In patients with hypothalamic amenorrhea, there are alterations of hormones and other factors that affect the secretion of gonadotropin-releasing hormone (GnRH), including :
# low levels of leptin and
# high levels of both ghrelin and neuropeptide Y (NPY).
β-endorphin, corticotropin-releasing hormone (CRH), dopamine, and γ-aminobutyric acid (GABA) are factors that negatively influence GnRH secretion. Some of these factors may also serve as hunger signals from the peripheral to the central nervous system and as links between nutrition and reproduction.
Hallmark findings in adolescents and young women with hypothalamic amenorrhea include overactivity of the hypothalamic–pituitary–adrenal axis, suppression of the hypothalamic–pituitary–ovarian axis, and alterations in thyroid hormone regulation. FSH denotes follicle-stimulating hormone, LH luteinizing hormone, TSH thyrotropin, and T3 triiodothyronine.
