The post-pill secondary amenorrhea: etiology and treatment.

315 women were observed after termination of oral contraception which had lasted 12-35 months. 6 women or 2.79% presented with secondary amenorrhea; 3 had galactorrhea and 3 were cases without lactic secretion. Basal determinations of immunoreactive prolactin (PRL) follicle stimulating hormone (FSH) and luteinizing hormone (LH) were done after which an intravenous bolus of 300 mcg of thyrotropin-releasing hormone (TRH) and 100 mcg of luteinizing hormone-releasing hormone (LHRH) was administered. Plasma levels of PRL FSH and LH were measured at 15 30 45 60 90 and 120 minutes after the injection. Results obtained were compared with those from a group of 7 regularly menstruating women. The comparison showed a rise in the basal values of PRL before and after stimulation with TRH. FSH levels were unaltered before and after LHRH stimulation. LH values were much lower in the group of amenorrheic women and decreased even further after LHRH stimulation. The 6 patients were treated with bromocryptine in daily doses of 5-10 mg for a period of 1-6 months. All cases except one recovered after treatment. The good results with bromocryptine treatment and the fact that LH basal levels were constantly low seems to point to the hyperprolactinemic etiology.