Drug-induced Amenorrhea

Abstract

Secondary amenorrhea is defined as the cessation of regular menses for a period of three months or the cessation of irregular menses for six months. Except for menstrual suppression, which purposely ceases menstruations for relief of menstrual-related symptoms or management of medical conditions, drug-induced amenorrhea includes hypothalamic amenorrhea due to hyperprolactinemia and ovarian amenorrhea after cancer treatment.

It is well-recognized that antipsychotics, also known as neuroleptics, and antidepressants can cause hyperprolactinemia. In cases of medication-induced hyperprolactinemia secondary to medication use, the preferred approach is to discontinue or change the offending causative drug. Therefore, discussion among psychiatrists and gynecologists about treatment strategy for each patient is essential.

As chemotherapy-induced amenorrhea, alkylating agents are the most common medications associated with ovarian dysfunction. Such cases are sometimes irreversible and lead to primary ovarian insufficiency, which causes infertility along with prolonged effects of estrogen deficiency. In order to keep the patient's quality of life, embryo cryopreservation and hormonal replacement therapy are performed, depending on the patient's underlying condition.