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- W2280298087 abstract "The chain of investigations that leads to the cause of amenorrhea and the management of the various causes are discussed. 5 t ests are applicable to the diagnosis of secondary amenorrhea when a diagnosis which can be acted upon is wanted: 1) measurement of serum follicle stimulating hormone (FSH) 2) radiography of the pituitary fossa 3) measurement of serum prolactin 4) progestogen withdrawal test and 5) clomiphene stimulation. If the patient has a raised FSH level and is estrogen-deficient she has primary ovarian failure and needs estrogen replacement. Some patients have high FSH and luteinizing hormone levels but are not deficient in estrogen; their ovaries contain numerous follicles that fail to respond to high levels of gonadotropins. Radiography of the pituitary fossa is the next step if the FSH level is not raised. If the pituitary fossa is normal the serum prolactin level should be measured. It is unsafe for patients with a pituitary tumor to use the contraceptive pill. When the serum prolactin is found normal the next step is an exogenous progestogen test with medroxyprogesterone. Patients who respond to medroxyprogesterone often also respond to clomiphene therapy." @default.
- W2280298087 created "2016-06-24" @default.
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- W2280298087 date "1977-05-07" @default.
- W2280298087 modified "2023-09-23" @default.
- W2280298087 title "The investigation and management of amenorrhoea." @default.
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