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. Amenorrhea is defined as absence of menstrual periods. Primary and secondary amenorrhea describe the occurrence of amenorrhea before and after menarche, respectively. Pdf primary amenorrhoea is a symptom with an extensive list of underlying causes, the majority of which are rare.
Feel free to download, reuse, or share the following english grammar lessons with your friends, colleagues, or students. Secondary amenorrhea is defined as the cessation of menstruation for at least 6 months or for at least 3 of the previous 3 cycle intervals. Treatment options differ for both primary and secondary amenorrhea. Irregular or absent menstrual periods should trigger an evaluation to identify the root cause. Up to 50% of competitive runners training 80 miles per week and up to 44% of ballet dancers have amenorrhea.
Feb 03, 2020 amenorrhea is the absence of menstruation your monthly period. Evaluation of primary amenorrhea differential diagnosis. It has been assumed that pregnancy is an efficient chelator of iron due to its hemodilutive effect and the fetal consumption of free iron. Primary amenorrhea is when a woman reaches the age of 16 and has never had a menstrual period. Details on treatments and causes of amenorrhea the absence of a monthly period are provided. Secondary sexual characteristics and menses in young girls seen in office practice. If you already have adobe acrobat reader, simply click on the red icon next to the topic for the grammar lesson you wish to view. Age 15 is commonly used as the cutoff for primary amenorrhea because 98% of girls in the u. Absence of menses for 6 months in a previously menstruating female. Primary amenorrhea is the failure to begin menstruation when expected. The book was written by dc dutta mbbs, dgo, mo cal and edited by hiralal konar, the language of the book is very simple and.
Primary amenorrhea is due to changes in organs, glands, and hormones related to menstruation. Secondary amenorrhea becomes a major concern for an individual who is low weight and has not had a period in 3 to 6 months. Primary amenorrhea, which by definition is failure to reach menarche, is often the result of chromo somal irregularities leading to primary ovarian insufficiency e. This is the bestrecommended book all over the world. Absence of a menstrual period in a woman of reproductive age.
While completely normal before puberty, during pregnancy, and after menopause, amenorrhea at other times can indicate a problem. This site complies with the honcode standard for trustworthy health information. It can be due to delayed puberty, a malformation of the vagina or the uterus, an endocrine or hormonal anomaly, or a genetic illness such as turners syndrome. Carlson division of adolescent medicine, stanford university school of medicine, mountain view, california, usa menstrual irregularity is a common occurrence during adolescence, especially within. Amenorrhea including hypothalmic amenorrhea is a condition in which there is an absense of menstrual periods in a woman. There are two types of amenorrhea primary or secondary. Outside the reproductive years, there is absence of menses during childhood and after menopause. Primary amenorrhea symptoms, diagnosis, treatments and. Timing of the evaluation of primary amenorrhea recognizes the trend to earlier age at menarche and is therefore. She states that her breasts began developing when she was, and she had a. Evaluation should be undertaken if there is no pubertal development by.
There are two types of amenorrhea, primary and secondary. Evaluation of a patient with primary amenorrhea should include a vaginal exam, uterine assessment, serum. Background primary amenorrhea is defined as the absence of menses at age 15 years in the presence of normal growth and secondary sexual characteristics. Secondary and primary amenorrhea definition, causes, treatment.
Find powerpoint presentations and slides using the power of, find free presentations research about primary amenorrhea presentation ppt. Ppt amenorrhea powerpoint presentation free to view id. 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. Hypothalamic amenorrhea guideline resources endocrine. Breasts and other signs of puberty that usually start to develop by age 14 do not develop. Discover more publications, questions and projects in amenorrhea. Its the only pdf viewer that can open and interact with all types of pdf content, including. Amenorrhea not due to pregnancy, lactation, or menopause is a relatively common abnormality of the reproductive years and indicative of a defect somewhere in the hypothalamicpituitaryovarianuterine axis. Primary amenorrhea is the lack of menstr uation by age 16. For example, if the ovaries are not functioning properly, you may be given supplemental ovarian hormones. Amenorrhea differential diagnoses medscape reference.
