility of pregnancy causing the amenorrhoea.

Progesterone Test. In this test, the estrogen and progesterone are given in the form of a pill. It induces menstrual bleeding in some types of amenorrhea, but not hypothalamic amenorrhea and thus helps with the diagnosis.

MRI (Magnetic Resonance Imaging). A tumor or any other abnormality is detected by performing this imaging test, which can be causing the amenorrhea.

The treatment and management of hypothalamic amenorrhea involves nutritional rehabilitation and management of stress and exercise levels. After nutritional deficit is met with properly, the menses return. As poor nutrition and stress are the major causative factors of hypothalamic amenorrhea, eating healthy and well-balanced diet and managing stress by following a good exercise routine including yoga and meditation are the best ways to manage hypothalamic amenorrhea. Along with amenorrhea, stress and poor nutrition is also a cause of various other illnesses and weak immunity. Lifestyle correction therefore is very important for treatment and management of hypothalamic amenorrhea.

If these treatment and management techniques do not work for hypothalamic amenorrhea, the doctor might also suggest hormone and fertility medications along with the lifestyle changes, so that the ovulation starts and the menstruation begins in the patient.