HAS OLIGOMENORRHEA A PATHOLOGICAL MEANING - THE IMPORTANCE OF THIS SYMPTOM IN INTERNAL-MEDICINE

Background: Oligomenorrhea, defined as a menstrual cycle lasting 36 to 90 days, can be a normal condition in the first years after the menar che. When it persists or appears after a period of normal menstrual cy cles, an underlying illness must be sought. Aim: To assess ovulation a nd causes of anovulatory cycles in women with oligomenorrhea, compared with causes of secondary amenorrhea. patients and methods: One hundre d one women of less the 35 years old, presenting with oligomenorrhea p ersisting 5 years after menarche or lasting more than two years after a period of normal menstrual cycles, were studied. Ovulation was studi ed measuring serial plasma progesterone during normal or induced (with intramuscular progesterone) menstrual cycles. Results: Eighty nine pe rcent of women had anovulatory oligomenorrhea. The main causes were po lycystic ovarian disease in 51% and hypothalamic dysfunction in 31%. T hirty percent of women with secondary amenorrhea had polycystic ovaria n disease and 14% had hyperprolactinemia. women older than 20 years ol d or with more than 10 years of gynecological age had a higher frequen cy of polycystic ovarian disease and a lower prevalence of hypothalami c dysfunction. Conclusions: There is a high frequency of anovulatory o ligomenorrheas. Therefore, this symptom deserves a thorough endocrinol ogical assessment to uncover underlying diseases. Special attention mu st be paid to polycystic ovary syndrome, due to its importance in inte rnal medicine as a risk factor for myocardial infarction, high blood p ressure, and type 2 diabetes mellitus.