Diagnostic Implications of Primary Amenorrhea

Clinical Staff Conference1 October 1966Diagnostic Implications of Primary AmenorrheaCombined Clinical Staff Conference at the National Institutes of HealthROY HERTZ, PH.D., M.D., WILLIAM D. ODELL, M.D., PH.D., GRIFF T. ROSS, M.D., PH.D.ROY HERTZ, PH.D., M.D.Search for more papers by this author, WILLIAM D. ODELL, M.D., PH.D.Search for more papers by this author, GRIFF T. ROSS, M.D., PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-4-800 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDr. Roy Hertz: Patients with amenorrhea represent a significant portion of the diagnostic problems seen by the physician interested in reproductive endocrinology. Such diagnostic problems can be subdivided into two major categories: one, those patients who have never had menses (so-called primary amenorrhea), and two, those who have had normal menses in the past but who present with amenorrhea (so-called secondary amenorrhea). The patient presenting withprimary amenorrheais the subject of this discussion. Physiologic considerations and clinical studies derived from these will be presented initially. Finally, the application of these principles to a series of illustrative patients seen on...References1. REICHLIN S: Neuroendocrinology. New Eng. J. Med. 269: 1182, 1246, 1296, 1963. CrossrefMedlineGoogle Scholar2. GUILLEMINJUTISZSAKIZ RME: Purification partielle d'un facteur hypothalamique (LRF) stimulant la secretion de l'hormone hypophysaire de luteinisation (LH). C. R. Acad. Sci. 256: 504, 1963. Google Scholar3. MITTLERMEITES JCJ: In vitro stimulation of pituitary follicle-stimulating-hormone release by hypothalamic extract. Proc. Soc. Exp. Biol. Med. 117: 309, 1964. CrossrefMedlineGoogle Scholar4. HERTZ R: Gonadotropin and adrenocorticotropin from rat pituitary homografts as manifested by host response to chorionic gonadotropin and amphenone. Endocrinology 66: 842, 1960. CrossrefMedlineGoogle Scholar5. PFEIFFER C: Sexual differences of the hypophyses and their determination by the gonads. Amer. J. Anat. 58: 195, 1936. CrossrefGoogle Scholar6. BARRACLOUGH CA: Modification in the CNS regulation of reproduction after exposure of prepubertal animals to steroid hormones. Recent Progr. Hormone Res. In press, 1965. Google Scholar7. LOOP JW: Precocious puberty. Pneumoencephalography demonstrating a hamartoma in the absence of cerebral symptoms. New Eng. J. Med. 271: 409, 1964. CrossrefMedlineGoogle Scholar8. DONOVANVAN DER WERFF TEN BOSCH BTJJ: Hypothalamus and sexual maturation in the rat. J. Physiol. (London) 147: 78, 1959. CrossrefGoogle Scholar9. KALLAS H: Puberte precoce par parabiose. C. R. Soc. Biol. (Paris) 100: 979, 1929. Google Scholar10. BYRNESMEYER WWRK: The inhibition of gonadotrophic hormone secretion by physiologic doses of estrogen. Endocrinology 48: 133, 1951. CrossrefMedlineGoogle Scholar11. GROSSMAN ER: Pituitary gonadotropins in gonadal dysgenesis. Age of appearance and variability in amount of follicle-stimulating hormone (FSH) in urine. Pediatrics 25: 298, 1960. MedlineGoogle Scholar12. ROSSODELL GTWD: Unpublished data. Google Scholar13. DICHIRONELSON GKB: The volume of the sella turcica. Amer. J. Roentgen. 87: 989, 1962. Google Scholar14. LIDDLEESTEPKENDALLWILLIAMSTOWNES GWHLJWWCAW: Clinical applications of a new test of pituitary reserve. J. Clin. Endocr. 19: 875, 1959. CrossrefMedlineGoogle Scholar15. KOHLERODELLO'MALLEYLIPSETT POWDBWMB: Effect of bacterial polysaccharide pyrogen (piromen) on plasma thyrotropin, somatotropin, luteinizing hormone, and 17-hydroxycorticoids. In preparation. Google Scholar16. ROTHGLICKYALOWBERSON JSMRSSA: Hypoglycemia: a potent stimulus to secretion of growth hormone. Science 140: 987, 1963. CrossrefMedlineGoogle Scholar17. BECKERALBERT KLA: Urinary excretion of follicle-stimulating and luteinizing hormones. J. Clin. Endocr. 25: 962, 1965. CrossrefGoogle Scholar18. ODELLROSSRAYFORD WDGTP: Radioimmunoassay for human luteinizing hormone. Metabolism 15: 287, 1966. CrossrefMedlineGoogle Scholar19. MARSHALLHAMMOND JCB: Ovarian biopsy under culdoscopic visualization. Amer. J. Obstet. Gynec. In press. Google Scholar20. LIPSETTKIRSCHNERWILSONFISHMANKORENMAN MBMAHLMSG: Some studies on Leydig cell physiology. Recent Progr. Hormone Res. 22: 245, 1966. MedlineGoogle Scholar21. ROSEMBERGCOLEMANDEMANYGARCIA EJMC: Clinical effect of human urinary postmenopausal gonadotropin. J. Clin. Endocr. 