Menstrual disorders in patients with chronic renal failure

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.