[Hormonal disorders, menstrual irregularities and future fertility]

Menstrual irregularities are common in puberty and adolescence during the development of ovarian function and until a regular ovulatory cycle is established. Hormonal disorders should be investigated promptly to avoid or alleviate possible long-term sequelae, including impaired fertility. Most irregularities are transient and self-limited, but some are severe or prolonged and require exploration and treatment. Symptoms such as prolonged oligomenorrhea andoligoamenorrhea may herald an incipient or preexisting endocrinopathy. An exact diagnosis by estimation of the hormonal parameters can identify a relevant disturbance. The prognosis for later fertility in patients with oligoamenorrhea depends on the etiology and degree of the condition. With a hypothalamic origin the prognosis is good when the offending stimuli are removed. Patients with pituitary lesions or hyperprolactinemia can be treated effectively. Hyper-androgenemic oligoamenorrhea, especially the polycystic ovarian syndrome, are common. Future fertility is reduced but may be improved by preventive measures and therapy in adolescence. Inpatients with primary ovarian insufficiency and persisting hyper-gonadotropic amenorrhea, the prognosis for fertility is poor.