Hypothalamic Amenorrhea? | The Gillett Health podcast #32

On today's podcast Dr. Gillett and James O'Hara NP, Discuss Hypothalamic Amenorrhea.

00:00 Intro
00:37 Progestins
03:53 "Potential Treatments"
11:42 Estradiol/estrogen
14:23 Testosterone
16:50 What is Hypothalamic Amenorrhea
23:34 Recommendations from others
24:27 Diet Interventions
28:10 Psychological support?
31:39 Suggests against oral contraceptives?
36:39 Short-term use of E2?
40:22 Testosterone/lepton to improve bone density?
41:31 Thyroid hormones
42:08 Full fertility treatment
43:19 Clomid/Clomiphene Citrate
44:25 Kisspeptin and leptin for fertility
47:31 inducing ovulation with FHA only?
48:45 Sensitivity of the pituitary
55:05 outro

Studies/References:

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[ZennyYogi]

I am so excited to be a patient. Appreciate this special topic. We do Search Engine Optimization for websites and this topic is searched on Google on average 4, 400 times per month. Doesn’t sound niche to me. 😉What sounds niche is finding Drs/NPs like you.

[roni-sh]

Thank you! This was so helpful. I have HA and the doctor was going to put me on the mini pill… basically to “shed the lining and start over again”. After listening to this podcast I’m hesitant as we want to plan for a pregnancy soon… and going on the pill would go against all this 😢

[Aki-wqxh]

You said Progesterone will be counterindicative 😢 but if I don’t do HRT my bone, brain, heart etc will continue to suffer 😢

I have tried to ‘jump start’ the pituitary many times and failed, so I am resorting to HRT. It has been ten years!

I wish I can consult with you as no practitioners in my area know about HA. They only want to treat me like a normal post-menstrual woman

[Aki-wqxh]

I am totally subscribing to your channel after watching!!!! Is it ok to ask a question? I would even pay for an answer at this point!

I lost my meses at the age of 20 and it never came back. I have not always been underweight though, even when I had a normal BMI in my 20s for some time, menses did not come back and Estradiol/ LT/ FSH remained low. But it is pretty surely Hypothalamus Amenohorrea

I regret not addressing this sooner and now aged 37 my osteoporosis is so bad that it is at about the level of an 80-year-old woman.

But what I really care about now is neuroprotection.

Here is my question, it is about that 'window of opportunity' theory: Some research indicates that HRT has "only negative effects" if started after the age of 65 or one-year post-menopause. Well, I have been 'menopausal' for 17 years! Research suggests that the risk of Alzheimer's actually increases rather than decreases in that case, which worries me a lot. I don't want to believe in the 'window' theory but I could really use some clarification.

[katri]

Wonderful podcast! (Check out the Strong Sistas video about Ashley's amenorrhea healing journey.)