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. However, patients with previously regular cycles are evaluated for secondary amenorrhea if menses have been absent for. After completing this activity, the participant should be better able to. Possible causes include pregnancy, hormonal changes, and losing or gaining a lot of weight quickly. The main symptom of amenorrhea is the absence of your monthly period.
We go over the definition of amenorrhea, causes, and. Pregnancy is the most common cause of amenorrhea in reproductiveage women. Ncert books pdf download 2020 for class 12, 11, 10, 9, 8. Download free sample and get upto 50% off on mrprental. Secondary amenorrhea occurs in women who have had normal menstrual cycles that have stopped for six months or more. 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. The most important cause of secondary amenorrhea is pregnancy, so it should be ruled out first. Up to 50% of competitive runners training 80 miles per week and up to 44% of ballet dancers have amenorrhea. Amenorrhoea of pituitary origin serum prl interpretation action free download as powerpoint presentation. Nov 30, 2015 magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. The most common etiologies are pregnancy and polycystic ovarian syndrome pcos. Testosterone, free and total includes sex hormone binding globulin, females or children dehydroepiandrosterone sulfate dhea. Primary amenorrhea is when a woman reaches the age of 16 and has never had a menstrual period.
Amenorrhoea amenorrhoea is the absence of menses in a woman of reproductive age. Primary and secondary amenorrhea describe the occurrence of amenorrhea before and after menarche, respectively. An initial secondary amenorrhea workup includes thyroid stimulating hormone tsh, prolactin, follicle stimulating hormone fsh, and luteinizing hormone. This may appear as primary amenorrhea, which is the lack of menstruation before age 16. Classification of amenorrhea prepuberty pregnancy related menopause primary. Secondary amenorrhea is defined by the absence of menstruation for at least 3 months after a previously regular cycle without an existing pregnancy. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic evaluation, with referral considerations. 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.
Magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. Amenorrhea pediatrics clerkship the university of chicago. Secondary amenorrhea is the absence of menstrual bleeding in a woman who has been menstruating normally but later stops menstruating for 3 or more months. Amenorrhea is the absence of menstrual bleeding and may be primary or secondary 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. Amenorrhea is the absence of a menstrual period in a woman of reproductive age. A comprehensive guide to hypothalamic amenorrhea recovery and much more, including fertility treatments, pregnancy and postpartum question, and life after recovery. There are primary and secondary causes of amenorrhea. Amenorrhea, the absence of menstrual bleeding, can be either primary or secondary. Childrens hospital at montefiore bronx, ny menstrual cycle abnormalities. Evaluation and management of secondary amenorrhea uptodate. Herbal therapy was given for 60 days, taken 2 times a. This is when periods start, but then they cease to occur. Treatment options differ for both primary and secondary amenorrhea.
Most cases of secondary amenorrhea can be attributed to. Current evaluation of amenorrhea the practice committee of the american society for reproductive medicine birmingham, alabama amenorrhea is the absence or abnormal cessation of the menses. Secondary amenorrhea means you have had periods, and then they stop, especially for more than 3 months. Amenorrhea article about amenorrhea by the free dictionary. 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. Full text full text is available as a scanned copy of the original print version. Classification of amenorrhea prepuberty pregnancy related menopause primary secondary amenorrhea physiological pathological 5. Project gutenberg is one of the largest sources for free books on the web, with over 60,000 downloadable free books available in a wide variety of formats. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Amenorrhea and absence of menstruation common problems help. Secondary amenorrhea can occur due to natural changes in the body. Amenorrhea including hypothalmic amenorrhea is a condition in which there is an absense of menstrual periods in a woman.
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. Ppt amenorrhea powerpoint presentation free to view. The pathophysiology of amenorrhea in the adolescent neville h. Scribd is the worlds largest social reading and publishing site. Primary care physicians are frequently faced with the challenge of evaluating primary amenorrhea in adolescent girls. Secondary amenorrhea important differential diagnoses. Most cases of secondary amenorrhea can be attributed to polycystic ovary. Amenorrhea is the absence or abnormal cessation of the menses physiologial amenorrhea pathologial amenorrhea 3.
This is obviously the most common form of amenorrhea and pregnancy is top ranking in this list. Other causes of amenorrhea and the evaluation and management of primary and secondary amenorrhea are discussed separately. Feb 26, 2019 there are many possible causes of amenorrhea, which is the absence of a menstrual period in a woman for three or more consecutive months or a delay in menstruation in a girl over the age of 15 who. Primary amenorrhea is the absence of menarche in a girl aged 16 years or older. It occurs in 35% of women in any specific year secondary amenorrhea can result from abnormal hypothalamus, pituitary, ovary, uterus, or outflow tract.
