This proposal is a competing renewal in response to PA-91-100, Special Issues Women's Mental Health Over the Life Cycle. FHA is the most common form of anovulation and data obtained through current investigation implicate dysfunctional attitudes, psychosocial stress and associated behaviors in the genesis of hypothalamic secretory alterations characteristic of FHA. We hypothesize that cognitive behavior therapy (CBT) aimed at improving attitudes and correcting problematic behaviors will reverse FHA and restore ovulation. However, as not all women will respond to CBT, we propose to continue defining the neurobiological mechanism underlying the synergism between psychogenic and metabolic stress with the goal of identifying pharmacologic interventions.
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