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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).
[congenital adrenal hyperplasia]
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
.
Five
women
(
ages
between
16
and
30
years
)
with
congenital
adrenal
hyperplasia
(
CAH
)
due
to
C
2
1
-
hydroxylase
deficiency
and
primary
or
secondary
amenorrhoea
were
treated
with
the
opiate
antagonist
naltrexone
at
a
dose
of
50
mg
per
day
.
In
all
patients
naltrexone
induced
normalization
of
menstrual
cycle
determined
by
endocrine
parameters
and
ultrasonography
.
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
.
Diseases
Validation
Diseases presenting
"hypothalamic origin"
symptom
congenital adrenal hyperplasia
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