Auxiliary diagnostic methods for pituitary amenorrhea

Pituitary amenorrhea is caused by organic lesions or dysfunction of the pituitary gland, which affects the secretion of gonadotropin, thereby affecting ovarian function and causing amenorrhea. The auxiliary diagnosis methods for pituitary amenorrhea are as follows:

Withdrawal test

Progesterone withdrawal blood test: Bleeding after withdrawal indicates that the lesion is in the hypothalamus-pituitary gland.

Estrogen withdrawal blood test: No bleeding after withdrawal of the drug indicates that the lesion is located in the uterus.

Ovarian function test

Methods for measuring ovarian function include: basal body temperature, cervical mucus examination, vaginal exfoliated cell smear, measurement of estrogen and progesterone levels in blood and urine, etc.

Ovarian function measurement can be used to identify whether the cause of amenorrhea is in the target organ or in a link above the ovary. When the ovary has ovulation function, the cause of amenorrhea is not in the ovary but may be in the uterus or vagina, thus excluding pituitary amenorrhea. Understanding ovarian function helps guide medication.

Pituitary function test

A follicle-stimulating hormone level higher than 40 IU/L indicates ovarian failure; a luteinizing hormone level lower than 51 U/L indicates gonadotropin insufficiency; a decrease in both follicle-stimulating hormone and luteinizing hormone often indicates a decrease in the function of the higher pituitary centers; a 24-hour urinary follicle-stimulating hormone excretion greater than 52.8 mouse uterine units indicates that the cause of the disease is in the ovaries.

Luteinizing hormone-releasing hormone stimulation test

If the pituitary gland's response to the hypothalamic luteinizing hormone-releasing hormone is about 3 times the base number, it means that the pituitary gland is functioning normally and the cause is in the hypothalamus; if the base number is low, the response is poor or no response, the cause is in the pituitary gland, part of which is due to the inertial response of the pituitary gland under long-term suppression. If there is no response or a slow response to a single injection of luteinizing hormone-releasing hormone, the test must be repeated. Only when there is no response after multiple tests, it has greater clinical significance.