Impact of new diagnostic methods on the differential diagnosis and treatment of secondary amenorrhoea
Shearman, R.P.; Fraser, I.S.
Lancet 1(8023): 1195-1197
1977
ISSN/ISBN: 0140-6736 PMID: 68286 Document Number: 110617
The development of homologous prolactin assays, multiple pituitary stimulation, tomography and computerized axial tomography permitted more detailed investigation of patients with secondary amenorrhea than was formerly possible. Of 90 patients, 39% with secondary amenorrhea had hyperprolactinemia. Ten patients (11% of total) had pituitary tumors. Of these women, 8 had galactorrhea (27% of those with galactorrhea). For patients with hyperprolactinemia but no tumor, bromocriptine was the treatment of 1st choice rather than clomiphene or human gonadotropins. The best treatment for patients with detectable tumor was controversial, particularly when the tumor was confined to the sella turcica. Whether or not these tumors were true neoplasms remains to be determined. Clinically, a history of secondary amenorrhea with or without galactorrhea following withdrawal or oral contraceptives remains the most common presenting syndrome.