For example, hypothalamic problems, anorexia or extreme exercise can play a major role in causing amenorrhea depending on the persons age and if she has experienced menarche. Secondary amenorrhea absence of a period amenorrhea is the medical term for the lack of menstrual periods, including on a permanent or temporary basis. Amenorrhea article about amenorrhea by the free dictionary. It is helpful to divide the evaluation of amenorrhea into three categories. Testosterone, free and total includes sex hormone binding globulin, females or children dehydroepiandrosterone sulfate dhea.
Up to 50% of competitive runners training 80 miles per week and up to 44% of ballet dancers have amenorrhea. Secondary amenorrhea an overview sciencedirect topics. Pdf disruptions in the menstrual cycle are a common complaint in primary care and womens health. If a uterus is present, outflow track obstruction may be to blame for primary amenorrhoea. Primary amenorrhea may be caused by developmental problems such as the congenital absence of the uterus, failure of the ovary to receive or maintain egg cells. Primary amenorrhea is the absence of menarche in a girl aged 16 years or older. Secondary amenorrhoea is absence of periods for at least 3 months if the patient has previously had regular periods, and 6 months if she has previously had oligomenorrhoea. Secondary amenorrhea north dakota department of health. Free and total testosterone and dehydroepiandrosterone sulfate.
Secondary amenorrhea is due to pregnancy, stress, illness or other causes. Amenorrhea absence of menses can be a transient, intermittent, or permanent condition resulting from dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina table 1 and table 2. Breastfeeding and menopause are also common, but natural, causes. Epidemiology and causes of secondary amenorrhea uptodate. The most common etiologies are pregnancy and polycystic ovarian syndrome pcos. Physiological states of amenorrhea are seen, most commonly, during pregnancy and lactation. Describe the classification of amenorrhea and list the major causes of primary and secondary amenorrhea. For example, the most common cause of secondary amenorrhea is pregnancy.
Secondary amenorrhea american academy of pediatrics. Carlson division of adolescent medicine, stanford university school of medicine, mountain view, california, usa menstrual irregularity is a common occurrence during adolescence, especially within the. Secondary amenorrhea gynecology video course lecturio. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic evaluation, with referral considerations. Most common cause of secondary amenorrhea rule out with a urine or serum hcg before proceeding consider each level of the control of the menstrual cycle. Amenorrhea clinical research trial listings in obstetricsgynecology womens health family medicine on centerwatch. However, patients with previously regular cycles are evaluated for secondary amenorrhea if menses have been absent for. Most cases of secondary amenorrhea can be attributed to polycystic ovary. Details on treatments and causes of amenorrhea the absence of a monthly period are provided. N2 objective analyses were undertaken to identify factors that may predispose women to secondary amenorrhea or galactorrhea, frequent sources of abnormal reproductive function. In some cases, the cause is functional, meaning that the hypothalamic gonadotropinreleasing hormone gnrh pulse generator has shut down the reproductive system in its role as an integrator of metabolic and psychogenic stress.
After pregnancy is ruled out, the initial workup should be based on patient history and physical examination. T1 risk factors for secondary amenorrhea and galactorrhea. The pathophysiology of amenorrhea in the adolescent. Hypothalamus pituitary ovary uterus cervix vagina involved structurally in the outflow of menstrual blood involved in endocrine regulation of the menstrual. Occasionally, the same underlying problem can cause or contribute to either primary or secondary amenorrhea. Ppt amenorrhea powerpoint presentation free to view. It is often classified as either primary absence of menarche by age 15 years or thereafter or secondary absence of menses for more than three months in girls or women. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that. Primary and secondary amenorrhea chapter pdf available. Amenorrhea can be due to pregnancy, anatomic defects of the outflow tract, ovarian disorders, and pituitary or hypothalamic disorders. Secondary amenorrhea article about secondary amenorrhea. Breastfeeding is a common cause of secondary amenorrhoea, and often the condition lasts for over six months. Amenorrhea is the absence of a menstrual period in a woman of reproductive age.
Magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. Secondary amenorrhea testing indications for testing amenorrhea with negative pregnancy test order prolactin. Childrens hospital at montefiore bronx, ny menstrual cycle abnormalities. Hence, we investigated the prevalence of secondary amenorrhea among all females n 1099 that consulted in our clinic, grouped by age 1550 yrs, time months of amenorrea and identifying the. Disruptions in the menstrual cycle are a common complaint in primary care and womens health. Risk factors for secondary amenorrhea and galactorrhea. There are two types of amenorrhea primary or secondary. Secondary amenorrhea is defined as the absence of menstrual flow in women with previously normal menstruation.