Weightrelated amenorrhoea anorexia nervosa 1 o or 2 o amenorrhea is often first sign a body mass index bmi amenorrhea the lack of menstruation is a symptom, not a disease unto itself, and may be divided into primary delayed menarche or secondary amenorrhea cessation of menses in someone who has previously menstruated. Primary amenorrhea is typically the result of a genetic or anatomic condition in young females that never develop menstrual periods by age 16 and is not pregnant. Amenorrhea, the absence of menstrual bleeding, can be either primary or secondary. Disruptions in the menstrual cycle are a common complaint in primary care and womens health. For example, in a study of high school adolescent girls, the rates of girls who missed 3 consecutive menstrual periods in a single year were 12. If by age menses has not occurred and the onset of puberty, such as breast development, is absent, a workup for primary amenorrhea should start. Therapeutic approaches fo r primary and secondary amenorrhea 5.
Primary amenorrhea is defined as the absence of menarche by age 16 years in the presence of. Downloaded from the american family physician website at. 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. Primary amenorrhea is a delay in or a failure to start menstruation. And now, its connected to the adobe document cloud. The pathophysiology of amenorrhea in the adolescent. The pathophysiology of amenorrhea in the adolescent neville h. Any copy, reuse, or modification of the content should be sufficiently credited to ccm health. Because only 3 diagnoses are unique to primary amenorrhea and never cause secondary amenorrhea, differentiating primary from secondary amenorrhea does little to enhance the clinicians understanding of the etiology. Primary amenorrhea is the absence of a first period in a young woman by the age of 16. A comprehensive guide to hypothalamic amenorrhea recovery and much more, including fertility treatments, pregnancy and postpartum question, and life after recovery. Synthesis of deoxycorticosterone doc and corticosterone b does not require 17hydroxylation and is increased with resultant hypertension. Evaluation of primary amenorrhea differential diagnosis of.
Primary amenorrhea an overview sciencedirect topics. If pcos is suspected see pcos fact sheet do testosterone, shbg, free androgen index. The majority of the causes of primary and secondary amenorrhea are similar. It is often classified as either primary absence of menarche by age 15 years or secondary absence of menses for more than three cycle intervals. Amenorrhoea amenorrhoea is the absence of menses in a woman of reproductive age. Primary amenorrhea means your period did not start by age 16. Download english grammar lessons, for free, in the pdf format. We report two cases of adolescents with mullerian agenesis that presented to a tertiary adolescent medicine center with primary amenorrhea and the.
Amenorrhea is defined as the absence of menstruation. We go over the definition of amenorrhea, causes, and treatment options for amenorrhea. Amenorrhea american academy of pediatrics textbook of. Oct 18, 20 this document, titled primary amenorrhea definition, is available under the creative commons license. Deficiency of these hormones results in increased adrenocorticotrophic hormone acth and folliclestimulating hormone fsh. Primary amenorrhea is the failure of menses to occur by age 16 years, in the presence of normal growth and secondary sexual characteristics. The etiology, diagnosis, and treatment of secondary amenorrhea are discussed separately.
Primary care physicians are frequently faced with the challenge of evaluating primary amenorrhea in adolescent girls. Primary amenorrhea primary amenorrhea is the failure to start menstruation by age of 16 in a girl with normal secondary sexual characteristics or by the age of 14 where there is a failure to develop secondary sexual characteristics 9. To view the following lessons you need to have adobe acrobat reader installed on your computer. Adobe acrobat reader dc download free pdf viewer for. Careful monitoring is needed in these cases because there is a high mortality rate associated with hypothalamic amenorrhea in the setting of eating disorders, particularly. Primary amenorrhea is an absence of secondary sexual characters until 14 years of age or absence of menstruation with secondary sexual characters until 16 years of age. The hormone foundation, the public education affiliate of the endocrine society.
It is often classified as either primary absence of menarche by age 15 years or secondary absence of menses for more than three cycle intervals or six months in women who were. Primary amenorrhea is defi ned as absence of menstruation by age 14 with absence of growth or development of secondary sexual characteristic or as absence of menstruation by 16 years regardless of presence of normal growth and development of secondary sexual characteristics 1. Secondary amenorrhoea is absence of periods for at least 3 months if the patient has. Secondary amenorrhea occurs when a woman no longer menstruates after having menstruated in the past. A free powerpoint ppt presentation displayed as a flash slide show on id. Evaluation of amenorrhea, anovulation, and abnormal. Download free sample and get upto 50% off on mrprental. Secondary amenorrhoea is much more common than primary amenorrhoea. Primary amenorrhea article about primary amenorrhea by the. Although amenorrhea has classically been defined as primary no prior menses. 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.
