[The clinical management of post-pill amenorrhea]

Post-pill amenorrhea is arare occurrence and is very often concurrent with galactorrhea and hyperprolactinemia. The authors of this article after carefully reviewing the literature on the clinical management of post-pill amenorrhea come to the conclusion that in more than half the number of cases the problem regresses spontaneously without treatment. Post-pill amenorrhea associated with anovulatory sterility can be treated with: 1) clomiphene by carefully adjusting its administration to every single case; clomiphene usually entails an increase in the volume of the ovary; 2) pituitary or chorionic gonadotropins when the ovary is normal but inactive; 3) cortisone; there are however few descriptions of its use in the literature; 4) pyridoxine which has the advantage of being extremely cheap and easy to administer; 5) bromocriptine whose mechanism of action is still not clear. Patients who desire to become pregnant must be treated not so much for amenorrhea but for anovulatory sterility. This can be accomplished with ovulation inductors after checking for the presence of hypophysary adenomas. Patients who do not desire pregnancy can be treated with bromocriptine to restore the menstrual cycle and be prescribed nonhormonal contraception. (Summary in ENG)