[Gynecological and endocrinological studies of thalidomide-damaged girls]

Gynaecological examinations were done for the first time in 32 girls, between age 13 and age 18 damaged by thalidomide. 11 of the girls had primary amenorrhoea at the time of examination. 9 of these cases showed genital malformations. 7 cases showed aplasia of the uterus. A rudimentary uterus and a hypo-plastic uterus were found in one patient each. In 8 girls these changes were combined with abnormalities of the vagina, 3 cases had vaginal aplasia. 4 cases had a blind vaginal sac. 1 case had a urogenital sinus. Two patients had primary amenorrhoea without genital malformations. In the girls who had started menstrual periods none of the 21 cases showed genital malformations. Supplementary endocrinological investigations were done to answer the question whether functional disturbances were caused by thalidomide in addition to organic changes. The development of puberty can be diagnosed from secondary sexual markers. Our patients had almost all advanced puberty with more mammary development than pubic development. The menarche between age 11 and age 16 showed no deviation from the normal in our patients. 11 girls had regular cycles. The hormonal vaginal cytology in 28 patients showed no sign of deficient estrogen. Neuro-endocrine maturation is responsible for the development of puberty. The basal secretions of FSH and LH increase. The dynamic functional test with LHRH shows the LH reserve of the pituitary which rises in a typical pattern. 14 patients had a LHRH test and nine of these showed a mature LH reserve corresponding to the index R2.(ABSTRACT TRUNCATED AT 250 WORDS)