This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the author's clinicalrecommendations.
A 30-year-old woman presents with a history of no menses sinceshe stopped taking oral contraceptives 6 months ago in orderto conceive. She had undergone puberty that was normal in bothtiming and development, with menarche at 12 years of age. At18 years of age, she started taking oral contraceptives forirregular menses. She reports stress at work. Her weight . . . [Full Text of this Article]
The Clinical Problem
Strategies and Evidence
Evaluation
Management
Emotional Health
Hormone-Replacement Therapy
Maintaining Bone Health
Associated Disorders
Family Planning
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Integrative Reproductive Medicine Unit, Intramural Research Program on Reproductive and Adult Endocrinology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD. An audio version of this article is available at NEJM.org.
Address reprint requests to Dr. Nelson at the Integrative Reproductive Medicine Unit, NICHD–Intramural Research Program on Reproductive and Adult Endocrinology, CRC, Rm. 1-3330, 10 Center Dr., MSC-1103, Bethesda, MD 20892, or at lawrence_nelson@nih.gov.
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