title: Naltrexone as a diagnostic tool to distinguish between hyperandrogenemic and hypothalamic ovarian failure in females with congenital adrenal hyperplasia due to 21-hydroxylase-deficiency (CAH).
abstract: OBJECTIVE
  Hypothalamic ovarian failure can be considered as a differential diagnosis in women suffering from CAH and amenorrhea. Naltrexone can be used as a tool to exclude hyperandrogenemia as a cause of amenorrhea in that condition.
  
  
  METHODS
  Five women (ages between 16 and 30 years) with congenital adrenal hyperplasia (CAH) due to C21- hydroxylase deficiency and primary or secondary amenorrhoea were treated with the opiate antagonist naltrexone at a dose of 50mg per day.
  
  
  RESULTS
  In all patients naltrexone induced normalization of menstrual cycle determined by endocrine parameters and ultrasonography.
  
  
  CONCLUSIONS
  Since naltrexone has been shown to restore normal menstrual cycles in hypothalamic amenorrhea it can be inferred that the cause of amenorrhea in those patients was not of hyperandrogenemic but of hypothalamic origin. Naltrexone may therefore be used to differentiate between hyperandrogenemic and hypothalamic ovarian failure in patients suffering from CAH.
authors: Department of Gynecologic Endocrinology and Reproductive Medicine, Innsbruck Medical University, Innsbruck, Austria.
authors: B
authors: B
authors: Böttcher
authors: Department of Pediatrics, University of Erlangen, Erlangen, Germany.
authors: H G
authors: HG
authors: Dörr
authors: Department of Gynecologic Endocrinology and Reproductive Medicine, Innsbruck Medical University, Innsbruck, Austria. Electronic address: Ludwig.wildt@i-med.ac.at.
authors: L
authors: L
authors: Wildt
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications*; D000328:Adult; D000568:Amenorrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000175:diagnosis*; D007027:Hypothalamic Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009839:Oligomenorrhea / Q000209:etiology*; D016649:Primary Ovarian Insufficiency / Q000209:etiology*; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: Congenital adrenal hyperplasia; Hyperandrogenemia; Hypothalamic amenorrhe; Naltrexone