Abstract
In adolescent girls, secondary amenorrhea can result from a variety of physiologic and psychologic disturbances. Previous reports associating amenorrhea and primary hypothyroidism have not distinguished between the alternative etiologic roles of thyroxine deficiency and hyperprolactinemia.
We have evaluated two girls with secondary amenorrhea who had clinical and chemical evidence of hypothyroidism. Both had low basal T4's (0.8 and 3.8 μg%), calculated free T4's (0.1 and 0.7 μg%), and T3's (51 and 81 ng%). Both had undetectable basal TSH with normal TSH response to TRH. Basal FSH and LH were normal, as was the response to LHRH. Basal prolactins were 6 and 14 ng/ml, and both girls had growth hormone responses of ≥15 ng/ml in response to insulin-induced hypoglycemia. Pituitary-adrenal function and reserve were also normal. In neither case were there any historical, physical, or laboratory features compatible with anorexia nervosa. After treatment with 1-thyroxine, both girls had a resumption in menses.
These two adolescent girls thus appear to have isolated hypothalamic hypothyroidism. The associated secondary amenorrhea demonstrates that thyroid deficiency alone, without hyperprolactinemia, can interfere with normal hypothalamic-pituitary-ovarian function.
(Supported by grant RR-125)
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Kramer, M., Kauschansky, A., Cenel, M. et al. 8 ADOLESCENT SECONDARY AMENORRHEA: ASSOCIATION WITH HYPOTHALAIC HYPIOTHYROIDISM. Pediatr Res 12 (Suppl 4), 365 (1978). https://doi.org/10.1203/00006450-197804001-00013
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DOI: https://doi.org/10.1203/00006450-197804001-00013