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Updated: Dec 10, 2025

Author Spotlight: Hypothalamic Neural Mechanism Insights
Published on: August 4, 2023
Current understanding of hypothalamic amenorrhoea
Rachel E Roberts1, Linda Farahani2, Lisa Webber3
1Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, London, UK.
Abstract:
Hypothalamic amenorrhoea (HA) accounts for approximately 30% of cases of secondary amenorrhoea in women of reproductive age. It is caused by deficient secretion of hypothalamic gonadotrophin-releasing hormone, which in turn leads to failure of pituitary gonadotrophin and gonadal steroid release. Functional HA (FHA) is defined as HA occurring in the absence of a structural lesion and is predominantly caused by significant weight loss, intense exercise or stress. Treatment of FHA is crucial in avoiding the long-term health consequences on fertility and bone health, in addition to reducing psychological morbidity. This article summarises our understanding of the mechanisms underlying FHA, the evidence base for its clinical management and emerging therapies.
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