ABSTRACT
Of 106 consecutive women referred for secondary amenorrhea of more than 1 year's duration, 65 were diagnosed as having functional amenorrhea. Of these 65, 29 had amenorrhea directly following discontinuation of oral contraceptives (OC group) and 36 had never used oral contraceptives (NOC group). There was no difference in the incidence of prior menstrual irregularity in either group. Similarly, there was no difference in the resting serum estrone, estradiol, luteinizing hormone, follicle-stimulating hormone, and prolactin levels between the OC and NOC groups. Nor was there a difference between the OC and NOC groups in response to medroxyprogesterone acetate, clomiphene citrate, or luteinizing hormone-releasing factor. Of 106 patients, 17 were proven to have prolactinomas. Eight patients had a prior history of OC use, whereas nine did not. With the exception of elevated serum prolactin levels, there were no significant differences in biochemical tests or history of oral contraceptive use between the prolactinoma group and patients with prolonged "functional" amenorrhea (OC plus NOC groups). The lack of historical or biochemical difference between the OC and NOC subjects indicates homogeneity between groups, and does not support the existence of a "postpill" syndrome.
PIP: 65 of 106 consecutive women referred for secondary amenorrhea of more than 1 year's duration were diagnosed as having functional amenorrhea. 29 of the 65 women had amenorrhea directly following discontinuation of oral contraceptives (OC group) and 36 had never used OCs (NOC group). There was no difference in the incidence of prior menstrual irregularity in either group, and there was no difference in the resting serum estrone, estradiol, luteinizing hormone, follicle-stimulating hormone, and prolactin levels between the 2 groups. There was no difference between the groups in response to medroxyprogesterone acetate, clomiphene citrate, or luteinizing hormone-releasing factor. 17 of the 106 patients were proven to have prolactinomas; 8 of these had a prior history of OC use and 9 did not. Except for elevated serum prolactin levels, there was no significant differences in biochemical tests or history of OC use between the prolactinoma group and patients with prolonged "functional" amenorrhea (OC plus NOC groups). The lack of historical or biochemical difference between the OC and NOC subjects suggests homogeneity between groups and fails to support the existence of a "postpill" syndrome.
