Re: Secondary amenorrhea
From: Andrew Folley (agfolley@hotmail.com)
Tue Mar 1 07:14:12 2005
Glen
It sounds like she is simply anovulatory following the depo-provera. She
probalby still has an atrophic lining form the depo and did thus did not
respond to the provera. BCPs caused menses therefore no end organ problem.
An MRI or is not necessary with porlactin of 58. the elevation could be form
the meds etc. I sugges doing nothing otherr than reassure and recheck
prolactin every 3 to 6 months to see where it is going. Barrier method ofr
birth control or put her back on pills. andrew
>From: "Elrod Darryl G MAJ 48 MDOS/SGOBO" <Darryl.elrod@LAKENHEATH.AF.MIL>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: RE: Secondary amenorrhea
>Date: Tue, 1 Mar 2005 05:34:40 -0600
>
>But imaging with lower prolactin levels doesn't give useful yield,
>right? If I were to find a microadenoma I wouldn't do anything
>different?
>
>I'm not sure I feel comfortable sending someone off to officer school
>with PT and such having just started parlodel either. Isn't orthostatic
>hypotension a side effect? I'll have her falling out of formation!
>
>Glen
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of R.
>Daniel Braun
>Sent: Tuesday, March 01, 2005 11:25 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Secondary amenorrhea
>
>Would strongly suspect the Prolactin is related to stress. and is
>probably causing the amenorrhea. Treatment with parlodel might have
>her resume her menses.
>
>On Tue, 1 Mar 2005 02:53:27 -0600, Elrod Darryl G MAJ 48 MDOS/SGOBO
><Darryl.elrod@lakenheath.af.mil> wrote:
> >
> > I have a 30 yo G0 that has been previously on DepoProvera and did not
>cycle
> > after stopping it. At the time, after several months they tried a
>provera
> > withdrawl with no bleeding. She started OCP and cycled normally.
> >
> > Now she has been off OCP for 10 months and has not cycled. I did a
>provera
> > withdrawl again and she didn't bleed.
> >
> > Labs are
> >
> > TSH normal
> >
> > FSH normal (low)
> >
> > Prolactin 58
> >
> > Free testosterone, DHEAS normal
> >
> > She is set to go off to officer training in 2 weeks. She will be gone
>for
> > 4-6 months before I see her again. She desires pregnancy in the
>future, but
> > not now while she is gone.
> >
> > Can I safely assume that this is prolactin related? With it being
>less than
> > 100, is there any role for MRI of the pituitary prior to her leaving?
>Would
> > you treat the prolactin now or do OCP while she is gone and recheck it
>when
> > she returns?
> >
> > Thanks,
> >
> > Glen
>
>--
>R. Daniel Braun
> Kinky for Governor
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