Case #4 A twenty-seven year old female presents to your endocrine clinic complai

Question

Case #4 A twenty-seven year old female presents to your endocrine clinic complaining, "I have been missing my period regularly." She denies any other complaints. She is in a long-term relationship and reports practicing safe sex. She is an avid long distance runner and has been training for an upcoming marathon. Vital signs are stable. A physical exam is remarkable for a lean female. Laboratory values are significant for negative pregnancy test, normal prolactin level, and decreased LH/FSH level:s. What is the most likely cause for this patient's amenorrhea? What advice would you give this patient?

Explanation / Answer

It has been observed that prolonged exercise can decrease the release of GnRH or gonadotropin-releasing hormone. As a result, pituitary gland decrease the secretion of LH or luteinizing hormone and FSH or follicular stimulating hormone. These two homones are controlling the menstrual cycle and can results in amenorrhea or menstrual irregularities.

A decrease in exercise schedule altogether with treatment with hromone or uses of oral contraceptives can be adviced for pateints.

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