Although the exact mechanism still remains unknown, it is hypothesized that this is due to metformins ability to increase the bodys sensitivity to insulin. Anti-androgen medications, such as spironolactone, can also be used to lower body androgen levels and restore menstruation. Oral contraceptive pills are also often prescribed to patients with secondary amenorrhea due to PCOS in order to regularize the menstrual cycle, although this is due to the suppression of ovulation. References
External links

Disability Onlines amenorrhoea page
Disability Onlines athletic amenorrhoea page
Amenorrhea
Treatment
Surgery has been the most common form of treatment for both localized: 101 : 361  and diffuse TGCT. : 103 : 361 : 1  After surgery, patients may receive physical therapy in order to help rehabilitate affected joints. However, recurrence of TGCT after surgery is common, with a higher rate of recurrence for diffuse TGCT than for localized TGCT. : 361  In cases of recurrent or resistant disease, multiple surgeries, total joint arthroplasties, or amputation may be required. : 1 A multidisciplinary approach, supplementing surgery with radiotherapy or other treatments, can also improve outcomes in cases of recurrent TGCT. In the late 2010s, treatment with CSF1R inhibitors emerged as an option that may help improve functionality for patients with recurrent TGCT or TGCT that is not easily managed by surgery. : 361

Epidemiology
A study conducted in the Netherlands estimated that the worldwide incidence of TGCT is 43 cases per million person-years. The majority – 39 cases per million person-years – were estimated to be localized TGCT; the remaining 4 cases per million person-years were estimated to be diffuse TGCT. TGCT can occur in patients of any age, but people with localized TGCT are typically between 30 and 50 years old,: 100–101  while diffuse TGCT tends to affect people under the age of 40.: 102–103

See also
Fibroma of tendon sheath
List of cutaneous conditions

References


== External links ==