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Postcontraceptive Amenorrhea

From the Department of Obstetrics and Gynecology, The Permanente Medical Group, and Kaiser Foundation Hospital, San Francisco, Calif.

Abstract

Prolonged postoral contraceptive amenorrhea in 41 women did not correlate with physical status, other endocrine abnormality or duration of pill therapy but did correlate with past menstrual dysfunction and/or absence of withdrawal bleeding during pill use. Duration of oral contraception did not correlate with length of amenorrhea or therapeutic response. Six patients had galactorrhea; while this probably does not alter prognosis, patients should be observed for a pituitary lesion. Menses resumed in 69% of the untreated women, 69% of the women treated with clomiphene and 42% after other agents. Patients with low serum LH and low total urinary estrogen levels responded poorly to clomiphene. A crude incidence of postpill amenorrhea of 2.2 per 1000 was noted among almost 20,000 oral contraceptive users.