Adobe acrobat reader dc software is the free global standard for reliably viewing, printing, and commenting on pdf documents. Pdf on oct 26, 2011, valentina chiavaroli and others published primary and secondary amenorrhea find, read and cite all the. This is usually because of a lack of reproductive organs, such as a uterus. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Nov 30, 2015 magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. Primary amenorrhea is defined as the failure to reach menarche. The dams handwritten notes are here for free download in pdf format for your mobile phone and. Dc duttas textbook of gynecology pdf free download. She has never had a period and is anxious that she is not keeping up with her friends. Estrogen lack results in primary amenorrhea and absent sexual maturation. Primary amenorrhea is defined as the absence of menarche by age 16 years in the presence of normal pubertal development or the absence of menarche by age 14 years in the absence of normal pubertal development or the absence of.
Ppt amenorrhea powerpoint presentation free to view. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. 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. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Congenital adrenal hyperplasia secondary to 17hydroxylase. Primary amenorrhea consists of the absence of the occurrence of the first menstruations in a girl who has passed the age of puberty. Jun 01, 20 although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum. There are numerous etiologies including outflow tract obstructions, gonadal dysgenesis, and anomalies of the hypothalamic axis. Primary amenorrhea is also suspected when a female hasnt had menarche by age and doesnt show signs of puberty, which include developing secondary sexual characteristics like breasts. Evaluation and management of primary amenorrhea uptodate. Causes of primary amenorrhoea cause % chromosomal gonadal dysgenesis 50 hypothalamic hypogonadism 20 absence of the uterus 15 transverse septum imperforate hymen 5 pituitary disease 5 other 5. Amenorrhoea of pituitary origin serum prl interpretation action primary amenorrhea caused by genetic abnormalities, treatment depends on the problem.
Hypothalamic amenorrhea patients should be evaluated for inpatient treatment if they have an abnormally slow heart rate, low blood pressure, or an electrolyte imbalance. Secondary amenorrhoea absence of menses for more than three cycles or 6. Evaluation and management of amenorrhea related to congenital. Primary amenorrhoea is defined as an absence of secondary sexual. Amenorrhea and absence of menstruation common problems help. 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. Menarche occurs, on average, 2 years after breast development. However, at age years, if no menses have occurred and there is a complete absence of secondary sexual characteristics such as breast development, evaluation for primary amenorrhea should. Differential diagnosis of primary amenorrhea causes of primary amenorrhea should be evaluated in the context of the presence or absence of secondary sexual characteristics. Secondary amenorrhoea is absence of periods for at least 3 months if the patient has previously had regular periods, and 6 months if she. Primary amenorrhea is defined as the absence of menstruation by the age of 16 years. It also considers the diagnosis and treatment of abnormal uterine bleeding at all stages of life.
If amenorrhea happens at other times, it may be the symptom of a treatable medical condition. Klein, md, mph, san antonio military medical center, san antonio, texas. These will allow development of normal secondary sex characteristics such as breasts and pubic hair. Many genetic conditions that are characterized by amenorrhea are circumstances in which some or all of the normal internal female organs either fail to form normally during fetal development or fail to function properly. Timing of the evaluation of primary amenorrhea recognizes the trend to earlier age. However, patients with previously regular cycles are evaluated for secondary amenorrhea if menses have been absent for. Secondary amenorrhea is due to pregnancy, stress, illness or other causes. Find out what are causes of primary secondary amenorrhea, clinical features, and management. 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. This chapter considers the various causes of amenorrhea and their treatment. Current evaluation of amenorrhea fertility and sterility. Primary amenorrhea is diagnosed when a female fails to start her menses by age 16. Approximately 15% of these women have abnormal genital examination, with mullerian agenesis being the second most frequent cause. View and download powerpoint presentations on primary amenorrhea presentation ppt.
Primary amenorrhea information including symptoms, diagnosis, misdiagnosis, treatment, causes, patient stories, videos, forums, prevention, and prognosis. This article discusses secondary amenorrhea and provides a systematic approach to. 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. A thorough history and physical examination should be the first step in the primary amenorrhea workup 4. Amenorrhea is the transient or permanent absence of menstrual flow and may be subdivided into primary and secondary presentations, relative to menarche.
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