Hypogonadotropic hypogonadism is a condition where the brain’s pituitary gland doesn’t produce enough of the hormones FSH (follicle-stimulating hormone) and LH (luteinizing hormone). These hormones are essential for triggering ovulation, the process where a mature egg is released each month. In this condition, the ovaries themselves are healthy and contain a normal number of eggs, but they don’t receive the necessary hormonal signals to ovulate regularly.  

This condition can be congenital (present from birth), often linked to delayed puberty, or acquired due to factors like benign or malignant brain tumors or their treatments. Some cases are linked to genetic conditions.  

Lifestyle factors can also play a role. Severe calorie restriction, very low body fat, or excessive physical activity can disrupt the brain’s hormone production, leading to what’s called hypothalamic amenorrhea—a type of ovulation disorder caused by the body’s stress response to energy imbalance.  

Diagnosis  

A doctor will suspect hypogonadotropic hypogonadism if a woman has absent or irregular periods. The diagnosis is confirmed through hormone tests, measuring FSH, LH, and estradiol levels. Unlike other causes of ovulation issues, ovarian reserve markers (like AMH levels or antral follicle count) are typically normal or only slightly reduced.  

Understanding the cause of missing periods is key to finding the right treatment, whether it’s lifestyle adjustments or hormone therapy. If you’re experiencing irregular cycles, it’s always best to check in with a healthcare provider to get to the root of the issue.