Q: What is Hypothalamic Pituitary Failure?

A: Hypothalamic Pituitary Failure could have many causes:

• Certain Medications (for example, phenothiazines, opiates)
• Extreme weight loss
• Extreme stress
• Extreme exercise
• Chronic or severe illness
• A pituitary or hypothalamic tumor

The next step in the evaluation is to do a blood prolactin level and an MRI of the pituitary. If it's normal and the imaging studies are normal then you have 'hypothalamic amenorrhea of uncertain etiology' (unknown cause). If the amenorrhea and lack of withdrawal bleeding persists, prolactin levels should be measured annually since a small microadenoma (tumor) could be present that is escaping laboratory and radiographic detection.