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Hypothalamic Amenorrhea

Hypothalamic amenorrhea is a cause of ovulatory dysfunction and infertility

Women can experience hypothalamic amenorrhea when poor nutrition or stress interferes with the brain’s regulation of the menstrual cycle. The result is an almost complete absence of menses and irregular ovulation, not due to hormonal contraception or replacement.

Our Austin fertility doctors often see this condition in women with very low BMI who severely restrict their calories and exercise multiple hours a day. As a result, it can present in performance athletes, dancers and women with anorexia nervosa. It can also appear in women who are under severe psychological stress. However, the condition can sometimes occur without an obvious cause.

The team at Texas Fertility Center (TFC) offers hope for women with this condition. Our doctors will perform thorough diagnostic testing before recommending the most effective course of treatment to restore fertility.

What are the symptoms of this condition?

Most women with hypothalamic amenorrhea will either miss periods or experience extremely light menstrual bleeding. Patients can also experience the following symptoms.

  • Anxiety and depression
  • Feeling cold
  • Increased hunger
  • Insomnia
  • Low energy and libido

If you are experiencing these symptoms, you may have this condition. Our Austin fertility doctors offer diagnostic tools and treatment that can help you overcome this form of ovulatory dysfunction.

Diagnosing and treating hypothalamic amenorrhea

When you visit TFC with the symptoms of this condition, our Austin fertility doctors will work hard to discover the cause. They will begin with bloodwork and an ultrasound evaluation.

  • We will take bloodwork to examine follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. In women with hypothalamic amenorrhea, these hormones are typically either in the low or normal range.
  • Our team will also perform bloodwork to take a serum estradiol level, which is typically less than 10 pg/ml in women with this condition.
  • We will conduct an ultrasound evaluation, which often reveals a very thin uterine lining and small ovaries in women with this condition.

After making a diagnosis, our doctors will develop a customized treatment plan. Women with this condition often do not respond to progesterone to induce menses because they lack an estrogen-primed uterine lining. Instead, your doctor may recommend Clomid or gonadotropins to induce ovulation.

If you have questions about ovulatory dysfunction, contact us to schedule an appointment. Our doctors can help you understand this issue and provide effective treatment to help you conceive.