The fallacy of the postpill amenorrhea syndrome.

In conclusion, although there are changes in the hypothalamic pituitary axis in terms of release of FSH and LH resulting in anovulation in women on oral contraceptives, the evidence to date does not support a cause and effect phenomenon. On the basis of both epidemiologic as well as biochemical studies, the etiology of secondary amenorrhea is diverse. This serves only to indicate that amenorrhea is a symptom, not a diagnosis. It appears at the present time that amenorrhea following the use of oral contraceptives should indicate only the preceding temporal use of exogenous steroids without implication as to a cause of the amenorrhea. Investigation should be aimed at determining the underlying cause of the amenorrhea.