Ovarian Changes During Progestogen Amenorrhoea

Abstract

Summary Ovarian tissue was studied from 19 women who developed prolonged amenorrhoea (6–21 months) after Depomedroxyprogesterone acetate or norethisterone enanthate injections for contraception for 18 to 33 months. The ovarian specimens were obtained in 11 of the patients during progestogen medication and in the other eight 2 to 6 months after stopping treatment. In four cases withdrawal bleeding was induced by oestrogen before examination of the ovaries. The ovarian tissue showed either follicular suppression, when only primordial follicles were detected, or a multicystic pattern with many non‐luteinized cystic follicles or follicular cysts in different stages of development and degeneration. This multicystic pattern was seen mainly in women with amenorrhoea persisting after stopping therapy. Oestrogen administration to induce withdrawal bleeding produced no change in the ovary other than increased congestion.