Endocrine Abstracts

Introduction

Primary amenorrhea should be considered in any patient who has not experienced periodic menstruation by 16 years regardless of the presence of normal growth and development of secondary sexual characteristics.

Observation

17-year-old patient, who exhibited normal secondary sexual characteristics, normal auxiliary and pubic hairs, normal breast development since the age of 12 with the non-appearance of menstruation beyond 16 years. No history suggestive of hypothyroidism, repeated infections, raised intracranial pressure was there. No history of difficulty in walking, deformity of extremities and nothing contributory from developmental and birth history. No similar history in family was present. Physical examination revealed Height: 162 cm, Weight: 74 kg, BMI: 28.24 kg/m². Secondary sexual characteristic: Pubic hair P 4, Breast development B 4. No signs of hirsutism and no clitoromegaly was seen and other systemic examinations were normal. The hormonal profile of the patient revealed hypogonadotropic hypogonadism, hyperprolactinemia at 2390 ng/ml and MRI showing a pituitary macroadenoma of 25 × 16 mm. It is extending into the left cavernous sinus. The patient was already treated with dopamine agonists with a decrease in the level of prolactin and the size of the pituitary adenoma.

Conclusion

The prolactin adenoma in our patients probably set in during puberty after the normal development of secondary sexual characteristics and stopped puberty development before the onset of menstruation.