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Hypothalamic disease presenting as amenorrhoea: value of computed tomography
British Journal of Obstetrics and Gynaecology
|December 1, 1985
Summary
Suprasellar abnormalities can cause amenorrhea (absent periods) in women. Computed tomography is crucial for diagnosing these hypothalamo-pituitary disorders.
Area of Science:
- Neuroendocrinology
- Reproductive Medicine
- Neuroradiology
Background:
- Amenorrhea, or the absence of menstruation, can stem from various causes, including hypothalamo-pituitary dysfunction.
- Investigating the cause of amenorrhea is essential for appropriate diagnosis and treatment.
Observation:
- Five women with amenorrhea (primary or secondary) exhibited suprasellar abnormalities on computed tomography (CT).
- Surgical confirmation revealed organic hypothalamic diseases, including craniopharyngioma, Rathke's cleft cyst, and aqueductal stenosis with arachnoid cyst.
Findings:
- Hyperprolactinemia was observed in four patients, while one had isolated gonadotropin deficiency.
- Bromocriptine therapy led to menses resumption in two patients pre-surgery.
- One patient achieved spontaneous menarche and pregnancy after surgical intervention for aqueductal stenosis.
Implications:
- Organic hypothalamic diseases may be a more frequent cause of amenorrhea than previously recognized.
- Computed tomography (CT) of the brain is recommended over conventional methods for evaluating hypothalamo-pituitary amenorrhea.
- Early diagnosis and targeted treatment of suprasellar abnormalities are vital for reproductive health.