Endocrine profiles and neuropsychologic correlates of functional hypothalamic amenorrhea in adolescents

Fertil Steril. 2007 Apr;87(4):876-85. doi: 10.1016/j.fertnstert.2006.09.011. Epub 2007 Jan 31.


Objective: To determine trigger factors and neuropsychologic correlates of functional hypothalamic amenorrhea (FHA) in adolescence and to evaluate the correlations with the endocrine-metabolic profile.

Design: Cross-sectional comparison of adolescents with FHA and eumenorrheic controls

Setting: Academic medical institution

Patient(s): Twenty adolescent girls with FHA (aged <18 years) and 20 normal cycling girls

Intervention(s): All subjects underwent endocrine-gynecologic (hormone) and neuropsychiatric (tests and interview) investigations. A separate semistructured interview was also used to investigate parents.

Main outcome measure(s): Gonadotropins, leptin, prolactin, androgens, estrogens, cortisol, carrier proteins (SHBG, insulin-like growth factor-binding protein 1), and metabolic parameters (insulin, insulin-like growth factor 1, thyroid hormones) were assayed in FHA and control subjects. All girls were evaluated using a test for depression, a test for disordered eating, and a psychodynamic semistructured interview.

Result(s): Adolescents with FHA showed a particular susceptibility to common life events, restrictive disordered eating, depressive traits, and psychosomatic disorders. The endocrine-metabolic profile was strictly correlated to the severity of the psychopathology.

Conclusion(s): Functional hypothalamic amenorrhea in adolescence is due to a particular neuropsychologic vulnerability to stress, probably related to familial relationship styles, expressed by a proportional endocrine impairment.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Amenorrhea / etiology
  • Amenorrhea / metabolism
  • Amenorrhea / psychology*
  • Anxiety / metabolism
  • Body Mass Index
  • Cross-Sectional Studies
  • Depression / metabolism
  • Feeding and Eating Disorders / metabolism
  • Female
  • Gonadal Steroid Hormones / blood
  • Gonadotropins / blood
  • Hormones / blood*
  • Humans
  • Hydrocortisone / blood
  • Hypothalamic Diseases / etiology
  • Hypothalamic Diseases / metabolism
  • Hypothalamic Diseases / psychology*
  • Insulin-Like Growth Factor Binding Protein 1 / blood
  • Leptin / blood
  • Psychophysiologic Disorders / metabolism
  • Sex Hormone-Binding Globulin / analysis
  • Stress, Psychological / metabolism


  • Gonadal Steroid Hormones
  • Gonadotropins
  • Hormones
  • IGFBP1 protein, human
  • Insulin-Like Growth Factor Binding Protein 1
  • Leptin
  • Sex Hormone-Binding Globulin
  • Hydrocortisone