5 papers reviewed
Functional Hypothalamic Amenorrhea & Energy Availability
2017 · guideline · 1 of 5
Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline
Gordon CM et al. · Journal of Clinical Endocrinology & Metabolism
Definitive guideline for a condition the app currently has no pathway for. FHA is chronic anovulation from energy deficit, stress or excessive exercise, and is a diagnosis of exclusion. First-line treatment is correcting the energy imbalance — increased intake, improved nutrition, reduced training load — with a multidisciplinary team. If 6-12 months of lifestyle correction fails, transdermal estrogen with cyclic progesterone is recommended. Critically, this is the opposite management to PCOS, and the two are easily confused.
Read the paper ↗2023 · review · 2 of 5
Functional Hypothalamic Amenorrhea: Recognition and Management of a Challenging Diagnosis
— · Mayo Clinic Proceedings
Practical recognition guidance. FHA is frequently missed or misdiagnosed as PCOS, which leads to exactly the wrong advice — further caloric restriction and more exercise in someone already in energy deficit.
Read the paper ↗2024 · review · 3 of 5
Dietary and Lifestyle Management of Functional Hypothalamic Amenorrhea: A Comprehensive Review
— · Nutrients / PMC
An energy availability threshold of approximately 30 kcal/kg fat-free mass per day is recommended to prevent and reverse FHA — a concrete, trackable target rather than a vague instruction to eat more.
Read the paper ↗2025 · systematic review · 4 of 5
Functional hypothalamic amenorrhea and dietary intervention: a systematic review to guide further research in amenorrheic women without overt eating disorder
— · Clinical Nutrition
Focuses on women without diagnosed eating disorders — the group most likely to be using a cycle-tracking app and least likely to be identified clinically.
Read the paper ↗2022 · review · 5 of 5
Functional hypothalamic amenorrhea: impact on bone and neuropsychiatric outcomes
— · Frontiers in Endocrinology / PMC
Consequences extend well beyond fertility: bone density loss and neuropsychiatric effects accrue during amenorrhea, which raises the urgency of recognizing it early rather than waiting until conception is desired.
Read the paper ↗A paper's presence documents the evidence reviewed; it does not mean Filia endorses every intervention or conclusion.