Psychological correlates of functional hypothalamic amenorrhea

Objective: To determine whether mood, attitudes, or symptoms of disordered eating discriminated women with functional hypothalamic amenorrhea (FHA) fr om those with organic causes of amenorrhea and eumenorrhea. Design: Cross-sectional comparison of women with FHA, women with organic am enorrhea, and eumenorrheic control women. Setting: Clinical research center in an academic medical institution. Patient(s): Seventy-seven women greater than or equal to 18 years old with time since menarche greater than or equal to5 and less than or equal to 25 years were recruited by advertisement. Intervention(s): Ovulation was confirmed in eumenorrheic control women. Cau ses of anovulation were carefully documented in amenorrheic participants an d LH pulse profiles were obtained to document the diagnosis of FHA. All par ticipants were interviewed and completed questionnaires. Main Outcome Measure(s): Self-report measures of dysfunctional attitudes, c oping styles, and symptoms of depression and eating disorders. Result(s): Women with FHA reported more depressive symptoms and dysfunction al attitudes than did eumenorrheic women, but not significantly more than w omen with organic amenorrhea. However, women with FHA reported significantl y more symptoms of disordered eating than did either anovulatory or ovulato ry women. Conclusion(s): The findings are consistent with the hypothesis that FHA is precipitated by a combination of psychosocial stressors and metabolic chall enge. (C) 2001 by American Society for Reproductive Medicine.