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To delineate the parameters which may predispose to postpill amenorrhea (PPA) of 6 months or more duration, a 3-year prospective study of 326 16-38 year old (mean, 20.3 years) nulliparous women was done at Brown University. Follow-up was obtained on 311 cases. 98% of these patients had not been amenorrheic for longer than 60 days during t he year prior to using oral contraceptives. Previous irregular menses w as not a predisposing factor to PPA. 89% began menstruating within 60 days after stopping oral contraceptives and only 11 took 120-179 days to menstruate; 7 took 180 days or longer. All of the 311 patients eventual ly menstruated spontaneously. The longest period of amenorrhea was 540 days. The incidence of PPA was 2.2% (p less than .001). The number of months any patient was on the pill continuously before stopping therapy showed no correlation with the time of onset of first menses. Of the 7 patients with PPA, 3 had their menarche at age 16 years, none older. There were only a total of 12 patients with menarche as late as 16 years. The less the number of years between menarche and the beginning or oral contraceptives, the longer it took these patients to menstruate.
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PMID:Amenorrhea following oral contraception. 124 51

New methods of ovulation detection were discused at a meeting of Family Health International researchers and other world experts in ovulation detection North Carolina in December, 1984. During the 1970s radioimmunoassay techniques revealed that hormonal surges occur at midcycle, and as a result of this discovery, a number of techniques for assessing hormone levels in blood, urine, saliva, and breast milk were developed, or in some cases, are in the process of being developed. Although radioimmunoassays of hormonal levels can be used to detect ovulation, these techniques are not generally used. They are expensive, require extensive laboratory facilities and skilled personnel, and contribute to the growing problem of radioactive waste disposal. The recently developed enzyme-linked-antibody methods, rather than radioimmunoassay techniques, are now widely used to determine hormonal blood serum levels. These methods overcome many of the disadvantages associated with the radioimmunoassays. Another, even simpler, technique for assessing serum prolactin levels was recently developed. Blood samples for the test are collected by patients themselves using a finger prick technique. The test provides a method for predicting the return of fertility during lactational amenorrhea. Dr. James Brown reported on the efforts currently underway in Australia to develop a self-testing kit for assessing the level og gonadotropins and steroid hormone metabolites in urine. Dr. Diana Riad-Fahmy of Wales discussed the development of techniques to determine the level of hormones in saliva. These techniques require sensitive measuring procedures since the concentrations of hormones in saliva are very low. A simple assay to determine the level of progesterone in saliva was developed, but an assay to determine levels of estradiol has not, as yet, been established. Dr. Peter Hartmann of Australia discussed the potential use of breast milk to detect ovulation. It is known that glucose and sodium levels vary at different times during the menstrual cycle. Variations in these substance may eventually be used to identify or predict ovulation. Future research discussed by the participants included 1) a Family Health International study to determine the success rate of ovulation detection for wwomen using natural family planning techniques by comparing their evaluations with those derived from ultrasound and other techniques, and 2) several studies to identify mucus patterns during lactation and during the postpartum period.
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PMID:Experts meet to discuss predictors of ovulation. 1226 47

Demographic, psychopathological and hormonal parameters of 22 women with previous anorexia nervosa (AN) presently recovered, in a state of stabilized nutritional normalization for 3 months to 2 years but with persistent amenorrhoea, and of 20 psychophysically healthy age- and sex-matched normally menstruating controls were studied. Body mass index (BMI) values did not differ in patients and controls. Psychological examination, monitored by Eating Disorder Inventory 1, Bulimic Investigation Test Edinburgh, Yale-Brown-Cornell Eating Disorder Scale, and Tridimensional Personality Questionnaire rating scales, showed the persistence of some of the psychopathological symptoms of AN. Hormonal examinations included basal plasma concentrations of follicle stimulating hormone, luteotropic hormone, estrogens (E), progesterone, thyrotropic hormone, FT(3), FT(4) (immunoradiometric assays), leptin (LEP) (enzymatic-linked-immunosorbent assay) and 24 h urinary free cortisol (immunoradiometric assay). Hormone values were the same in patients and controls, except for E and LEP levels, which were significantly lower in patients than in controls. The concentrations of the two hormones were not correlated with the BMI of the patients, but LEP values were correlated negatively with the difference between the present BMI and the preanorexic one. The values of both hormones correlated negatively with some of the psychopathological aspects typical of AN, in particular with high 'body dissatisfaction', 'ineffectiveness', and 'interpersonal distrust' and with low 'interoceptive awareness'.
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PMID:Persistent amenorrhoea in weight-recovered anorexics: psychological and biological aspects. 1283 19