Hormonal dysfunction pituitary responses

Secondary amenorrhea also is caused by uterine failure. The patient with a uterine problem is normal hormonally, but does not menstruate. Ashermans syndrome, or intrauterine adhesions, is the most common outflow-tract abnormality that causes amenorrhea. Endometrial damage may occur in response to a dilatation and curettage and to infections of the endometrium. Pituitary dysfunction can cause secondary amenorrhea. This is most often caused by intrinsic pituitary tumors. However, Sheehan s syndrome and pituitary apoplexy can also restilt in hormone deficiency. 

Thyroid dysfunction continues to be an infrequent and unpredictable complication found in only 3% of patients according to one review (47 ) and occurring more often in women. A study of the mechanism of action (50 ) in 17 patients on lithium maintenance therapy involved exploration of the hypothalamic-pituitary-thyroid axis. Fourteen subjects showed an exaggerated thyrotropin response to intravenous thyrotropinreleasing hormone that persisted during lithium therapy. However, only 2 of these patients showed any clinical or biochemical evidence of hypothyroidism both showed a delayed recovery of normal TRH response after discontinuing lithium. 

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