Sex hormone therapy for pituitary amenorrhea

Pituitary amenorrhea is caused by organic lesions or dysfunction of the pituitary gland, which affects the secretion of gonadotropin and thus the ovarian function. Sex hormone therapy is effective in treating pituitary amenorrhea. There are several methods:

Sequential Cycle Therapy

Diethylstilbestrol 0.5-1.0 mg per day for 20 days. On the last 5 days of medication, add progesterone 10 mg per day intramuscular injection for 5 days. There will be withdrawal bleeding about 3 days after stopping the medication. The second medication starts on the 5th to 7th day of menstruation, and 3 consecutive times as a course of treatment. This method of medication dosage will inhibit pituitary function, so it is not suitable for long-term use. The purpose of treatment is to enhance the responsiveness of the endometrium to ovarian sex hormones, and hope that the rebound effect after stopping the medication will restore pituitary function to normal.

Estrogen therapy

Take 0.25 mg of diethylstilbestrol once every night for 20 days. Start the second cycle of medication 6 days after the onset of menstruation. It can be used for 3 to 6 cycles. A small amount of estrogen can promote the function of the pituitary gland. It can enhance the sensitivity of the pituitary gland to the hypothalamic luteinizing hormone-releasing hormone and accelerate the recovery of the pituitary gonadotropin function.

Combination therapy

Start taking oral contraceptives on the 5th day of menstruation, take them 22 days a month, for 3 to 6 months. Its working principle is the same as the sequential cycle therapy of estrogen and progesterone.

Pituitary gonadotropin therapy

It is suitable for amenorrhea caused by hypogonadism. First, human menopausal gonadotropin is used to promote follicular growth and development. The dosage is about 75-1501U per day for 7-10 days. Vaginal smears and cervical mucus are taken every day to reach a level close to follicular maturity or the estrogen content in 24-hour urine is 50μg. The drug is stopped when there is no response in 10 days. For those who respond, chorionic gonadotropin is injected intramuscularly at 1000IU every day or every other day from the 15th day, and the total dose is 3000-5000IU.