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Target Audience: Pediatric and adolescent health providers, gynecologists
Functional hypothalamic amenorrhea (FHA) is a form of chronic anovulation often associated with stress, weight loss, and/or excessive exercise. A task force was formed to develop evidence-based recommendations for diagnosis and treatment of FHA.
FHA is a diagnosis of exclusion. Evaluate for FHA if amenorrhea has lasted 3 months or the time between menses regularly exceeds 45 days.
Focus the history on medications, diet, any suggestions of an eating disorder, exercise history, weight fluctuations, sleep patterns, presence of stressors or mood disorders, prior fractures, substance abuse, and pr…