Abstract

The effect of megestrol acetate mestranol and a combination of these on the development of ovarian follicles in 16 patients was studied. After 1 cycle of treatment with megestrol acetate 6 patients had macroscopically normal ovaries; follicular development seemed normal and there were 3 fresh corpora lutea. Mestranol alone for 1 cycle in 3 women also showed macroscopically normal ovaries with normal follicles and 1 fresh corpus luteum. 8 patients were treated with megestrol acetate and mestranol. There were no fresh corpora lutea in any cycles. After treatment with the combined hormones for 3 cycles (1 patient) and 6 cycles (1 patient) there were no visible follicles and the ovaries were smooth and inactive. Follicular development had stopped at the secondary follicle stage and the tunica albuginea was definitely thickened. These changes are likely to be reversible. The few women who develop secondary amenorrhea may have a marked follicular fibrosis which fails to regress upon cessation of therapy.

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