Hypothalamic amenorrhea happens when a part of your brain stops making a hormone that’s essential to your menstrual cycle. Excessive exercise, stress and undereating are common causes of it. This condition is usually treatable with changes to your daily habits.
Advertisement
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Hypothalamic amenorrhea is when you don’t get your period (menstruate) because your hypothalamus doesn’t release enough hormones. Another name for this condition is functional hypothalamic amenorrhea (FHA).
Advertisement
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Your hypothalamus is a part of your brain that regulates many bodily functions, including aspects of reproduction. It releases a hormone called gonadotropin-releasing hormone (GnRH), which helps control menstruation. If it stops releasing this hormone, your periods will be irregular or absent.
This condition is usually reversible with changes to your eating and exercise patterns.
The main symptom of hypothalamic amenorrhea is not getting your period.
Most commonly, it happens in females who have had their period before but stop getting it for three months or longer. This is called secondary amenorrhea. Sometimes, it can cause primary amenorrhea, which is when you don’t get your period at all by age 15.
You may have other symptoms, like:
In most cases, hypothalamic amenorrhea happens because your body doesn’t have enough energy or is too stressed to release gonadotropin-releasing hormone (GnRH).
When your hypothalamus gets a message that something is stressing your body, it can go on strike (or stop working). That means it stops secreting GnRH, which is key to menstruation.
Reasons this may happen include:
Advertisement
Often, a combination of these factors lead to FHA.
In rare cases, direct damage to your hypothalamus can cause this condition — for example, from a tumor. A genetic condition called Kallmann syndrome can cause it, as well.
Not getting your period may seem harmless. But it can cause both short- and long-term problems. That’s because it leads to a lack of estrogen in your body. Estrogen has many important roles.
Possible complications include:
Your healthcare provider diagnoses hypothalamic amenorrhea after ruling out other conditions that can cause your period to stop. These could include thyroid or pituitary gland disorders, or pregnancy.
Your provider will also ask about your medical history and do a physical exam. Tests they may suggest include:
The main treatment for hypothalamic amenorrhea is adjusting your lifestyle. You may need to limit vigorous exercise, gain weight or find ways to reduce stress.
Your provider may recommend speaking with a dietitian so you can better understand what nutrients your body needs and how many calories you should eat each day. A dietitian can help you determine a healthy BMI (body mass index) and work with you to balance your diet to support your activity level.
Talk therapy is another form of treatment, especially if you have an eating disorder. Mental health specialists can also help with stress management techniques.
In some cases, your provider may recommend hormone treatment or fertility medication.
Several factors can affect how long it takes for your period to come back, like your:
It’ll most likely take three to six months of consistent treatment.
The good news is that hypothalamic amenorrhea is often treatable. But it may be challenging to make changes to your eating and activity patterns to get your period back.
Try to stick to your treatment plan. This condition is a sign that your body is overworked and under-fueled.
It’s unlikely that you’ll get pregnant when you have this condition because disruptions in your menstrual cycle usually prevent ovulation.
Advertisement
But sometimes, ovulation still happens. And it can be hard to predict when your cycle will return to normal.
Remember that you ovulate and can get pregnant before your menstrual bleeding returns the first time. It’s a good idea to talk with your healthcare provider about birth control options if you’re sexually active and don’t want to get pregnant.
If you aren’t getting your period, hypothalamic amenorrhea could be the reason why. While it may seem like no big deal, missing periods can cause other health problems. So, it’s best to talk to a healthcare provider if you experience this change. They can determine the underlying cause and offer a treatment plan.
Advertisement
Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more.
Learn more about the Health Library and our editorial process.
Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
When your periods aren’t acting the way they typically do, the experts at Cleveland Clinic can help craft a treatment plan that works for you.
