Investigation of Amenorrhea with a Simplified Clomiphene Test

Abstract

To simplify the clinical evaluation of the hypothalamic-pituitary-ovarian function, a 5-day treatment regimen of 100 mg clomiphene administered daily was tested on a group of 30 amenorrheic women (4 with primary amnenorrhea and 26 with secondary amenorrhea). Vaginal smears and serum follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol-17beta and progesterone levels were obtained prior to treatment and 5 and 12 days after treatment ended. According to her response to clomiphene, each patient was assigned to one of the four response categories established by Kjeld et al. (6). Based on clinical findings and changes in serum hormone levels, the patients' responses to clomiphene were categorized as "normal" (the patient ovulated), "partial" (the patient experienced menstrual bleeding without ovulation), "minimal" (rise in estradiol without menses), and "nil". Of the parameters studied, the patient's serum estradiol level was the most sensitive index of her response to clomiphene.