Yaginuma T
Fertil Steril. 1979 Jul;32(1):36-9.
Thirty-two patients with stress amenorrhea of less than 1 years duration were found to have withdrawal bleeding after progestin administration, normal serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, and good responsiveness to LH-releasing hormone (LH-RH); ovulation was induced following the admininstration of clomiphene citrate. On the other hand, in 11 of 14 patients with stress amenorrhea of longer than 1 years duration, no bleeding followed the administration of progestin, and there were noted high serum FSH and LH levels, exaggerated release responsiveness to LH-RH, and atrophic vaginal smears and endometrium. In addition, it was difficult to induce ovulation by various treatments. The findings suggest that dysfunction in the hypothalamic cyclic (not tonic) center regulating ovulation was the originating factor in the amenorrhea in question and that ovulation should be induced at least once yearly to prevent ovarian function from declining in this type of anovulatory state existing for more than 1 year.
32例病程不足1年的应激性闭经患者在给予孕激素后出现撤药性出血，血清卵泡刺激素（FSH）和黄体生成素（LH）水平正常，对促黄体生成素释放激素（LH-RH）反应良好；给予枸橼酸氯米芬后可诱导排卵。另一方面，在14例病程超过1年的应激性闭经患者中，有11例在给予孕激素后无出血，血清FSH和LH水平升高，对LH-RH释放反应过度，阴道涂片和子宫内膜萎缩。此外，通过各种治疗诱导排卵困难。这些发现表明，调节排卵的下丘脑周期性（而非紧张性）中枢功能障碍是所讨论闭经的起始因素，对于这种持续超过1年的无排卵状态，应至少每年诱导排卵一次以防止卵巢功能下降。
