Amenorrhea medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
Treatment varies depending upon the underlying condition. For those who do not plan to have biological children, treatment may be unnecessary if the underlying cause of the amenorrhoea is not threatening to the patient's health.
Lifestyle Changes
The best way to treat 'athletic' amenorrhoea is to decrease the amount and intensity of exercise. Weight gain may be helpful as well. To prevent osteoporosis, consider oral contraceptives. Pulsatile gonadotropin-releasing hormone (GnRH) or exogenous gonadotropins may be necessary.
Pharmacotherapy
Hormone replacement therapy should be considered for ovarian failure. Unless receiving eggs from an egg donor or invetro fertilization, a woman is unable to conceive while she is amenorrhoeic. On the other hand, 'athletic' and drug-induced amenorrhoea has no effect on long term fertility as long as menstruation can recommence. Similarly, to treat drug-induced amenorrhea, stopping the medication on the advice of a doctor is the usual course of action.
In polycystic ovarian disease the following may be helpful:
- To decrease peripheral estrogen, reduce weight
- To decrease ovarian androgen secretion, consider oral contraceptives
- Clomiphene enhances fertility
- Endometrial hyperplasia is prevented by cyclic progesterone
Psychological Counseling
Psychological counseling may be helpful if there is the presence of a Y chromosome or absent mullerian organs.