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Adolescent secondary amenorrhea: association with hypothalamic hypothyroidism
The Journal of Pediatrics
|February 1, 1979
Summary
Secondary amenorrhea in adolescent girls can stem from hypothyroidism. This study shows thyroxine deficiency alone, without hyperprolactinemia, can disrupt reproductive function, resolving with thyroid hormone treatment.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Pediatric Endocrinology
Background:
- Secondary amenorrhea is common in adolescent girls, with diverse causes.
- Previous studies linked amenorrhea and hypothyroidism but didn't differentiate thyroxine deficiency from hyperprolactinemia.
- Understanding the specific endocrine roles is crucial for accurate diagnosis and treatment.
Observation:
- Two adolescent girls presented with secondary amenorrhea and clinical/chemical hypothyroidism.
- They exhibited low thyroxine (T4) and triiodothyronine (T3) levels with undetectable basal thyroid-stimulating hormone (TSH).
- Normal pituitary function (FSH, LH, prolactin, GH) was observed, ruling out other common causes like anorexia nervosa.
Findings:
- The patients had isolated hypothalamic hypothyroidism.
- Treatment with 1-thyroxine led to the resumption of menses in both girls.
- This indicates that isolated thyroid deficiency can independently cause secondary amenorrhea.
Implications:
- Thyroid hormone replacement is effective for secondary amenorrhea caused by isolated hypothyroidism.
- This finding clarifies the etiology of amenorrhea in specific endocrine disorders.
- Highlights the importance of assessing thyroid function in adolescent girls with amenorrhea.