Treatment of Amenorrhea

Hypothalamic Causes

■ Tumor removal

■ Stress relief

■ Exogenous pulsatile GnRH

Pituitary Causes

■ Tumor removal

■ Bromocriptine (dopamine agonist inhibits prolactin release)

■ Exogenous FSH/LH

Ovarian Causes

■ Ovarian failure—in vitro fertilization, oral contraceptives

■ PCOD—clomiphene (an antiestrogen)

Uterine Causes

■ Obstruction—surgery

HYPERPROLACTINEMIA

Elevated prolactin levels could be due to:

■ Hypothyroidism—check TSH level (hypothyroidism causes a rise in prolactin).

■ Central nervous system (CNS) tumors—perform head CT/MRI.

■ Dopamine antagonists

■ Methyldopa

■ Serotonin agonists

■ Spinal cord lesions—perform spinal CT/MRI.

Early menopause is idiopathic.

PCOD patients are usually obese and have hirsutism and insulin resistance. It is the most common cause of hirsutism.

PREMENSTRUAL SYNDROME (PMS)

PMS refers to a group of symptoms experienced during the luteal phase of the menstrual cycle. Symptoms are cyclic in nature with resolutions and exacerbations.

Symptoms may manifest as:

■ Somatic complaints: Headaches, bloating, breast tenderness

■ Emotional changes: Anxiety, depression, irritability

■ Behavior symptoms: Problems concentrating, food cravings, sleep changes

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