Secondary amenorrhea secondary amenorrhea is the absence of menstrual periods for 6 months in a woman who had previously been regular, or for 12 months in a woman who had irregular periods without any physiological reasons. It is helpful to consider secondary amenorrhea as an abnormality in. It is caused by dysfunctioning of the pituitary gland, ovaries, uterus, and hypothalamus, by surgical removal of the ovaries or uterus, by medication, or by emotional trauma. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Secondary amenorrhea, which is defined as 3 months of absence of menstruation, occurs in approximately 35% of adult women. Primary amenorrhea is due to changes in organs, glands, and hormones related to menstruation. Secondary amenorrhea is defined as the cessation of regular menses for three months or the ces sation of irregular menses for six months. Secondary amenorrhea occurs when youve had at least one menstrual period and you stop menstruating for three months or longer. Secondary and primary amenorrhea definition, causes, treatment. Amenorrhea is when a woman of childbearing age fails to menstruate.
Outside the reproductive years, there is absence of menses during childhood and after. Testosterone, free and total includes sex hormone binding globulin, females or children dehydroepiandrosterone sulfate dheas, serum prolactinoma high moderate. Secondary amenorrhea is a condition when period cycle of women with irregular. Choose when to start an evaluation for secondary amenorrhea2. The pathophysiology of amenorrhea in the adolescent neville h. Secondary amenorrhea can occur due to natural changes in the body. Learning objectives and cmedisclosure information this activity is intended for healthcare providers delivering care to women and their families.
Secondary amenorrhea may be due either to complete obliteration of the uterine cavity or to stenosis or atresia of the internal os, as proved by radiologic studies. Secondary amenorrhea secondary amenorrhea is the absence of menses for more than three cycle intervals in women who previously had regular menses, or more than six months in women with history of irregular menses. Secondary amenorrhea is arbitrarily defined as the absence of menses for 6 months or the equivalent of three previous cycle intervals, whichever is longer, in women who previously had menses. The part of the brain called the hypothalamus regulates the menstrual cycle. The most common cause of secondary amenorrhea is pregnancy. Primary amenorrhea is a delay in or a failure to start menstruation.
Secondary amenorrhea definition of secondary amenorrhea by the free dictionary. Pdf on oct 26, 2011, valentina chiavaroli and others published primary. Amenorrhoea amenorrhoea is the absence of menses in a woman of reproductive age. The hormone foundation, the public education affiliate of the endocrine society. Most cases of secondary amenorrhea can be attributed to. Women who take birth control pills or who receive hormone shots such as depoprovera may not have any monthly bleeding. Look up amenorrhea in wiktionary, the free dictionary. It occurs in 35% of women in any specific year secondary amenorrhea can result from abnormal hypothalamus, pituitary, ovary, uterus, or. Secondary amenorrhea is defined by the absence of menstruation for at least 3 months after a previously regular cycle without an existing pregnancy.
Secondary amenorrhea definition of secondary amenorrhea. Winner of the standing ovation award for best powerpoint templates from presentations magazine. After completing this activity, the participant should be better able to. Etiology a variety of factors can contribute to secondary amenorrhea including medication use, lifestyle factors. It is often classified as either primary absence of menarche by age 15 years or secondary absence of menses for more than three months in girls or women who. An initial secondary amenorrhea workup includes thyroid stimulating hormone tsh, prolactin, follicle stimulating hormone fsh, and luteinizing hormone lh tests. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Secondary amenorrhea important differential diagnoses. It is often classified as either primary absence of menarche by age 15 years or thereafter or secondary absence of menses for more than three months in girls or women who previously. Secondary amenorrhea in a patient with common variable immunodeficiency the prevalence of menstrual side effects such as amenorrhea in patients on risperidone is reported to be 110% 6. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation breastfeeding, the latter also forming the basis of a form of contraception known as the lactational amenorrhoea method.1530 711 467 794 1105 1015 1563 1047 1433 1234 922 1243 475 733 713 275 270 1002 491 930 939 160 181 959 1394 45 1235 63 409 660 1192 1453 580 1325 1241