Presentation
Types of Amenorrhea Primary amenorrhea is the lack of menstruation in a girl who is 16 years or older or if there are signs of puberty present for more than 2 years with no menses. [healthhype.com]
Other symptoms and signs may be present, which are highly variable and depend upon the underlying cause of the amenorrhea. [medicinenet.com]
Summary Cytogenetic investigations were carried out on 103 women presenting with either primary ( n 88) or secondary ( n 15) amenorrhea. A sex chromosome anomaly was found in 26% and 33% of these patients, respectively. [link.springer.com]
Affected girls usually present with primary amenorrhea or pubertal delay as well as elevated FSH levels and low estradiol levels. As adrenarche is driven by the adrenal gland, which is unaffected, pubic hair may still be present. [obgynmorningrounds.com]
We present the case of a 17 y.o. girl who presented in our clinic with secondary amenorrhea. She had only one spontaneous menstrual bleeding at the age of 15. [endocrine-abstracts.org]
Entire Body System
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Rigor
A number of conditions can affect the hypothalamus: extreme weight loss, emotional or physical stress, rigorous exercise, and severe illness. [medicinenet.com]
Rigorous sports – If you have low body weight and are expending more energy through exercise than food you are taking in on a prolonged basis then you have a higher risk of developing amenorrhea. [info.isabelhealthcare.com]
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Tall Stature
stature, and lack of internal genitalia treat with gonadectomy and HRT 17 Alpha Hydroxylase Deficiency these patients are not producing ANY sex hormones have primary amenorrhea have a crap ton of aldosterone with hypokalemia, hypernatremia, ovarian failure [quizlet.com]
stature and abnormally rapid growth Tenosynovitis Tension headaches Teratogenic birth defects Testicular torsion Testicular tumors Tetanus Thalassemia The breasts The cell The cell cycle The cerebral cortex, basal ganglia, and meninges The ear The leg [amboss.com]
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Accelerated Growth
Puberty The orderly progression of puberty begins with breast budding (thelarche), accelerated growth, and menses (menarche). [emedicine.medscape.com]
Immune System
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Splenomegaly
Sodium disorders Soft tissue lesions of the shoulder Somatic symptom and related disorders Spasticity Specialized nutrition support Spinal cord tracts and reflexes Spinal muscular atrophy Spinal stenosis Spinocerebellar ataxia Spleen Splenic rupture Splenomegaly [amboss.com]
Cardiovascular
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Tachycardia
[…] management Pancreas Pancreatic and hepatic surgery Pancreatic cancer Paraneoplastic syndromes Parapsoriasis Parasympathomimetic drugs Parenteral anticoagulation Parenteral fluid therapy Parkinson disease Parkinson-plus syndromes Paroxysmal supraventricular tachycardia [amboss.com]
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Vascular Disease
The possible presence of müllerian-inhibitory-like substance early in development has been suggested. 22 An immune etiology or an association with collagen vascular disease has also been suggested. 23 In cases of aplastic urogenital sinus, the internal [glowm.com]
Skin
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No Pubic Hair
Evaluation In cases of primary amenorrhea, it is important to assess if and at what age other pubertal milestones have been reached, such as breast and pubic hair development. [obgynmorningrounds.com]
Primary amenorrhoea is when: periods have not started by 14 years and there are no signs of other sexual characteristics (such as developing breasts and pubic hair), or periods have not started by 16 years, even though other sexual characteristics have [betterhealth.vic.gov.au]
Primary amenorrhea is the absence of menstrual bleeding and secondary sexual characteristics (for example, breast development and pubic hair) in a girl by age 14 years or the absence of menstrual bleeding with normal development of secondary sexual characteristics [emedicinehealth.com]
These will allow development of normal secondary sex characteristics such as breasts and pubic hair. If amenorrhea is caused by a structural problem, surgery is usually necessary. [drugs.com]
Background Menarche (the onset of menses) is an important milestone in female adolescent development, and is preceded by the onset of breast development (thelarche) and pubic hair (pubarche). [pedclerk.bsd.uchicago.edu]
Breast
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Large Breast
breasts, NO pubic/axillary hair, tall stature, and lack of internal genitalia treat with gonadectomy and HRT 17 Alpha Hydroxylase Deficiency these patients are not producing ANY sex hormones have primary amenorrhea have a crap ton of aldosterone with [quizlet.com]
Neurologic
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Confusion
Menstruation marks the beginning of a stage where hormones are changing and, depending how these changes occur, it could be a straightforward process, or it might be delayed and confusing. [teenzeen.org]
