Abstract

Summary A case of long-standing secondary amenorrhea was studied psychiatrically at the same time that the urinary, estrogen, and gonadotrophin levels were measured. This case was used to illustrate distortion of the normal attitudes toward menarche and menstruation, and the change in emotional responses and adaptive functioning during two phases of increased estrogen urinary output. The question was raised as to whether the therapeutic relationship and the changes in the patient's adaptive functioning may not have influenced the rise in hormonal levels. Conversely, the hormonal rise occurring spontaneously may in turn have affected the emotional balance of the patient. It is felt that it may be dangerous to some patients' ego integration to use hormone therapy or psychiatric therapy without exercising great caution.

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