Secondary Amenorrhea in the Context of Psychosomatic Medicine

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  • 心身医療と続発性無月経
  • シンシン イリョウ ト ゾクハツセイ ムゲッケイ

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Abstract

<p>Secondary amenorrhea in the context of psychosomatic medicine has two important aspects : one is “amenorrhea induced by psychosomatic diseases or treatments thereof”, and the other is “the effects of amenorrhea on the psychology of adolescent women.” The former is represented by functional hypothalamic amenorrhea (FHA) and drug-induced amenorrhea, and the latter by primary ovarian insufficiency (POI). In FHA, the pulsatile release of gonadotropin releasing hormone in hypothalamus is disturbed by either excessive psychosocial stress, weight loss, or exercise, or any combination of those, leading to secondary amenorrhea. The most complex cases of FHA are those of anorexia nervosa. The drugs that could induce amenorrhea most frequently by elevating serum prolactin levels are typical antipsychotics. On the other hand, the psychological burdens and their management in POI women are not usually paid much attention. However, the effects of abrupt decline in serum estrogen on the mood of women with POI should be taken into consideration in the clinical practice of psychosomatic medicine, as well as their anxiety towards the disorder in their menstrual cycles.</p>

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