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Primary Amenorrhea

Amenorrhea Primary Physiologic


Presentation

  • It has a reported incidence of 1:2,100-1:72,000 and a variety of clinical presentations. A 16-year-old patient presented with primary amenorrhea and a large abdominal mass that was palpated on clinical exam and confirmed on MRI imaging.[ncbi.nlm.nih.gov]
Broad Chest
  • Short stature, absent secondary sexual characteristics, neck webbing, cubitus valgus and broad chest with widely spaced nipples were commonly seen in patients with Turner syndrome and variant forms.[ncbi.nlm.nih.gov]
  • chest flat feet Identification of a 45,X or 45,X mosaic karyotype in an amenorrheic patient with an elevated FSH confirms the cause of primary amenorrhea.[clinicaladvisor.com]
Turkish
  • Our objective was to identify the distribution of cytogenetic abnormalities of 175 Turkish women with primary amenorrhea (PA) or premature ovarian insufficiency (POI).[ncbi.nlm.nih.gov]
Tall Stature
  • Aromatase deficiency should be suspected when a patient presents with primary amenorrhea, absence of female secondary sexual characters, virilization and tall stature with eunuchoid body proportions, and biochemical features of ovarian failure.[ncbi.nlm.nih.gov]
Learning Difficulties
  • difficulty and facial dysmorphism. aCGH analysis revealed an Xq27.2-q28 deletion, an 11q24.3-q25 duplication, and an inverted duplication of Xq22.3-q27.1.[ncbi.nlm.nih.gov]
Language Delays
  • They had minor facial dysmorphism and neuropsychiatric disorders including mental retardation, language delay and epilepsy. The sister had primary amenorrhea.[ncbi.nlm.nih.gov]
Amenorrhea
  • AIMS: The aim of this study was to determine the prevalence of etiologic causes of primary amenorrhea in Thailand.[ncbi.nlm.nih.gov]

Workup

  • This review's aims are to define primary amenorrhea and describe the various causes, their workups, associated comorbidities, and treatment options.[ncbi.nlm.nih.gov]
  • A pregnancy test should always be included in the workup of secondary amenorrhea, regardless of reported history. The most common causes of secondary amenorrhea include: Pregnancy: second most common cause of secondary amenorrhea.[pedclerk.bsd.uchicago.edu]
  • Initial workup of primary and secondary amenorrhea includes a pregnancy test and serum levels of luteinizing hormone, follicle-stimulating hormone, prolactin, and thyroid-stimulating hormone.[aafp.org]
Karyotype Abnormal
  • Abnormal: Turner syndrome, rare chromosomal disorders Pregnancy test Positive: Pregnancy, ectopic pregnancy Prolactin High: Pituitary adenoma, medications, hypothyroidism, other neoplasm Thyroid-stimulating hormone High: Hypothyroidism Low: Hyperthyroidism[aafp.org]

Treatment

  • This review's aims are to define primary amenorrhea and describe the various causes, their workups, associated comorbidities, and treatment options.[ncbi.nlm.nih.gov]

Prognosis

  • The prognosis after gross total resection is likely favorable; however, long-term follow-up is indicated for these rare neoplasms.[ncbi.nlm.nih.gov]
  • ., vaginal outlet obstruction will require surgical correction Prognosis, Prevention, and Complications Complications infertility Please rate topic. Average 5.0 of 2 Ratings Thank you for rating![medbullets.com]
  • Treatment of infertility in these groups of patients is directed towards the cause of the amenorrhea and the prognosis is generally good.[laivfclinic.com]
  • Outlook (Prognosis) The outlook depends on the cause of the amenorrhea and whether it can be corrected with treatment or lifestyle changes.[ufhealth.org]

Etiology

  • The presentation, etiology, diagnosis, and surgical treatment of a transverse vaginal septum are discussed.[ncbi.nlm.nih.gov]

Epidemiology

  • BJOG: An International Journal of Obstetrics & Gynaecology, 1958;65: 734–738. doi: 10.1111/j.1471-0528.1958.tb08863.x Malkani PK : Epidemiology of genital tuberculosis in India. In Rippman ET, Wenner R (eds): Latent Genital Tuberculosis.[jpgo.org]
  • Epidemiology of secondary amenorrhea: incidence and prevalence rates. Am J Obstet Gynecol. 1973;117:80-86. Even when causes of primary and secondary amenorrhoea overlap, the relative likelihoods of these aetiologies may differ.[bestpractice.bmj.com]
  • Epidemiology The prevalence of non-physiological amenorrhoea (in women of menstruating age) is around 3-4%. [ 1 ] Secondary amenorrhoea is more common in athletes.[patient.info]
  • The epidemiology of polycystic ovary syndrome. Prevalence and associated disease risks. Endocrinol Metab Clin North Am . 1999;28:247–63. 23. Chang RJ, Katz SE. Diagnosis of polycystic ovarian syndrome.[aafp.org]
  • Epidemiology/Normal Menses The median age of menarche in the United States is 12.4 years, with African-American girls experiencing menarche slightly earlier on average than non-Hispanic white and Mexican-American girls, as determined in the third National[pedsinreview.aappublications.org]
Sex distribution
Age distribution

Pathophysiology

  • Reproductive endocrinology: physiology, pathophysiology and clinical management. Philadelphia: WB Saunders, 1978: 189–240. Google Scholar 3. Coulam CB. Testicular regression syndrome. Obstet Gynecol 1979; 53: 44–49. PubMed Google Scholar 4.[link.springer.com]
  • Crowley Jr Gonadotropin-releasing hormone deficiency in the human (idiopathic hypogonadotropic hypogonadism and Kallmann's syndrome): pathophysiological and genetic considerations [5.] S.N. Kalantaridou, G.P.[elsevier.es]
  • Pathophysiology, genetics, and treatment of hyperandrogenism. Pediatr Clin North Am 1997;44:375-95. Fardella CE, Hum DW, Homoki J. Miller WL. Point mutation of Arg440 to his cytochrome P450c 17 causes severe 17 alfa hydroxylase deficiency.[revista.fecolsog.org]
  • Defining the level of primary dysfunction is critical in determining the pathophysiology of amenorrhea. Hypothalamus, pituitary and ovaries form a functional endocrine axis, known as HPO axis with hormonal regulations and feedback loops.[emedicine.medscape.com]

Prevention

  • Nurses working with adolescents may prevent more serious problems through early identification and intervention.[ncbi.nlm.nih.gov]
  • Can amenorrhea be prevented? Amenorrhea is a symptom and not a disease in itself. Therefore, amenorrhea can be prevented only to the extent that the underlying cause can be prevented.[medicinenet.com]
  • How can Primary Amenorrhea be Prevented? Primary Amenorrhea is a disorder that may be prevented if the underlying cause is known and can be treated. Prevention of the condition is based on the underlying factors that lead to Primary Amenorrhea.[dovemed.com]
  • ., vaginal outlet obstruction will require surgical correction Prognosis, Prevention, and Complications Complications infertility Please rate topic. Average 5.0 of 2 Ratings Thank you for rating![medbullets.com]

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