Amenorrhea is defined as the absence of menstruation. Primary amenorrhea is a delay in or a failure to start menstruation. Secondary amenorrhea is defined as the cessation of regular menses for three months or the ces sation of irregular menses for six months. Diseases of the genitourinary system n00n99 noninflammatory disorders of female genital tract n80n98 absent, scanty and rare menstruation n91 n91. Even if you dont have periods, you could still get pregnant. Secondary amenorrhea gynecology video course lecturio.
Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Secondary amenorrhea is defined as the absence of menstruation for at least three cycles or. We go over the definition of amenorrhea, causes, and treatment options for amenorrhea. List the most common causes of secondary amenorrhea in women of. Project gutenberg is the oldest and quite possibly the largest library on the web, with literally thousands free books available for download. Klein, md, mph, san antonio military medical center, san antonio, texas. Secondary amenorrhea testing indications for testing amenorrhea with negative pregnancy test order prolactin. List the most common causes of secondary amenorrhea in women of reproductive age estimated time. Herbal therapy was given for 60 days, taken 2 times a day with dose of 15 grams of turmeric. For example, the most common cause of secondary amenorrhea is pregnancy. Patient presents for her first gynecological exam with.
Secondary amenorrhea testing algorithm arup consult. Mar 28, 1987 full text is available as a scanned copy of the original print version. Secondary amenorrhea is when you miss a period for 3 months in a row or more. Furthermore, there must be none of the known physiologic or druginduced causes of amenorrhea. While completely normal before puberty, during pregnancy, and after menopause, amenorrhea at other times can indicate a problem. An initial secondary amenorrhea workup includes thyroid stimulating hormone tsh, prolactin, follicle stimulating hormone fsh, and luteinizing hormone lh tests. Secondary amenorrhea is clinically defined as the absence of menses for more. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Women who take birth control pills or who receive hormone shots such as depoprovera may not have any monthly bleeding. Katherine pereira is an associate professor at duke university school of nursing, durham, n. Breastfeeding and menopause are also common, but natural, causes. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic.
Secondary amenorrhea american academy of pediatrics. Secondary and primary amenorrhea definition, causes, treatment. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. A detailed history including growth, development including other pubertal signs, especially breast development, nutrition, exercise, weight andor bmi changes, sexual history, firstdegree relatives ages at menarche, medical conditions including chronic disease, and medications. 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. The etiology, diagnosis, and treatment of secondary amenorrhea are discussed separately. Links to pubmed are also available for selected references. Choose when to start an evaluation for secondary amenorrhea2. Primary amenorrhea is when you are late to start your period for the first time.
Primary amenorrhea means you never start your periods. Secondary amenorrhea is defined as the absence of menstrual flow in women with previously normal menstruation. Outside the reproductive years, there is absence of menses during childhood and after. The initial evaluation of primary amenorrhea should include. Secondary amenorrhea occurs when youve had at least one menstrual period and you stop menstruating for three months or longer. Mar 17, 2011 amenorrhea is the absence or abnormal cessation of the menses physiologial amenorrhea pathologial amenorrhea 3. Secondary amenorrhea is the absence of menses for 6 months in women with previously irregular cycles or 3 months in women with regular cycles 25 days1,2. Amenorrhea 2050% hirsutism 6570% polycystic ovary 80% insulin resistance 3070% acne 2735% alopecia 35% infertility 2075% overweight 4085% pathophysiology androgen production increased circulating lh hirsutism, acne sex hormone binding globuin failed growth of dominant follicle free androgen anovulation, amenorrhea estrogen. 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. To access free multiple choice questions on this topic, click here.
Causes of primary amenorrhea should be evaluated in the context of the presence or absence of secondary sexual characteristics. Evaluation and management of a patient with amenorrhea is common in. Details on treatments and causes of amenorrhea the absence of a monthly period are provided. There are two types of amenorrhea, primary and secondary. Secondary amenorrhea an overview sciencedirect topics. Describe the classification of amenorrhea and list the major causes of primary and secondary amenorrhea. The pathophysiology of amenorrhea in the adolescent. Amenorrhea means you do not have menstrual periods. Primary amenorrhea is due to changes in organs, glands, and hormones related to menstruation.
In the treatment of secondary amenorrhea, acupuncture therapy was given 21 times, three times a week. Neuroendocrine causes of amenorrhea and infertility, including functional hypothalamic amenorrhea and hyperprolactinemia, constitute a majority of these cases. Learning objectives and cmedisclosure information this activity is intended for healthcare providers delivering care to women and their families. Downloaded from the american family physician website at. Amenorrhea is characterized by a complete lack of menstrual cycles. This is normal during pregnancy or while breastfeeding, but it. There are two types of amenorrhea primary or secondary. Table 43,6,15 includes the differential diagnosis of primary. Get a printable copy pdf file of the complete article 619k, or click on a page image below to browse page by page.
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