Gonadal dysgenesis: a review of 15 years' management.

Fifteen years' experience in a Menstrual Disorder Clinic revealed that gonadal dysgenesis was the commonest cause of primary amenorrhoea. Investigations using Barr Body study and laparoscopic examination were unsatisfactory and inaccurate. The invasive nature of laparoscopy was the likely principal cause for the high default rate in the early years of the Clinic. The availability of hormone radioimmunoassay and cytogenetic study has improved the diagnostic acuity. Gonadal malignancy associated with the "Y" chromosome could also be identified at its early stage. Oestrogen replacement therapy has been found to be beneficial and is associated with little side effects and no endometrial pathology has been identified.