The diagnosis and treatment of amenorrhea present a challenging problem. The amenorrhea must first be classified as primary or secondary, and menopause, pregnancy, and lactation must be excluded. The next step is to determine whether the disorder originates in one of the following areas: the hypothalamus and central nervous system, the anterior pituitary, the ovary, and/or the reproductive tract.
Several treatments can alleviate infertility problems,- for example, some success has been achieved in hypothalamic disease with pulsatile administration of GnRH. When hy-pogonadotropism is the cause of infertility, sequential administration of FSH and hCG is a common treatment for inducing ovulation, although the risk of ovarian hyperstimulation and multiple ovulations is increased. Hyperpro-lactinemia can be treated surgically by removing the pituitary adenoma containing numerous lactotrophs (prolactin-secreting cells). It can also be treated pharmacologically with bromocriptine, a dopaminergic agonist that reduces the size and number of the lactotrophs and PRL secretion. Treatment with clomiphene, an antiestrogen that binds to and blocks estrogen receptors, can induce ovulation in women with endogenous estrogens in the normal range. Clomiphene reduces the negative feedback effects of estrogen and thus increases endogenous FSH and LH secretion. When reproductive tract lesions are the cause of infertility, corrective surgery or in vitro fertilization is the treatment of choice.
Was this article helpful?
Prior to planning pregnancy, you should learn more about the things involved in getting pregnant. It involves carrying a baby inside you for nine months, caring for a child for a number of years, and many more. Consider these things, so that you can properly assess if you are ready for pregnancy. Get all these very important tips about pregnancy that you need to know.