Abstract

PIP: This study attempted to identify factors related to development of postpill amenorrhea in 32 women who underwent diagnostic tests after 6-24 months of amenorrhea. Patients were aged 18-40, with a mean of 25 years. 27 had never been pregnant, 4 were primiparas, and 1 was a grand multipara. The physical examination was normal in most cases, but 7 were found to suffer from galactorrhea and 3 from abnormal hairiness. 28 had used a combined pill, 1 each had used sequential and biphasic pills, and 2 did not know what type they had taken. There was no apparent relationship between the duration of pill use and the duration of amenorrhea. 26 patients, or 53%, had had a late menarche (16 years or later) and irregular cycles before beginning pill use. 9, or 28%, had had irregular cycles but normal menarche and 2, or 6%, had had late menarche but normal cycles. Postpill amenorrhea is difficult to distinguish from spontaneous amenorrhea and its etiology is still unknown, although in general it may be due to the effects of combined pills on the hypothalamus. The rate of spontaneous remission is high; 12 of the 32 spontaneously resumed menstruating after 6-12 months. All of the 18 patients with different characteristics who were treated with either clomid, dexamethasone, and thyroid extract, or bromocriptin resumed menstruation and 10, or 55%, subsequently became pregnant.