[Treatment of secondary adolescent amenorrhea with purified FSH]

The dysfunctional features of adolescent secondary amenorrhea are here considered: anovulation, immaturity of estrogenic feed back, multi-follicular ovary. We described the opportunity of using gonadotrophin in the treatment of hypogonadotrophic amenorrhea. Among 64 patients with menstrual delay, we examined a group of 23 selected girls, 21 of them affected by secondary amenorrhea and 2 affected by primary amenorrhea; their average age is 17 years. The selection excludes organic and psychiatric pathologies, while includes anovulation, low rates of FSH and inadequate response to LHRH test, multi-follicular ovary. Some patients were also affected by acne, hypertrichosis, weight disorders, emotional stress. The therapeutic approach with purified FSH (urofollitrophin) is described on an amount of 48 treatments. We used 75/225 UI/day at 3 degrees to 5 degrees/7 degrees of each menstrual cycle, and for 3/5 cycles. Doses are in some subjects modified during the treatment in relation to menstrual response. Hormonal, echographic and clinical evaluation were given before and after each treatment. The results of giving FSH demonstrate an 81.2% of immediate success, while an 43.7% up to 12 months. We observed a significant reduction of LH rates as well as estrogenic increase and subsequent menstrual response. Ovarian follicles increased in number and volume, while no hyperstimulation effects appeared. In general we suppose these data are satisfactory; nevertheless we point out the opportunity of only treat selected patients, even in considering the complaint due to this therapeutic engagement and the eventual consequent renouncing.