Hypothalamic-pituitary dysfunction

Hypothalamic-pituitary dysfunction is a term to describe a nonorganic relative inactivity of the gonadotropin-releasing hormone (GnRH) system of the hypothalamus and its dependent pituitary gonadotrophs that normally produce follicle stimulating hormone, FSH, and luteinizing hormone, LH. The condition occurs during the reproductive years and leads to hypogonadotropic hypogonadism. Women will experience primary or secondary amenorrhea and men lack of sexual interest and impotence.

The immediate cause is a decrease or lack of GnRH pulses. This may occur idiopathic, or as a result of stress or lack of caloric support. Eating disorders may lead to hypothalamic-pituitary dysfunction. Measurements of FSH and/or LH tend to show low or undetectable values, and sex hormones produced by the gonads show low levels as well. Hyperprolactinemia as well as a number of lesions in the hypothalamic or pituitary area may also lead to hypogonadotropic hypogonadism and need to be excluded before the diagnosis of hypothalamic-pituitary dysfunction can be made.

Treatment may need to address issues of hypogonadism, infertility, and osteoporosis.