Secondary amenorrhea occurs in about 0.7% of women and may be more common among the less than 25 years of age. Any disturbance in the established norm of the cyclinical pattern of menstrual bleeding can have social and emotional impact on the patient. Thu, a thorough investigation to discount any life threatening cause for a timely intervention should be done. A case of a 24 year old, nulligravid, with secondary amenorrhea for 12 years came in for evaluation. No other associated signs were seen. Diagnostic evaluation revealed she has a polycystic ovary with normal serum prolactin, follic;e stimulating hormone and estradiol. The progesterone challenge test was negative. Pending the result of the respone to the estrogen/progesterone challenge test, a diagnosis of functional hypothalamic amenorrhea, with concomitant polycystic ovarian morphology is likely. Therapy will include exogenous GnRH secretion is deficient and gonadotropin secretion and ovarian function can be normalized with physiologic replacemnt of exogenous, pulsatile GnRH. Monitoring the patients' glucose tolerance secondary to the polycystic ovary syndrome should also be done to prevent the long term sequelae of this disease. Despite the presentation of anovulation with polycystic ovary in this patients, the likehood of a hypothalamic dysfunction cannot be discounted, and has to be confirmed since exogenous GnRH will be needed to resume a pulsatile pattern of release, and return the patient's ovarian function.
Human ; Female ; Young Adult ; AMENORRHEA ; POLYCYSTIC OVARY SYNDROME