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 a report from Beijing Anzhen Hospital, the hospital followed up 240 female patients with schizophrenia. After taking the above drugs, weight gain (more than 5KG) ranked first (116/240), and amenorrhea accounted for 69%, of which chlorpromazine caused amenorrhea in 30%, perphenazine in 25%, sulpiride in 14.17%, and haloperidol in 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: They are mostly estrogen-progesterone compounds 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 hypothalamus-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, subcutaneous implants and intrauterine sustained-release contraceptive devices (such as Mi Yue Shou) are more likely to cause amenorrhea, which changes the endometrium through constant, continuous low-dose release of progesterone, causing reduced menstruation or amenorrhea.