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2015 ; 100
(3
): 812-24
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Neuroendocrine causes of amenorrhea--an update
#MMPMID25581597
Fourman LT
; Fazeli PK
J Clin Endocrinol Metab
2015[Mar]; 100
(3
): 812-24
PMID25581597
show ga
CONTEXT: Secondary amenorrhea--the absence of menses for three consecutive
cycles--affects approximately 3-4% of reproductive age women, and
infertility--the failure to conceive after 12 months of regular
intercourse--affects approximately 6-10%. Neuroendocrine causes of amenorrhea and
infertility, including functional hypothalamic amenorrhea and hyperprolactinemia,
constitute a majority of these cases. OBJECTIVE: In this review, we discuss the
physiologic, pathologic, and iatrogenic causes of amenorrhea and infertility
arising from perturbations in the hypothalamic-pituitary-adrenal axis, including
potential genetic causes. We focus extensively on the hormonal mechanisms
involved in disrupting the hypothalamic-pituitary-ovarian axis. CONCLUSIONS: A
thorough understanding of the neuroendocrine causes of amenorrhea and infertility
is critical for properly assessing patients presenting with these complaints.
Prompt evaluation and treatment are essential to prevent loss of bone mass due to
hypoestrogenemia and/or to achieve the time-sensitive treatment goal of
conception.
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