Winner of the standing ovation award for best powerpoint templates from presentations magazine. If a uterus is present, outflow track obstruction may be to blame for primary amenorrhoea. Amenorrhea in pregnancy is a normal physiological function. Secondary amenorrhea is defined as the absence of menstruation for at least three cycles or at least 6 months in females who have already established menstruation. For example, the most common cause of secondary amenorrhea is pregnancy.
Secondary amenorrhea testing indications for testing amenorrhea with negative pregnancy test order prolactin. Look up amenorrhea in wiktionary, the free dictionary. List the most common causes of secondary amenorrhea in women of. Primary and secondary amenorrhea chapter pdf available. Most cases of secondary amenorrhea can be attributed to polycystic ovary. It is helpful to consider secondary amenorrhea as an abnormality in. Secondary amenorrhea is a condition when period cycle of women with irregular. Women who take birth control pills or who receive hormone shots such as depoprovera may not have any monthly bleeding. Amenorrhoea amenorrhoea is the absence of menses in a woman of reproductive age. 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. 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. Pdf on oct 26, 2011, valentina chiavaroli and others published primary. Details on treatments and causes of amenorrhea the absence of a monthly period are provided. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that. Secondary amenorrhea an overview sciencedirect topics. 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 common cause of secondary amenorrhea is pregnancy. Secondary amenorrhea is defined as the cessation of regular menses for three months or the ces sation of irregular menses for six months. Up to 50% of competitive runners training 80 miles per week and up to 44% of ballet dancers have amenorrhea. Primary amenorrhea is the absence of menarche in a girl aged 16 years or older. Breastfeeding and menopause are also common, but natural, causes. Exclude physiologic amenorrheas, such as pregnancy, the immediate postpartum state, lactation, and menopause. 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.
Secondary amenorrhea absence of a period amenorrhea is the medical term for the lack of menstrual periods, including on a permanent or temporary basis. Outside the reproductive years, there is absence of menses during childhood and after. 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 definition of secondary amenorrhea. Secondary amenorrhea is defined as the absence of menstrual flow in women with previously normal menstruation. Secondary amenorrhea testing algorithm arup consult. Secondary amenorrhea is due to pregnancy, stress, illness or other causes. Secondary amenorrhea can occur due to natural changes in the body. 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. Describe the classification of amenorrhea and list the major causes of primary and secondary amenorrhea.
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 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. T1 risk factors for secondary amenorrhea and galactorrhea. Hypothalamus pituitary ovary uterus cervix vagina involved structurally in the outflow of menstrual blood involved in endocrine regulation of the menstrual. Secondary amenorrhea north dakota department of health. Etiology a variety of factors can contribute to secondary amenorrhea including medication use, lifestyle factors. 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. Risk factors for secondary amenorrhea and galactorrhea. After pregnancy is ruled out, the initial workup should be based on patient history and physical examination. 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. 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.
The hormone foundation, the public education affiliate of the endocrine society. Magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. 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. Epidemiology and causes of secondary amenorrhea uptodate. Secondary amenorrhea occurs when youve had at least one menstrual period and you stop menstruating for three months or longer. Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal infertility that occurs when a woman is amenorrheic not menstruating and fully breastfeeding. Pdf disruptions in the menstrual cycle are a common complaint in primary care and womens health. Disruptions in the menstrual cycle are a common complaint in primary care and womens health. Childrens hospital at montefiore bronx, ny menstrual cycle abnormalities. Secondary amenorrhea gynecology video course lecturio. Testosterone, free and total includes sex hormone binding globulin, females or children dehydroepiandrosterone sulfate dhea. Amenorrhea can be due to pregnancy, anatomic defects of the outflow tract, ovarian disorders, and pituitary or hypothalamic disorders.
The part of the brain called the hypothalamus regulates the menstrual cycle. There are two types of amenorrhea primary or secondary. Secondary amenorrhea is defined by the absence of menstruation for at least 3 months after a previously regular cycle without an existing pregnancy. Amenorrhea is the absence of a menstrual period in a woman of reproductive age. It occurs in 35% of women in any specific year secondary amenorrhea can result from abnormal hypothalamus, pituitary, ovary, uterus, or. Choose when to start an evaluation for secondary amenorrhea2.
Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. After completing this activity, the participant should be better able to. Secondary and primary amenorrhea definition, causes, treatment. Learning objectives and cmedisclosure information this activity is intended for healthcare providers delivering care to women and their families. Secondary amenorrhea important differential diagnoses. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic evaluation, with referral considerations. N2 objective analyses were undertaken to identify factors that may predispose women to secondary amenorrhea or galactorrhea, frequent sources of abnormal reproductive function. 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. Secondary amenorrhea article about secondary amenorrhea. An initial secondary amenorrhea workup includes thyroid stimulating hormone tsh, prolactin, follicle stimulating hormone fsh, and luteinizing hormone lh tests. Occasionally, the same underlying problem can cause or contribute to either primary or secondary amenorrhea. Breastfeeding is a common cause of secondary amenorrhoea, and often the condition lasts for over six months. Primary amenorrhea is due to changes in organs, glands, and hormones related to menstruation.
Free and total testosterone and dehydroepiandrosterone sulfate. The pathophysiology of amenorrhea in the adolescent. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. However, patients with previously regular cycles are evaluated for secondary amenorrhea if menses have been absent for. Testosterone, free and total includes sex hormone binding globulin, females or children dehydroepiandrosterone sulfate dheas, serum prolactinoma high moderate. Secondary amenorrhea definition of secondary amenorrhea by the free dictionary. 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. Physiological states of amenorrhea are seen, most commonly, during pregnancy and lactation. 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. Primary amenorrhea is a delay in or a failure to start menstruation. Most cases of secondary amenorrhea can be attributed to.
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. Amenorrhea article about amenorrhea by the free dictionary. It is helpful to divide the evaluation of amenorrhea into three categories. Amenorrhea is when a woman of childbearing age fails to menstruate. 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. 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. Amenorrhea clinical research trial listings in obstetricsgynecology womens health family medicine on centerwatch.15 405 1134 1098 40 1217 359 924 309 1388 353 1176 1196 1357 315 146 610 151 1178 713 1108 1373 455 1280 1305 65 458 1503 693 1082 1066 745 837 938 222 531 1365 943 405 46 430 198 475