Endocrine therapy for patients with primary amenorrhea

Primary amenorrhea is a type of amenorrhea that requires endocrine therapy, which can be done as follows:

Estrogen supplementation

For patients with a small uterus or those who are not sure whether they have a uterus, give Premarin, starting from 0.3mg/day, and gradually increasing to 0.625mg according to the situation, 1-2 times a day. After 1-3 months, do B-ultrasound to observe whether there is a uterus and the size of the uterus; for patients without a uterus and lack of secondary sexual characteristics, those who have had their orchiectomy, ovarian dysplasia, or those without ovaries, give small doses of estrogen supplements for a long time.

Manual cycle

Artificial cyclical supplementation can be given to those with a uterus who need estrogen. Especially for those who are too tall and whose epiphyses have not healed, supplementation should be given for a longer period of time (about one year or more) to prevent their height from continuing to grow.

Other hormone supplements

Patients with congenital adrenal hyperplasia require supplementation with thyroxine and prednisone.

Estrogen androgen application

For patients with epiphyseal failure and short stature, such as Turner syndrome, a small dose of estrogen and androgen should be used to increase height before estrogen supplementation. Livial 0.625 mg can be used, twice a week, and the height can increase by 2-3 cm in 3-6 months. Long-term use can make the patient's height over 150 cm.

Bromocriptine application

Patients with hyperprolactinemia and normal ovarian function have a better prognosis and can use bromocriptine to promote ovulation. The dosage should start from 1.25 mg and increase gradually, then slightly reduce the dosage for long-term maintenance. The dosage should be taken with a small amount of food before going to bed at night, then eat food and then go to sleep to reduce adverse reactions. At the same time, measure the basal body temperature to observe the menstrual ovulation situation.