In hypothalamic amenorrhea, which hormone level is typically normal?

In hypothalamic amenorrhea, which hormone level is typically normal?

• A. Prolactin
• B. FSH
• C. LH
• D. Estradiol

Answer: (A)

Hypothalamic amenorrhea stems from reduced GnRH pulsatility due to stress, caloric restriction, or other hypothalamic disruption. When GnRH release drops, the pituitary makes less FSH and LH, so ovarian estradiol falls and regular menses stop. Prolactin stays normal because this scenario doesn’t involve elevated prolactin production; high prolactin would suppress GnRH and cause similar menstrual issues for a different reason (hyperprolactinemia). So the hormone level that remains typically normal in this condition is prolactin, helping distinguish it from causes like prolactin-secreting tumors where prolactin would be elevated.

Hypothalamic amenorrhea stems from reduced GnRH pulsatility due to stress, caloric restriction, or other hypothalamic disruption. When GnRH release drops, the pituitary makes less FSH and LH, so ovarian estradiol falls and regular menses stop. Prolactin stays normal because this scenario doesn’t involve elevated prolactin production; high prolactin would suppress GnRH and cause similar menstrual issues for a different reason (hyperprolactinemia). So the hormone level that remains typically normal in this condition is prolactin, helping distinguish it from causes like prolactin-secreting tumors where prolactin would be elevated.