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amenorrheaFrom: Epippin@aol.comWed Mar 1 17:46:08 2000
I am following a group of women who are institutionalized for mental health reasons and are on lots of psychotropic and seizure meds. These women are 20 years and older and most smoke. Some are sexually active. Many have been amenorrheic for years because of the meds they are on. Any interventions or testing I consider need to be kept to a minimum because of non-compliance. Those that are sexually active are on depo or BCP's unless >35 yo and smokers. My questions are 1) should I be concerned if they are amenorheic? osteoporosis? any other concerns? 2) how long is too long to be amenorrheic? should I try to induce a withdrawal bleed? if so, How often? 3) any particular workup recommended? TSH, Prolactin level? Dexa? Cell maturation index? pelvic ultrasound for endometrial stripe thickness? what recommendations would give the "biggest bang for the buck"? 4) are there treatment options I should be considering? Thanks for your input in advance. Ellen Kawadler MS, RN, CS, FNP
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