What is the Origin of Term 20?

The term is central to reproductive endocrinology, recognizing the profound impact of energy balance and stress on the central reproductive axis. It falls under the broader category of functional hypothalamic amenorrhea (FHA), differentiating it from organic causes. The understanding that the reproductive system is a barometer of overall health and energy status is a key clinical takeaway.

What is the Mechanism of Term 20?

Energetic stress, such as chronic caloric deficit or excessive energy expenditure, signals to the hypothalamus via metabolic hormones like leptin and ghrelin. This input suppresses the pulsatile secretion of GnRH, which is essential for stimulating the pituitary to release Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). Consequently, the ovaries are not adequately stimulated to produce estrogen and progesterone, leading to an anovulatory state and the absence of a menstrual period.

Term 20 ∞ Area

Term 20

Meaning

Hypothalamic Amenorrhea (HA) is a clinical condition characterized by the cessation of menstruation (amenorrhea) resulting from the suppression of the hypothalamic-pituitary-gonadal (HPG) axis due to energetic stress. This suppression is often triggered by a combination of low energy availability, excessive exercise, and/or significant psychological stress, signaling to the brain that the environment is not conducive to reproduction. HA is a diagnosis of exclusion, representing a functional and reversible form of reproductive hormone deficiency where the core pathology lies in the pulsatile release of Gonadotropin-Releasing Hormone (GnRH) from the hypothalamus.