Has your monthly period stopped? Perhaps the cause is Hypothalamic Amenorrhea!

Do you remember that your monthly menstruation, or periods, used to come on time. But has it stopped for a few months now? Or has it become irregular? Although we sometimes do not pay much attention to these things, this is something that we should really be concerned about. Today we are going to talk about one specific reason that affects the cessation of menstruation. That is hypothalamic amenorrhea, or as doctors call it `(Functional Hypothalamic Amenorrhea - FHA)`.

What is Hypothalamic Amenorrhea?

Simply put, hypothalamic amenorrhea is when your monthly period stops due to a problem with the functioning of a part of your brain called the hypothalamus . Now you might be wondering what the hypothalamus is, right? Think of your entire body as a big company. The hypothalamus is like the main control center of that company. It controls many things like body temperature, hunger, and thirst. It also controls some important processes related to our reproductive system. Specifically, for menstruation to occur, the hypothalamus needs to release a hormone called gonadotropin-releasing hormone (GnRH) . This `(GnRH)` hormone, along with the hormones `Follicle-stimulating hormone (FSH)` and `Luteinizing hormone (LH) ,` and `Estrogen`, help your menstrual cycle run smoothly. So, if for some reason your hypothalamus stops producing this `(GnRH)` hormone or reduces it, the balance of those other hormones will also be lost. That's when your monthly periods will start to become irregular or stop altogether.

What is Amenorrhea?

Amenorrhea is simply the absence of your monthly period. There are two main types of this: 1. Primary amenorrhea: This means that you have not had your first period by the age of 16, or five years after reaching puberty. 2. Secondary amenorrhea: This means that you have previously had regular monthly periods, but suddenly stop having them for more than three months. Hypothalamic amenorrhea, which we are talking about today, is a type of secondary amenorrhea. Hypothalamic amenorrhea affects about 1.62 million women between the ages of 18 and 44 in the United States alone. If you look at the entire world, this number is about 17.4 million. This means that this is not something that can be ignored.

Why does hypothalamic amenorrhea occur? What are the causes?

Think of your hypothalamus as a command center that works in an emergency. It gets messages from the body, saying, "Oh, this body is under a lot of pressure, a lot of stress." When it senses that, the hypothalamus decides, "Okay, let's stop some of the work for a while. Because the most important thing for the body right now is to survive." That's when it stops producing that `(GnRH)` hormone. So, what are the reasons why this hypothalamus might feel "stressed"?

• Not eating enough or restricting food: Some people restrict their food intake because they want to be thin or because of some fashion . When this happens, the body does not get the energy it needs.
• Nutritional deficiencies: When you don't eat a balanced diet, your body lacks the nutrients and vitamins it needs. It's not enough to just eat something to fill your stomach.
• Excessive exercise: Exercise is good for the body. However, some people exercise more than they need, to the point of becoming overly active. For example, staying at the gym all day, or people like athletes who train excessively.
• Severe mental or emotional stress: This is something that affects many people. Stress caused by things like problems at home, problems at work, exams, and problems in romantic relationships can affect the hypothalamus.
• Very low body fat: A certain amount of fat is required for hormones to function. This condition can also occur if it is too low.
• Eating disorders: Conditions such as Anorexia Nervosa, for example, are characterized by a fear of eating and negative attitudes toward food.

Often, one or two of these factors come together to cause the condition `(FHA)`. Imagine, if someone is not eating properly and exercising excessively, then the hypothalamus thinks that the body is in "survival mode", that is, in a state of fighting just to survive. Then, it uses energy only for the most essential things like breathing and heartbeat, and stops some "not currently essential" things like reproduction. As we said earlier, the hormone `(GnRH)` is what signals the body to produce the hormones `(FSH)` and `(LH)`. These two hormones `(FSH)` and `(LH)` are what cause an egg to be released from your ovary every month, which is called `ovulation`.It helps to be. So when the levels of `(FSH)` and `(LH)` decrease, both ovulation and menstruation stop. We often think that this only happens to athletes and Olympians. Because their activity level is high. But, in reality, this condition can occur in young girls, or anyone who is stressed due to everyday problems at work or at home.

What are the symptoms of hypothalamic amenorrhea?

The main and most obvious symptom of this condition is that you don't have a monthly period for three months or more. However, other symptoms may appear due to hormonal imbalance. These include:

• Depression and Anxiety : Feeling sad, fearful, and anxious can occur.
• Insomnia or sleep problems: You may find yourself tossing and turning at night, unable to sleep properly.
• Lack of physical energy (laziness): A feeling of being lifeless and not wanting to do anything.
• Feeling hungry more often: Some people may feel hungrier than usual during this time.
• Vaginal dryness: This can also be caused by a decrease in estrogen hormone levels.
• Low sex drive:
• Hair loss :
• Headaches :

Remember, just having one or two of these symptoms doesn't mean you have hypothalamic amenorrhea. However, if your periods have stopped and you have other symptoms like these, it's best to see a doctor.

Can PCOS cause hypothalamic amenorrhea?