23: 181, 1963. CrossrefGoogle Scholar22. ROSSTIJO GTJH: Cytogenetics in clinical endocrinology. JAMA 192: 977, 1965. CrossrefMedlineGoogle Scholar23. BONGIOVANNIROOT AMAW: The adrenogenital syndrome. New Eng. J. Med. 268: 1283, 1342, 1391, 1963. CrossrefMedlineGoogle Scholar24. TANNER JM: Growth at Adolescence. Blackwell Scientific Publications, Oxford, 1962. Google Scholar25. KIRSCHNERPOWELLLIPSETT MARDMB: Cushing's syndrome: nodular cortical hyperplasia of adrenal glands with clinical and pathological features suggesting adrenocortical tumor. J. Clin. Endocr. 24: 947, 1964. CrossrefMedlineGoogle Scholar26. SCHULZROSEN ESW: Gynecography: technique and interpretation. Amer. J. Roentgen. 86: 866, 1961. Google Scholar27. ROSSHOLLANDKISERDOUGLAS GTJMWSGW: XO/XY chromosomal mosaicism and extragenital stigmata of Turner's syndrome in a phenotypic male. J. Clin. Endocr. 25: 141, 1965. CrossrefGoogle Scholar28. ODELL WD: Isolated deficiencies of anterior pituitary hormones: a discussion of symptomatology and diagnosis. JAMA. In press. Google Scholar29. KALLMANSCHOENFELDBARRERA FJWASE: The genetic aspects of primary eunuchoidism. Amer. J. Ment. Defic. 48: 203, 1944. Google Scholar30. MONEYHAMPSONHAMPSON JJGJL: Hermaphroditism: recommendations concerning assignment of sex, change of sex, and psychologic management. Bull. Hopkins Hosp. 97: 284, 1955. MedlineGoogle Scholar31. BERGADACLEVELANDJONESWILKINS CWWHWL: Gonadal histology in patients with male pseudohermaphroditism and atypical gonadal dysgenesis: relation to theories of sex differentiation. Acta Endocr. (Kobenhavn) 40: 493, 1962. MedlineGoogle Scholar32. MORRIS JM: Syndrome of testicular feminization in male pseudohermaphrodites. Amer. J. Obstet. Gynec. 65: 1192, 1953. CrossrefMedlineGoogle Scholar33. WILKINS L: Masculinization of female fetus due to use of orally given progestins. JAMA 172: 1028, 1960. CrossrefMedlineGoogle Scholar34. GRUMBACHDUCHARME MMJR: The effects of androgens on fetal sexual development: androgen-induced female pseudohermaphrodism. Fertil. Steril. 11: 157, 1960. CrossrefMedlineGoogle Scholar35. BONGIOVANNIDIGEORGEGRUMBACH AMAMMM: Masculinization of the female infant associated with estrogenic therapy alone during gestation: four cases. J. Clin. Endocr. 19: 1004, 1959. CrossrefGoogle Scholar36. MERRILLRAMSEY JAJE: True hermaphroditism: report of a case and review of literature. Obstet. Gynec. 22: 505, 1963. Google Scholar37. TURNER HH: A syndrome of infantilism, congenital webbed neck, and cubitus valgus. Endocrinology 23: 566, 1938. CrossrefGoogle Scholar38. KEATSBURNS TETW: The radiographic manifestations of gonadal dysgenesis. Radiol. Clin. N. Amer. 2: 297, 1964. MedlineGoogle Scholar39. HUNGLOPRESTI WJM: Urinary tract anomalies in gonadal dysgenesis. Amer. J. Roentgen. 95: 439, 1965. CrossrefGoogle Scholar40. LISTEN J: The Nature and Origin of X Chromosome Aberrations in Turner's Syndrome. Almqvist & Wiksell, Stockholm, 1963, p. 167. Google Scholar41. SOHVALMILLERCHRISTAKOSEPSTEIN AROJACWA: "Pure" gonadal dysgenesis with XO/XX mosaicism. J. Clin. Endocr. 24: 811, 1964. CrossrefGoogle Scholar42. MELICOW MM: Tumors of dysgenetic gonads in intersexes—case reports and discussion regarding their place in gonadal oncology. Bull. N. Y. Acad. Med. 42: 3, 1966. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bethesda, MarylandThis is an edited transcription of a combined clinical staff conference at the Clinical Center, Bethesda, Md., by the National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service, U. S. Department of Health, Education, and Welfare.Requests for reprints should be addressed to Griff T. Ross, M.D., Clinical Center, Room 10-B-09, National Institutes of Health, Bethesda, Md. 20014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByRadioimmunoassay of free ß-subunit of human chorionic gonadotropin in diagnosis of high-risk and low-risk gestational trophoblastic diseaseAmenorrheaA radioimmunoassay which specifically measures human chorionic gonadotropin in the presence of human luteinizing hormoneSustained Remissions after Chemotherapy for Primary Ovarian Cancers Containing Choriocarcinoma 1 October 1966Volume 65, Issue 4Page: 800-820KeywordsChild healthMedical servicesPrevention, policy, and public healthReproductive endocrinology Issue Published: 1 October 1966 PDF DownloadLoading ...