Amenorrhea following oral contraception.

Abstract

In 21 patients with amenorrhea after taking oral contraceptives, the urinary excretion of estrogens and the plasma concentrations of LH, FSH and prolactin were determined. In five of these women the amenorrhea was accompanied by galactorrhea. Ten of the 21 patients had had origomenorrhea before contraceptive therapy. The progesterone test was negative in 9 patients and clomiphene test was negative in 10 patients. The urinary excretion of estrogens and plasma LH and FSH values were low normal while the prolactin concentration in group A (amenorrhea without galactorrhea) amounted to 12.8 +/- 2.4 micrograms/l of plasma and in group B (amenorrhea with galactorrhea) to 85.4 +/- 15.8 micrograms/l (p < 0.01). The pituitary response to 100 micrograms synthetic LH-RH i.m. was similar to that found in the early follicular phase of the ovulatory cycle and showed that the pituitary was capable of synthesizing and secreting LH and FSH. Two of the three women from group A who wanted to become pregnant conceived under the therapy with Clomid and HCG. In all women from group B, in response to Parlodel (bromocriptine) therapy administered in 5-mg dose daily, the plasma concentration of prolactin decreased to a normal level, galactorrhea ceased within 15-62 days, and menstruation resumed within 38-75 days. In three women it is very probable that the cycle became biphasic, and a previously clomiphene negative patient became a clomiphene responder.