Common drugs and types that cause amenorrhea

Amenorrhea is a common symptom of gynecological diseases. The absence of menstruation during pregnancy, breastfeeding or after menopause is called physiological amenorrhea. It is a normal physiological phenomenon and has nothing to do with disease. So what kind of amenorrhea is a symptom of disease, and what causes amenorrhea? Let us learn about the common drugs and types that cause amenorrhea.

(1) Commonly used drugs in psychiatric medicine: Common drugs such as chlorpromazine, perphenazine, sulpiride, haloperidol, etc. cause amenorrhea, galactorrhea, etc. However, new antipsychotic drugs such as risperidone, olanzapine, zotepine, loxapine, etc. have good efficacy, low toxicity, and few clinical reports on amenorrhea and galactorrhea. According to reports, in a follow-up of 240 female schizophrenia patients, weight gain (more than 5KG) after taking the above drugs ranked first (116/240), and amenorrhea accounted for 69%, of which chlorpromazine caused amenorrhea accounting for 30%, perphenazine 20%, sulpiride 14.17%, and haloperidol 10.83%. Amenorrhea mostly occurred 40-60 days after taking the drug, accounting for about 75%. Galactorrhea accounted for 37%, decreased libido accounted for 32%, and only 6 cases of hypersexuality. The causes of amenorrhea and galactorrhea are directly related to the drugs. When treating mental disorders, the drug interferes with the 5-HT central dopamine D2 receptor, resulting in an increase in PRL (prolactin) in the blood, a decrease in GnRH secretion, and a decrease in FSH and LH, leading to amenorrhea and galactorrhea.

(2) Oral contraceptives and sustained-release contraceptive systems: ① Short-acting oral contraceptives: Most of them are estrogen-progesterone complexes that achieve contraceptive effects through multiple pathways. Inhibiting ovulation and changing the endometrium can cause reduced menstruation or amenorrhea. Some women are particularly sensitive to drugs, and the hypothalamic pituitary ovarian axis is significantly suppressed, resulting in amenorrhea (but third-generation oral contraceptives such as Marvelon and Mindio rarely cause amenorrhea). ② Long-acting oral contraceptives: Taking long-acting contraceptives causes more amenorrhea than short-acting oral contraceptives. ③ In sustained-release contraceptive systems, amenorrhea is more common from subcutaneous implants and intrauterine sustained-release contraceptive devices (such as Mi Yue Shou), which change the endometrium through constant, continuous low-dose release of progesterone, causing reduced menstruation or amenorrhea.