A group of women with secondary amenorrhea of at least six months´ duration was studied for the diagnostic approach to the underlying etiologies. The materials were 48 women seen at the Department of Obstetrics and Gynecology of the Han Yang University Hospital during the period of 2 years and 4 months from Nov. 1, 1979 to Mar. 31,198 2.
1. The blood levels of prolactin, FSH, LH, and estradiol were measured by radioimmunoassay after single blood sampling and then each hormone levels were placed into a "flowchart of the initial classification". By the use of this formula, it was possible to classify these amenorrheic patients into 4 major gropus; 1) hyperprolactinemia (9 patients), 2) hypothalamopituitary dysfunction (26 patients), 3) hypothalamo-pituitary failure (5 patients), and 4) ovarian failure (8 patients).
2.Each group of patients was subclassified by the use of an appropriate diagnostic flowchart:
a) In hyperprolactinemia group, 2 patients were identified as pituitary adenoma, 1 patient as hypothyroidism and 6 patients as pituitary hyperplasia. The mean hormone levels of this group were revealed as: prolactin; 132.02 ng/ml, FSH; 12.48 mIU/ml, LH; 7.06 mIU/ml, and estradiol; 72.46 ml.
b) In hypothalamo pituitary dysfunction group, 2 patients were identified as.Stein-Leventhal syndrome and the remaining 24 patients idiopathic in origin. The mean hormone levels of this group were revealed as: prolactin; 10-.47 ng/ml, FSH; 5.29 mIU/ml, and estradiol;109.25-pg/ml:
c) The hypothalamo pituitary failure group, 1 patient was identified as left adrenal adenoma, I patient as Sheehan´s syndrome and the remaining 3 patients idiopathic in origin. The mean hormone levels of this group were revealed as: prolactin; 9.75 5 ng/ml, FSH; 2.96 mIU/ml, LH; 4.48 mIU/ml, and estradiol; 25.01 pg/ml.
d) In ovarian failure group, 1 patient was identified as chromosomal anomaly and the remaining 7 patients as. premature menopause. The mean hormone levels of this group were revealed as: prolactin; 8.48 ng/ml, FSH; 115.33.mIU/ml, LH; 64.82 mIU/ml, and estradiol; 23.01 pg/ml.
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