Petrucco O M
Drugs. 1986 Jun;31(6):550-7. doi: 10.2165/00003495-198631060-00005.
The advent of radioimmunoassays enabling measurement of pituitary gonadotrophins, ovarian and adrenal steroids and prolactin has allowed precise investigation of patients with secondary amenorrhoea. The most frequently encountered causes of this disorder are associated with hypothalamic-pituitary failure or dysfunction. Clinical and radiographic investigations must be utilised to look for the presence of a pituitary fossa space occupying lesions, particularly when hyperprolactinaemia is found. The presence of hirsutism should alert to the possibility of an adrenal or ovarian tumour or more commonly the presence of the polycystic ovary syndrome. When fertility is required, recommencement of menstrual cycles will often be possible with ovulation-inducing drugs. Patients not wishing to be fertile will often require oestrogen therapy while amenorrhoea persists, as low endogenous oestrogen levels may otherwise lead to menopausal degenerative changes.
放射免疫测定法的出现使得能够测量垂体促性腺激素、卵巢和肾上腺类固醇以及催乳素，从而可以对继发性闭经患者进行精确的调查。这种疾病最常见的病因与下丘脑 - 垂体功能衰竭或功能障碍有关。必须利用临床和影像学检查来寻找垂体窝占位性病变的存在，尤其是在发现高催乳素血症时。多毛症的出现应警惕肾上腺或卵巢肿瘤的可能性，或者更常见的是多囊卵巢综合征的存在。当需要生育能力时，使用促排卵药物通常可以重新开始月经周期。不希望生育的患者在闭经持续期间通常需要雌激素治疗，因为否则低内源性雌激素水平可能会导致绝经后退行性变化。
