What are the symptoms of hypothalamic amenorrhea?

Hypothalamic amenorrhea is the most common type of amenorrhea. It is caused by hypothalamic dysfunction affecting the pituitary gland, which in turn affects the ovaries. Its causes are complex and can be divided into the following types:

(1) Mental stress: Clinically, it is common for patients with regular menstruation to develop amenorrhea after sudden or long-term mental depression, tension, anxiety, or environmental changes.

(2) Weight loss and anorexia nervosa: Clinical manifestations include extreme anorexia, severe emaciation, amenorrhea, dry skin, withdrawn personality, few words, and extremely difficult to cooperate. This is more common in women who have intense internal emotional conflicts or who are forced to diet to maintain their body shape. Most mild patients can resume menstruation with proper treatment. If there is severe malnutrition, parenteral nutrition is required to prevent death.

(3) Exercise-induced amenorrhea: This is more common in people who do long-term strenuous exercise or train in ballet or modern dance. It is characterized by infrequent menstruation and secondary amenorrhea. Exercise-induced amenorrhea does not necessarily lead to weight loss. When the amount of exercise is reduced, menstruation may resume.

(4) Drug-induced amenorrhea: After long-term use of certain drugs, common drugs that cause secondary amenorrhea include perphenazine, chlorpyrifos, reserpine, cottonpol tablets, tripterygium wilfordii, etc. Young patients have strong reproductive functions and can resume menstruation 3-5 months after stopping the drug. For patients over 40 years old and approaching the menopausal transition period, it is difficult to resume menstruation after stopping the drug.

(5) Craniopharyngioma: The enlarged tumor compresses the hypothalamus and pituitary stalk, causing amenorrhea. The clinical manifestations include secondary amenorrhea, genital atrophy, obesity, increased intracranial pressure, visual impairment, etc.