EMOTIONAL SETTINGS OF FUNCTIONAL AMENORRHEA

Secondary amenorrhea: two kinds of psychogenic disorder--a case report

A brief review of the limited sources in the literature on secondary amenorrhea indicates that this symptom may, in many cases, be psychogenic in origin. The disorder in such instances is often short term, spontaneously reversible, and occurs as a reaction to stress or a traumatic event. Most of these women are basically healthy, psychologically speaking. In some cases, however, this menstrual disturbance may continue for months or longer. In such instances, one may expect to find a neurotic conflict related to feminine identity as the cause. The therapeutic approach in these two alternative forms of secondary psychogenic amenorrhea (SPA) will differ; hence, it is essential that the gynecologist and psychiatrist distinguish between them. A case illustration is presented, describing in detail the treatment of a women with longstanding SPA which resolved with dynamically-oriented psychotherapy.

Pituitary function in young women in a reformatory institution

Pituitary function was assessed by measuring serum prolactin thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH) and luteinizing hormone (LH) before and after LH releasing hormone (LH-RH) (100 mg intravenously) and sulpiride (100 mg intramuscularly) administration in 13 young women in a reformatory institution, and in six employees of the same establishment with regular cycles, serving as control group. Ovarian endocrine activity was assessed with basal oestradiol estimations. Seven out of the 13 restricted women had secondary amenorrhea that began shortly after their imprisonment and six had regular cycles. Basal oestradiol concentration was similar in the three groups, but prolactin response to sulpiride was significantly higher in the control group than that in either group of inmates. Basal FSH, LH and TSH concentrations as well as FSH and TSH responses were not different in the three groups, but the LH response to LH-RH was significantly higher in the group of inmates with amenorrhea than that in the two remaining groups.