Chapter 45: Amenorrhea and Anovulation

Hilgers TW

Reproductive Endocrinology · Ovulation Physiology

Chapter 45: Amenorrhea and Anovulation

Hilgers TW

The Medical and Surgical Practice of NaProTECHNOLOGY, 603-606, 2004

RRM Academy Synopsis

Amenorrhea without ovulation is treatable once the cause is found

A 2004 textbook chapter on NaProTECHNOLOGY says women who stop ovulating and have no periods are among the best groups to treat once the cause is found. It names PCOS (also called PMOS), stress and high prolactin as causes suited to treatment. Early menopause is usually permanent.

Key Findings

Infertility from missing ovulation with amenorrhea is uncommon. The chapter calls patients with an identifiable underlying cause one of the most successful groups to treat.
In PCOS (polyendocrine metabolic ovarian syndrome, PMOS), long, irregular cycles are most common and amenorrhea is occasional. In hypothalamic amenorrhea, chronic stress disrupts the hypothalamus and pituitary.
Hyperprolactinemia usually comes from a prolactin-secreting microadenoma of the pituitary gland, found on MRI. Medication brings these tumors under control in nearly every case, though on occasion they cause fairly extensive damage.
Premature menopause usually comes unexpectedly. Hormone levels sometimes normalize, but the chapter calls it most often permanent and says these women need hormone replacement to prevent bone loss.
Pope Paul VI Institute charts show two Creighton Model patterns: predominant dryness, or a variable return of Peak-type mucus, apparently from waxing and waning low estrogen.

RRM Context

Restorative care asks why ovulation stopped and treats that cause. NaProTECHNOLOGY pairs Creighton Model charting with hormone testing, ultrasound and a seminal fluid analysis for the partner. The level of dysfunction is located before treatment begins. A missed ovulation with a named cause is a diagnosed condition.

Our editorial summary of this paper, not the article's abstract.

Abstract

This chapter describes anovulation with amenorrhea as an uncommon cause of infertility and considers polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia and premature onset of the menopause, along with Kallmann syndrome. Hilgers notes that the standard amenorrhea profile is normal in hypothalamic amenorrhea, that prolactin is highly elevated in hyperprolactinemia, and that FSH and LH are highly elevated in premature menopause. An evaluation protocol for infertility related to amenorrhea is presented with two CREIGHTON MODEL charting patterns seen in this group: predominant dryness and a variable return of Peak-type mucus.

Topics

Reproductive Endocrinology › Ovulation Physiology › Anovulation · Menstrual Cycle › Cycle Disorders › Amenorrhea · Diagnostics › Cycle Biomarkers › Cervical Mucus Monitoring

Thomas W Hilgers

Tom Hilgers, T Hilgers

Hilgers et al. 2004, Hilgers 2004

Chapter 45: Amenorrhea and Anovulation

Amenorrhea without ovulation is treatable once the cause is found

Key Findings

RRM Context

Abstract

Topics

By this author

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