Abstract
ObjectiveHypothalamic ovarian failure can be considered as a differential diagnosis in women suffering from CAH and amenorrhea. Naltrexone can be used as a tool to exclude hyperandrogenemia as a cause of amenorrhea in that condition. Study designFive women (ages between 16 and 30 years) with congenital adrenal hyperplasia (CAH) due to C21- hydroxylase deficiency and primary or secondary amenorrhoea were treated with the opiate antagonist naltrexone at a dose of 50mg per day. ResultIn all patients naltrexone induced normalization of menstrual cycle determined by endocrine parameters and ultrasonography. ConclusionSince naltrexone has been shown to restore normal menstrual cycles in hypothalamic amenorrhea it can be inferred that the cause of amenorrhea in those patients was not of hyperandrogenemic but of hypothalamic origin. Naltrexone may therefore be used to differentiate between hyperandrogenemic and hypothalamic ovarian failure in patients suffering from CAH.
Published Version
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