Workup
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]
If the history and physical exam are suggestive of a certain etiology The workup can sometimes be more directed CLINICAL ASSESSMENT - INVESTIGATIONS - 30. [slideshare.net]
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]
A review of the literature of 33 cytogenetic studies composed of 1,757 phenotypic females with primary amenorrhea revealed a 32% incidence of chromosome abnormalities. 22 Figure 1 gives a schematic outline of the laboratory workup. Fig. 1. [glowm.com]
Serum
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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
What is the treatment for amenorrhea? Treatment of primary and secondary amenorrhea is determined by the specific cause. [medicinenet.com]
Part of the encyclopedia is a disease dictionary including not only recommendation how to prevent each disease but also its initial symptoms, causes and useful advices about treatment for given illness. [beltina.org]
There are hormone treatments that have been used in the past, but their success rates are low. Often irregular periods are like other menstrual problems and will improve as you get older. [teenzeen.org]
Treatment by Type The classification by function is the most useful in the treatment of amenorrhea, as this is indicative of where the problem originates and which areas should be targeted in treatment. [news-medical.net]
TREATMENT OF AMENORRHEA The need for treatment depends on Underlying causes Need for regular periods Trying to conceive (fertility Need for contraception) 41. [slideshare.net]
Prognosis
What Is Amenorrhea Prognosis? Amenorrhea is typically not a life-threatening condition. The prognosis for amenorrhea depends upon the underlying cause and the type of treatment that is available. [emedicinehealth.com]
Prognosis The prognosis of either primary or secondary amenorrhea depends on the underlying cause. [healthofchildren.com]
If you are not sexually active, see your doctor if: You have missed three consecutive menstrual periods Your periods are irregular Prognosis In most instances, symptoms and conditions related to amenorrhea are reversible and treatable. [drugs.com]
TREATMENT OF AMENORRHEA TRYING TO CONCEIVE The prognosis for women with confirmed ovarian failure is poor. [slideshare.net]
Etiology
HYPOTHALAMIC CAUSES Secondary Amenorrhea - ETIOLOGY - Hypothalamic dysfunction is a common cause (30%). [slideshare.net]
While some etiologies can cause both primary and secondary amenorrhea, they are distinct entities with subtly different diagnostic and etiologic frameworks. [pedclerk.bsd.uchicago.edu]
Research designed to determine the etiology of the amenorrhea and the associated changes has shown mixed results. Low body fat cannot be linked in a causative fashion to hormonal changes or decreased levels of circulating estrogen. [pediatrics.aappublications.org]
Conclusion: Genetic causes occupy the first place in the etiology of premature/primary ovarian failure (POF). Not only abnormalities of the sexual CRs but also of the autosomal ones can lead to POF. [endocrine-abstracts.org]
Etiology Because multiple factors may play a role in the development of secondary amenorrhea, it is difficult to construct a complete etiologic classification. [glowm.com]
Epidemiology
"Epidemiology of secondary amenorrhea. I. Incidence and prevalence rates". Am. J. Obstet. Gynecol. 117 (1): 80–6. PMID 4722382. 13.0 13.1 Tomten SE (1996). [wikidoc.org]
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]
Pathophysiology
If PCOS is the cause, weight loss may be helpful. return to top Pathophysiology return to top Resources and References return to top Topic Development authors: reviewers: return to top [sharinginhealth.ca]
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]
Pathophysiology and Etiologies of Amenorrhea For normal menstrual function to occur, a succession of properly communicated signals and functional end organs must be present. [obgynmorningrounds.com]
This distinction is descriptive and artificial, because the underlying pathophysiologic conditions responsible for primary or secondary amenorrhea may be similar. [glowm.com]
Prevention
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]
Part of the encyclopedia is a disease dictionary including not only recommendation how to prevent each disease but also its initial symptoms, causes and useful advices about treatment for given illness. [beltina.org]
[…] high LH/FSH and low E2/P4 Premature Ovarian Failure this is a hypogonadotropic hypogonadism that is very rare and usually from unknown causes but is likely caused by autoimmune causes (hypothyroid, hypoparathyroid, hypoadrenal, pernicious anemia) must prevent [quizlet.com]
Prevention In many cases, teenage girls can help to prevent primary amenorrhea. They should follow a sensible exercise program. And they should maintain a normal weight. Primary amenorrhea caused by anatomic abnormalities cannot be prevented. [drugs.com]
Prevention Amenorrhea related to pregnancy, the female athletic triad, drug or alcohol abuse, or eating disorders is preventable insofar as these are lifestyle choices. [healthofchildren.com]