Disease factors of hypothalamic amenorrhea

Hypothalamic amenorrhea is caused by a decrease or disorder in the secretion of gonadotropin by the hypothalamus. Many diseases can directly or indirectly affect the function of the hypothalamus and cause amenorrhea, as follows:

Intracranial lesions

The following intracranial lesions can lead to hypothalamic dysfunction and cause amenorrhea.

1. Tumors, such as prolactinoma, craniopharyngioma, pineal tumor, thalamic tumor, third ventricle tumor, etc.;

2. Inflammation, such as acute meningitis and chronic granulomatous lesions - tuberculous meningitis;

3. Vascular damage, such as hemorrhage, infarction, ischemia, capillary hyperplasia and fat embolism;

4. Others, such as trauma, degeneration, porphyria, Wernicke syndrome, sarcoidosis, xanthomas and histiocytic diseases, etc.

Chronic wasting disease

Malnutrition caused by chronic liver and kidney diseases, tuberculosis, severe anemia and gastrointestinal disorders can affect the function of the anterior pituitary and the sensitivity of the endometrium to sex hormones through the hypothalamus. Nutritional deficiencies can also affect the synthesis and secretion of gonadotropins by the anterior pituitary, leading to amenorrhea.

Amenorrhea and lactation syndrome

Due to the decrease in the secretion of hypothalamic prolactin release inhibitory factor, the secretion of pituitary prolactin increases, resulting in lactation. Because prolactin can competitively inhibit the ovarian gonadotropin receptor, it leads to amenorrhea and forms the amenorrhea-galactorrhea syndrome.

Obesity reproductive dystrophy

Due to the lesions of the hypothalamus and its surrounding tissues, the neurohumoral connection between the hypothalamus and the pituitary gland is abnormal, resulting in obesity, amenorrhea, incomplete development of reproductive organs and secondary sexual characteristics, diabetes insipidus, and incomplete or reduced intellectual development.

Other endocrine diseases

For example, hypothyroidism or hyperthyroidism, adrenocortical hypofunction or hyperfunction, and diabetes can all affect the secretion of pituitary gonadotropin through the hypothalamus and cause amenorrhea. In adrenal hyperplasia syndrome, increased androgen causes amenorrhea.