Reversing Infertility Caused By Hypothalamic Amenorrhea

The Scoop

Women with extremely low body fat, including runners and professional dancers, as well as women with eating disorders, are at risk for having their menstrual periods cease, a trigger for infertility and a cascade of other health issues, including osteoporosis.

But now there’s hope for reversing this condition, known as hypothalamic amenorrhea (HA), thanks to research that pinpoints a certain hormone that seems to be the linch pin for female fertility. Curiously enough, the hormone is leptin, one of the body’s “hunger hormones” that signals the brain when you have had enough to eat (leptin is sometimes called the “satiety hormone”).

As explained in a another study, leptin levels reflect the amount of energy stored in fat cells; low levels of leptin mean not much energy is being stored—it’s being used by the body to fuel athletic pursuits or simply survive, in the case of some women with anorexia. When the body senses this “famine,” researchers believe it shifts away from reproductive hormone production as it focuses on fueling the bottom line basics of life, including feeding the brain and muscles.

“We had known that organisms respond to famine [lack of food availability] by directing their energy into survival and away from reproduction ... we demonstrated that diminishing leptin levels caused by starvation had a critical role in regulating hormonal responses to food deprivation,” explains the study’s senior author Dr. Christos Mantzoros, director of the Human Nutrition Unit at Beth Israel Deaconess Medical Center and Professor of Medicine at Harvard Medical School.

Researchers now believe the solution for stopped menstruation and skipped ovulation among some women who suffer from HA may come in the form of taking a synthetic leptin supplement. Researchers administered leptin to 10 women between the ages of 18 and 35 who had developed HA.

“These are young, mostly college-age women, mainly runners. They watch their diets, they are slim and appear healthy. But they have abnormal hormone levels, they have ceased menstruating and stopped ovulating and they also have low bone density measures,” says Dr. Mantzoros.

Within just a month of treatment with leptin, “Seventy percent of the women began to menstruate and of these women, over half were found to be ovulating,” says Dr. Mantzoros.

Your Health

Is low leptin at the root of your fertility problems? If you suspect, or have been diagnosed with hypothalamic amenorrhea, talk to your doctor about your options. For female athletes, restarting normal reproductive hormone production may be as simple as taking training down a notch for a few months before trying to conceive—no special hormone treatments necessary.

If your HA is the result of an eating disorder, however, be aware that addressing your body image and eating patterns first, before any kind of hormone treatment is considered, is critical for your health and the health of your baby-to-be. Don’t leave out this important piece of information when talking to your doctor about conception and fertility issues.