Methods of regulating endocrine in patients with primary amenorrhea

Patients with primary amenorrhea often have endocrine abnormalities. Some patients can have menstruation by regulating their endocrine system. There are mainly the following methods:

Manual cycle

Artificial cycle is a method of supplementing exogenous estrogen and progesterone according to the law of ovarian physiological activity, thereby promoting the recovery of ovarian function and natural menstruation. It can directly treat primary amenorrhea caused by insufficient ovarian function. For those who are too tall and whose epiphyses have not healed, they need to persist in treatment for more than one year to prevent their height from continuing to grow.

Estrogen supplementation

1. For patients with a small uterus or those who are uncertain about the presence of a uterus, give Premarin, starting with 0.3 mg per day, and gradually increasing to 0.625 mg per day depending on the situation. Perform B-ultrasound examination to check the presence of a uterus and its size in 1-3 months.

2. Those without a uterus, lacking secondary sexual characteristics, having had their orchiectomized, or those with ovarian hypoplasia or without ovaries should be given small doses of estrogen supplementation for long-term treatment.

Combination of estrogen and androgen

Short people with unhealed epiphyses should use a small dose of estrogen and androgen to increase their height before taking estrogen supplements. Generally, it can increase 2-3cm in 3-6 months. Long-term use can make the height reach more than 150cm.

Symptomatic supplementation of other hormones

Patients with hypothyroidism and congenital adrenal hyperplasia should supplement thyroid hormone and adrenal cortical hormone according to their condition.

Use of bromocriptine

Patients with primary amenorrhea caused by hyperprolactinemia and normal ovarian function generally have a good recovery. Bromocriptine can be used to reduce prolactin and promote ovulation. Start with 1.25 mg per day, gradually increase until prolactin is normal, and then slightly reduce the dose to maintain it for a long time. At the same time, measure basal body temperature to observe menstruation and ovulation.