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Physiologic amenorrhea is present before menarche, during pregnancy and breastfeeding, and after menopause. [3] Breastfeeding or lactational amenorrhea is also a common cause of secondary amenorrhoea. [26] Lactational amenorrhea is due to the presence of elevated prolactin and low levels of LH, which suppress ovarian hormone secretion. [27]
Hypoprolactinemia can result from autoimmune disease, [2] hypopituitarism, [1] growth hormone deficiency, [2] hypothyroidism, [2] excessive dopamine action in the tuberoinfundibular pathway and/or the anterior pituitary, and ingestion of drugs that activate the D 2 receptor, such as direct D 2 receptor agonists like bromocriptine and pergolide, and indirect D 2 receptor activators like ...
Spironolactone can cause breast pain and breast enlargement in women. [ 128 ] [ 129 ] This is "probably because of estrogenic effects on target tissue." [ 111 ] At low doses, breast tenderness has been reported in only 5% of women, but at high doses, it has been reported in up to 40% of women.
Hyperandrogenism, especially high levels of testosterone, can cause serious adverse effects if left untreated. High testosterone levels are associated with other health conditions such as obesity, hypertension, amenorrhea (cessation of menstrual cycles), and ovulatory dysfunction, which can lead to infertility.
Hyperprolactinemia, characterized by abnormally high levels of prolactin, may cause galactorrhea (production and spontaneous flow of breast milk), infertility, and menstrual disruptions in women. In men, it can lead to hypogonadism , infertility and erectile dysfunction .
Progestogen-only medications, including progestogen-only pills and a slow-release (depot) injectable medication, depot medroxyprogesterone acetate (DMPA; Depo-Provera) do not contain an estrogen. DMPA is given as an injection every 90 days, and is typically associated with amenorrhea in about 50 to 60% of users at the end of one year.
Chronic anovulation is a common cause of infertility. In addition to the alteration of menstrual periods and infertility, chronic anovulation can cause or exacerbate other long-term problems, such as hyperandrogenism or osteopenia. It plays a central role in the multiple imbalances and dysfunctions of polycystic ovary syndrome.
Symptoms of the condition in women may consist of menstrual irregularities, amenorrhea, abnormal vaginal bleeding, and enlargement of the uterus and breasts. [1] [2] It may also present as isosexual precocity in children [1] [2] and as hypogonadism, gynecomastia, feminization, impotence, and loss of libido in males. [3]