A 25-year-old woman was seen for the complaint of secondary amenorrhea. Skull roentgenograms revealed a markedly enlarged sella turcica. Studies of pituitary and hypothalamic function including prolactin were normal. A pneumoencephalogram revealed dilated ventricles and a mass in the septum pellucidum and hypothalamus. Partial removal of this hypothalamic astrocytoma and placement of an interventricular shunt resulted in the return of menses. Recurrent obstruction a few months later resulted in headache, disorientation, and amenorrhea. A shunt was placed again, resulting in clearing of symptoms and a reestablishment of normal menstrual cyclicity. It appears that the occurrence of increased intracranial pressure rather than the hypothalamic tumor caused the amenorrhea.