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Query: UMLS:C0003128 (anovulation)
 1,718 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The protocol of investigation of seconday amenorrhea, based on a functional classification of the endocrine causes of anovulation is described. The investigation takes 6 weeks to complete. A blood sample is taken for the measurement of basal serum gonadotropins, prolactin, thyroxine, and free thyroxine index. X-rays are taken of the pituitary region. Serum estradiol level and the response to a combined injection of thyrotropin-releasing hormone and gonadotropin-releasing hormone can also be measured. Medroxyprogesterone acetate is given, 5 mg for 5 days, followed 1 week later by a 5-day course of clomiphene. The response to clomiphene is evaluated. The patient returns 6 weeks later and may undergo further investigations (pituitary tomography, intramuscular progesterone, and insulin hypoglycemia). Preliminary analysis of the results in 75 cases of amenorrhea who have all completed the above protocol reveals the commonest disorder to be a defect of negative feedback control of gonadotropin secretion (30%). 22% suffered from defects of cycle initiation. 22% had hyperprolactinemia. Ovarian failure accounted for 15% of the cases, but hypogonadotrophic hypogonadism was rare. A brief analysis of cost-effectiveness of this program is discussed.
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PMID:Therapy-orientated diagnosis of secondary amenorrhoea. 77 6