Polycystic ovary syndrome (PCOS) can also cause irregular menstrual cycles or complete cessation of ovulation in women. However, PCOS is not a direct cause of hypothalamic amenorrhea. FHA is a condition in which menstruation stops due to a problem in the hypothalamus. PCOS is caused by hormonal changes in the ovaries.

How do doctors diagnose hypothalamic amenorrhea?

A doctor will conclude that hypothalamic amenorrhea is present after ruling out all other causes of menstrual irregularity. For example:

• I'm checking to see if you're pregnant.
• They check to see if there is any problem with the thyroid gland or adrenal gland.

These things will be checked first. In addition, your doctor will also do the following:

• Your complete medical history will be asked: things like your previous illnesses, medications you take, and whether anyone in your family has had similar problems.
• A physical exam and a pelvic exam will be performed.
• Several different tests are also ordered. The main ones are:
• Blood tests: These check the levels of hormones that affect menstruation, such as estrogen , prolactin , follicle-stimulating hormone (FSH) , and luteinizing hormone (LH) .
• Complete blood count (CBC): This gives an idea of ​​the types of cells in the blood.
• Pregnancy test:
• Sometimes you may also be asked to do an MRI scan of the pituitary gland, as the pituitary gland is also involved in hormone control.

What are the treatments for this?

The good news is that there is a treatment for hypothalamic amenorrhea! Doctors mainly recommend making lifestyle changes . These include:

• Limiting excessive exercise: If you exercise a lot, you may need to cut back a bit.
• Gain weight (if necessary): If you are underweight, it is recommended that you gain some weight in a healthy way.
• Finding ways to reduce stress: You can try to manage stress through things like yoga, meditation, and calming hobbies.

Your doctor may also refer you to a dietitian . This will help you understand exactly what nutrients your body needs, how many calories you should eat each day, and how to maintain a healthy body mass index (BMI) based on your activity level. Some people also benefit from mental health counseling , such as cognitive behavioral therapy (CBT) . This is especially helpful for people who have an eating disorder or are reluctant to admit they have one. It can also help you learn ways to manage stress. In rare cases, your doctor may also prescribe hormone therapy, birth control pills, or other medications that can help you get your period.

How long does treatment take?

This can vary from person to person. It depends on factors like your age, weight, activity level, and genetics. But in general, it takes about three to six months of consistent treatment before your period starts again.

Can hypothalamic amenorrhea be prevented?

Yes, definitely! The main thing to do is to avoid the main causes that contribute to this condition.

• Eat in amounts appropriate to your activity level.
• Don't restrict calories unnecessarily.
• Find ways to reduce and manage stress.
• Limit excessive, unbearable exercise.

Simply put, listen to your body. Give it the rest, nutrition, and mental well-being it needs.

How does this condition affect my body?

Not only is it a loss of your monthly period, but it can also cause both short-term and long-term problems. Here are some of the effects that missing your period can have on your health:

• Infertility: If menstruation is irregular and ovulation does not occur, it becomes difficult to conceive a child.
• Deterioration in bone health: This can lead to bone-thinning diseases like osteoporosis , as the hormone estrogen is very important in keeping bones strong.
• Increased risk of cardiovascular disease.
• Skin and hair problems: Things like hair loss, acne.

Is it possible to get pregnant with hypothalamic amenorrhea?

Your chances of getting pregnant while you are in this condition are very low. This is because ovulation usually does not occur due to changes in your menstrual cycle. However, ovulation can occur sometimes. It is also difficult to say exactly when your menstrual cycle will return to normal. Remember, you can ovulate and become pregnant before your first period starts. Therefore, if you are sexually active and do not want to become pregnant, it is very important to talk to your doctor about birth control.

What are the possible complications of this condition?

Hypothalamic amenorrhea can cause low levels of estrogen in the body. Estrogen is a very important hormone for our body. One of the functions of estrogen is to maintain healthy, strong bones. Without estrogen, women are at increased risk of osteoporosis and heart disease. Estrogen also helps maintain your mood. When estrogen levels are low, symptoms such as depression and anxiety can occur.

When should I see a doctor?

If you haven't had your period for three months, definitely see a doctor. Even if you're not trying to conceive, irregular periods can be a sign of other problems. And they can lead to long-term complications.

Hypothalamic amenorrhea is just one reason why your period may stop. While it may not seem like a big deal, irregular periods can be a sign of other health problems. So, if you haven't had your period for three months or more, talk to your doctor. He or she can run tests to find out why you're not getting your period, and give you the treatment you need to get your period started again.

In summary, let us remember (Take-Home Message)

Dear you, I hope you now have a better understanding of the condition called hypothalamic amenorrhea that we discussed today. The most important things to remember are:

• If your monthly period has stopped for more than three months, don't ignore it. Be sure to seek medical advice.
• The main causes of hypothalamic amenorrhea are excessive stress, inadequate nutrition, and excessive exercise.
• There are treatments for this condition. The main treatment is to make positive changes in lifestyle .
• Decreasing estrogen levels can cause long-term effects such as weakened bones and an increased risk of heart disease .
• You are not alone. There are many people with similar problems. With the right medical advice and support, this condition can be managed.

It is very important to take care of your health. Therefore, if you have any doubts or problems, do not be afraid to talk to a doctor. I wish you good health!