Epidural corticosteroid injections as a possible cause of menorrhagia: A case report

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

A 47-year-old female was referred for evaluation of chronic lower back pain. A magnetic resonance imaging of her lumbar spine revealed a broad-based disc herniation at L4-L5 with bilateral neural foraminal narrowing. A decision was made to treat her with bilateral L4-5 transforaminal epidural steroid injections. Following moderate pain relief, the procedure was repeated. Several days after each injection, the patient experienced unusually heavy and painful menstrual bleeding. We postulate that the introduction of exogenous corticosteroids directly into the neuraxial space can initiate a negative feedback loop on the hypothalamic-pituitary-ovarian axis. As a result, this may lead to decreased levels of circulating hormones, resulting in episodes of menorrhagia in the premenopausal population. Wiley Periodicals, Inc.

Original languageEnglish (US)
Pages (from-to)713-715
Number of pages3
JournalPain Medicine
Volume11
Issue number5
DOIs
StatePublished - 2010

Fingerprint

Epidural Injections
Menorrhagia
Low Back Pain
Adrenal Cortex Hormones
Spine
Steroids
Magnetic Resonance Imaging
Hormones
Hemorrhage
Pain
Injections
Population

Keywords

  • Epidural Steroid
  • Hypothalamus
  • Menorrhagia
  • Transforaminal

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • Medicine(all)

Cite this

Epidural corticosteroid injections as a possible cause of menorrhagia : A case report. / Gitkind, Andrew I.; Shah, Binod; Thomas, Mark A.

In: Pain Medicine, Vol. 11, No. 5, 2010, p. 713-715.

Research output: Contribution to journalArticle

@article{122366aa5b1d49bb8edc54c68f78eb0a,
title = "Epidural corticosteroid injections as a possible cause of menorrhagia: A case report",
abstract = "A 47-year-old female was referred for evaluation of chronic lower back pain. A magnetic resonance imaging of her lumbar spine revealed a broad-based disc herniation at L4-L5 with bilateral neural foraminal narrowing. A decision was made to treat her with bilateral L4-5 transforaminal epidural steroid injections. Following moderate pain relief, the procedure was repeated. Several days after each injection, the patient experienced unusually heavy and painful menstrual bleeding. We postulate that the introduction of exogenous corticosteroids directly into the neuraxial space can initiate a negative feedback loop on the hypothalamic-pituitary-ovarian axis. As a result, this may lead to decreased levels of circulating hormones, resulting in episodes of menorrhagia in the premenopausal population. Wiley Periodicals, Inc.",
keywords = "Epidural Steroid, Hypothalamus, Menorrhagia, Transforaminal",
author = "Gitkind, {Andrew I.} and Binod Shah and Thomas, {Mark A.}",
year = "2010",
doi = "10.1111/j.1526-4637.2009.00775.x",
language = "English (US)",
volume = "11",
pages = "713--715",
journal = "Pain Medicine",
issn = "1526-2375",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Epidural corticosteroid injections as a possible cause of menorrhagia

T2 - A case report

AU - Gitkind, Andrew I.

AU - Shah, Binod

AU - Thomas, Mark A.

PY - 2010

Y1 - 2010

N2 - A 47-year-old female was referred for evaluation of chronic lower back pain. A magnetic resonance imaging of her lumbar spine revealed a broad-based disc herniation at L4-L5 with bilateral neural foraminal narrowing. A decision was made to treat her with bilateral L4-5 transforaminal epidural steroid injections. Following moderate pain relief, the procedure was repeated. Several days after each injection, the patient experienced unusually heavy and painful menstrual bleeding. We postulate that the introduction of exogenous corticosteroids directly into the neuraxial space can initiate a negative feedback loop on the hypothalamic-pituitary-ovarian axis. As a result, this may lead to decreased levels of circulating hormones, resulting in episodes of menorrhagia in the premenopausal population. Wiley Periodicals, Inc.

AB - A 47-year-old female was referred for evaluation of chronic lower back pain. A magnetic resonance imaging of her lumbar spine revealed a broad-based disc herniation at L4-L5 with bilateral neural foraminal narrowing. A decision was made to treat her with bilateral L4-5 transforaminal epidural steroid injections. Following moderate pain relief, the procedure was repeated. Several days after each injection, the patient experienced unusually heavy and painful menstrual bleeding. We postulate that the introduction of exogenous corticosteroids directly into the neuraxial space can initiate a negative feedback loop on the hypothalamic-pituitary-ovarian axis. As a result, this may lead to decreased levels of circulating hormones, resulting in episodes of menorrhagia in the premenopausal population. Wiley Periodicals, Inc.

KW - Epidural Steroid

KW - Hypothalamus

KW - Menorrhagia

KW - Transforaminal

UR - http://www.scopus.com/inward/record.url?scp=77953727973&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953727973&partnerID=8YFLogxK

U2 - 10.1111/j.1526-4637.2009.00775.x

DO - 10.1111/j.1526-4637.2009.00775.x

M3 - Article

C2 - 20070546

AN - SCOPUS:77953727973

VL - 11

SP - 713

EP - 715

JO - Pain Medicine

JF - Pain Medicine

SN - 1526-2375

IS - 5

ER -