Clinical Psychopharmacology and Neuroscience 2010; 8(1): 21-25  
Menstrual Irregularities and Sex Hormones in Female Patients Treated with Conventional Antipsychotics for more than 5 Years
Jihyeon Kim, Suyeon Kim, Sohee Kim, Sohyun Choi
Yongin Mental Hospital, Yongin, Korea
© The Korean College of Neuropsychopharmacology. All rights reserved.

Objective: This study was designed to observe the menstrual patterns of female chronic psychiatric patients treated with antipsychotic drugs and to assess prolactin and estradiol levels to determine the relationship among prolactin, menstrual irregularities and sex hormones. Methods: Sixty female inpatients who had been treated with antipsychotics for more than 5 years participated in this study.The first day of each menstrual cycle during a 6-month period was recorded after menstruation was confirmed by nursing staff. Blood samples were taken at an early follicular phase for menstruating patients and randomly for amenorrheic patients to assess prolactin and estradiol levels. Results: Of the 60 subjects, 12 experienced regular and 23 experienced irregular menstruation. Twenty-five patients were amenorrheic. Hyperprolactinemia was found in 80% of all subjects. The amenorrheic group showed higher prolactin levels, and these levels were correlated with dosage of antipsychotics. Estradiol was lower than 10 pg/ml (undetectable) in 77% of the patients but was exceptionally high in a few participants. Conclusion: About 80% of participants experienced menstrual disturbance, hyperprolactinemia, or hypoestrogenism. These findings suggest that hypothalamic-pituitary-ovarian axis dysfunction was very common in chronic psychiatric patients receiving long-term treatment with antipsychotic medication and should be considered in clinical practice.
Keywords: Antipsychotics; Menstruation; Prolactin; Estradiol.

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