Functional hypothalamic amenorrhea: hormonal changes as an adaptive response to an energy deficit

Abstract

Functional Hypothalamic Amenorrhea (FHA) is a reversible disorder characterized by suppression of the hypothalamic-pituitary-ovarian (HPO) axis in response to stress and low energy availability. Growth hormone, corticotropic hormone, kisspeptins and thyroid hormones participate as part of an adaptive response. AHF occurs frequently in female athletes and in patients with anorexia nervosa, and may be caused by stressful situations. It is accompanied by changes in bone mineral density, infertility and emotional disorders, generating deterioration in the quality of life of women. Knowing and acting on the stressor agent and the energetic imbalance are part of the therapeutic strategy to recover ovulatory menstrual cycles.