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Amenorrhea


Description

Amenorrhea is defined as the absence of menses. Primary amenorrhea occurs when menarche has not occurred by age seventeen. Secondary amenorrhea is the cessation of menses for three cycles in a non-pregnant woman.

Causes

Causes of primary amenorrhea include: Imperforate hymen; Agenesis of the uterus and upper 2/3 of the vagina; Turner's syndrome; Constitutional delay; Secondary amenorrhea; Physiological - pregnancy, corpus luteal cyst, breast-feeding, menopause; Suppression of the hypothalamic-pituitary axis - post pill amenorrhea, stress, intercurrent illness, weight loss, low body mass index; Pituitary disease - ablation of the pituitary gland, Sheehan's syndrome, prolactinoma; Uncontrolled endocrinopathies - diabetes, hypo- or hyperthyroidism; Polycystic ovarian disease (POD), (Stein-Leventhal syndrome); Chemotherapy; Pelvic irradiation; Endometrial ablation (Asherman's syndrome); Drug therapy - systemic steroids, danazol, GRH-RH analogs; and Premature ovarian failure.

Risk factors for amenorrhea include: Over-training (e.g., long-distance runner, ballet dancer); Eating disorders; and Psycho-social crisis.

 

 

 

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