Nutritional deficiencies, menstrual irregularities and anaemia are commonly noticed among women in our population. To understand if nutritional anaemia could also be a contributing factor for secondary amenorrhoea (SA) in addition to various other factors known, a total of 50 patients, married and unmarried with SA of 3 months to 24 months duration were investigated for thyroid (T3, T4 and thyroid-stimulating hormone (TSH), gonadotrophic hormones (luteinising hormone (LH), follicle-stimulating hormone (FSH) and prolactin), a few haematological parameters and serum protein, iron and total iron binding capacity (TIBC) levels. In these patients, uterine and ovarian factors were ruled out. Among these patients, thyroid dysfunction was seen in 46% of cases, whereas only 10% had LH, FSH and prolactin variations. Haematological studies revealed that the majority of these patients exhibited moderate to severe anaemia. From the estimation of serum protein, serum iron and TIBC levels the type of anaemia was found to be protein-iron deficiency anaemia (nutritional anaemia). These results conclude that hormonal factors apart from uterine and ovarian anamolies, need not be the main causes for SA and it was found that in the majority of the cases tested, SA was due to nutrition-related anaemia. In a few patients, it was noteworthy that the presence of anaemia along with thyroid disorder caused early onset of SA which was also of longer duration.
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Raghuraman, V., Rathika, V. Secondary Amenorrhoea: Nutritional Anaemia a Cause or Reason. Comp Haematol Int 10, 208–211 (2001). https://doi.org/10.1007/s005800170007