Hypothalamic Amenorrhoea

Hypothalamic amenorrhoea (or HA for short) is a form of chronic anovulation (ie. Long term issues with not ovulating). 

If you have ovaries and you’re of reproductive age, this could affect you! The symptoms may sound like PCOS, however, they are a little different. 

Okay, so, first things first. Let’s break down some of the language here. 

Hypothalamic = this just means that the hypothalamus in your brain is involved in this condition. 

Amenorrhoea = the absence of a menstrual cycle.

Why is the hypothalamus involved? The hypothalamus produces a number of hormones, including gonadotropin-releasing hormone (GnRH). GnRH signals the production of other hormones, including follicle-stimulating hormone (FSH), and luteinising hormone (LH) to help eggs mature and get released. 

If the hypothalamus stops the production of GnRH, the amount of FSH and LH (and oestrogen by extension) will reduce. This is what causes the anovulation on the cessation of your menstrual cycle. 

Let’s leave the sciencey stuff for a second.

 

How can you diagnose HA?

Unfortunately, it’s tricky. All other causes of anovulation and amenorrhoea have to be excluded first. It’s kind of like diagnosing IBS.

HA is associated with stress, weight loss, excessive exercise, or a combination of these factors. It’s often seen in people who exercise a lot without consuming adequate calories. It can even pop up if you have a stressful job and don’t manage to fit in enough food each day! 

So, let’s say you have HA and you leave it untreated – then what? 

Well, the lack of ovulation can lead to troubles conceiving. You can get periods but not ovulate! So, things might look okay on the surface, but the lack of ovulation will cause issues!

The low oestrogen levels can compromise your bone health long term as well – oestrogen is bone protective, so we actually need good levels of oestrogen to keep our bones healthy as we age. 

What should you do to manage your HA?

1. Increase your overall energy intake (for some people, weight gain may be required) 

2. Make sure your meals have plenty of healthy fats – this helps make reproductive hormones in the body 

3. Reduce high intensity exercise!!! Take rest days! 

4. Ensure you are eating adequate calcium each day 

5. If you’re trying to conceive within the next 3-6 months, take a prenatal supplement and an omega 3 supplement

5. See a psychologist if you need assistance working through any disordered eating behaviours and patterns

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