[Hyperandrogenemia as a cause of amenorrhea]

The so-called postpill amenorrhea remains a much debated subject in gynecological endocrinology. We have therefore scrutinized the reproductive history and endocrinological parameters of 145 patients with the presumptive diagnosis of postpill amenorrhea, seen at our department during the last two years. 166 cases of secondary amenorrhea served as a control group. Both groups showed a high incidence of late menarche (20%), previous oligomenorrhea and elevated androgen serum levels. There were no significant differences between both collectives. These findings suggest that although oral contraceptives may unfavorably influence the menstrual cycle, there is no causal relationship between such agents and the development of secondary amenorrhea. It seems that in many cases of presumptive postpill amenorrhea the common juvenile hyperandrogenemic ovarian insufficiency might be the underlying problem.