Wednesday, May 03, 2006

Female Spinal Cord Patients w/ Amenorrhea May Still Conceive Children

Some Female Spinal Cord Patients With Amenorrhea May Still Conceive Children: Presented at AACE

Many women who sustain permanent spinal cord injury and develop resulting transitory amenorrhea may still be able to conceive children, according to a poster presented here at the annual meeting of the American Association of Clinical Endocrinologists (AACE).

Amenorrhea has been proven to be stress-related, but women return to normal sexual function after transitory amenorrhea," said Ghasa Mahmood, MD, endocrinology fellow, Martin Luther King/Charles Drew University Medical Center, Los Angeles, California, United States, in a presentation on April 27th.

Of 128 women who sustained a spinal cord injury, 53 immediately developed amenorrhea, or a cessation of menstrual flow. Of those, 3 went into menopause, Mahmood said. The study was a retrospective analysis of patients in a cardiovascular risk study. All of the women who went into menopause were over 40 years of age at the time, she said.

"Of the remaining 50 women, we had 10 pregnancies," Dr. Mahmood said, calling the study the largest to date in the field. The median period of transitory amenorrhea was 7.96 months, she said. "But even if the patient gets amenorrhea for 15 months, not 6 months, she can still get pregnant, because the duration of amenorrhea is not statistically significant."

Also bearing no apparent relation to the likelihood of pregnancy in the study was the level of a patient's injury. Spinal trauma experience by the patients included cervical, thoracic, and lumbar spinal trauma. "All of these were permanent injuries, resulting in irreversible paralysis," Dr. Mahmood emphasized.

"The only thing that our data suggested to be a relevant factor was the patient's age at the time of the trauma," Dr. Mahmood said. "The mean age was 21 among women who later got pregnant, and 28 among the women who didn't."

Among the 10 women who conceived, 4 elected to terminate the pregnancy, while at least half of the remaining 6 gave birth via Caesarean section, according to the poster.

Dr. Mahmood said he intends to investigate the relationship between spinal cord trauma and amenorrhea.

"We're going to go back and check the levels of prolactin, luteinizing hormone (LH), and follicle stimulating hormone (FSH), as well as the estrogen and progesterone levels among those patients," she said, noting that traumatic injuries can affect the hypothalamus or the pituitary stalk, possibly resulting in amenorrhea.

"Another reason for the amenorrhea may be the drugs these patients take to control spasms which result from the injury," Mahmood said.

By John Otrompke