Secondary Amenorrhea in a Patient of Type 1 Diabetes Mellitus

OBJECTIVES: To highlight the association between Type 1 Diabetes Mellitus (T1DM) and secondary amenorrhea, a reproductive dysfunction, and emphasize the need for timely interventions to mitigate reproductive and pregnancy complications. MATERIALS AND METHODS: CASE PRESENTATION: An 18-year-old female with complaints of: 1. Polyuria and polydipsia: 2 years. 2. Weight loss: 2 years. 3. Amenorrhea: 1 year. Investigations: FSH: 2.59 mIU/mL, LH: <0.100 mIU/mL, Prolactin: 14.2 ng/mL. HbA1c: 10%, RBS: 687 mg/dL, C-peptide: 0.09 ng/mL. FT3: 1.2 pg/mL, FT4: 77.7 pmol/L, TSH: 2.07 pIU/mL. Anti-GAD Ab and anti-islet cell Ab: Negative. Ultrasound: Bilateral normal ovaries and uterus. RESULTS: The findings suggest hypothalamic amenorrhea secondary to poor metabolic control in T1DM. The endocrine investigations confirm low gonadotropin levels, correlating with a disrupted hypothalamic-pituitary-gonadal axis.(1,2) CONCLUSION: Reproductive dysfunction is a less recognized complication of T1DM. Greater awareness among women, couples, and clinicians is essential. Further studies are required to explore other mechanisms of reproductive dysfunction in diabetic patients and establish effective preconception counseling protocols.