Depression and anxiety associated with secondary amenorrhea.

Secondary amenorrhea, when an organic etiology has been ruled out, is a considerable challenge to gynecologists and family physicians. Five of 18 patients suffering from amenorrhea were found to have major depressive disorder and four others generalized anxiety disorder. The dexamethasone suppression test corroborated clinical findings in three of the five depressed patients, but otherwise yielded low specificity. Since antidepressants may potentially reverse amenorrhea when a severe depressive state is present, the findings should alert the physician to include clinical and biologic criteria for depression in the diagnostic work-up for amenorrhea.