RESUMO
PIP: The various types of menstrual dysfunctions are classified, their symptoms are described, and appropriate treatment is suggested. The types considered are: subfollicular, persistent follicular (subdivided into simple, macrofollicular and microfollicular or androgenic), subluteal and persistent luteal. The subfollicular type is characterized by the early onset of menopause (before age 40); the follicular type by amenorrhea and sterility (simple type), alternating amenorrhea and bleeding (macrofollicular), and amenorrhea with occasional bleeding and hirsutism (microfollicular); the subluteal type by sterility; and the luteal type by either amenorrhea or hypermenorrhea. The type of dysfunction can be detected by laboratory tests (such as urinary estrogens, pregnanediol, and gonadotropins, functional cytology, 17-ketosteroids, plasma testosterone, appearance of the endometrium, and basal temperature). The subfollicular type is treated with estrogen, with or without progesterone, the follicular type with cyclical administration of progesterone (clomiphene can also be used), the subluteal type with progesterone, 17alpha-hydroxyprogesterone, and chorionic gonadotropin, and the luteal type with high doses of progesterone.^ieng