What is amenorrhoea?
Amenorrhea is the absence of structural menstruation in a woman of reproductive age. The physiological states of amenorrhea appear, generally during pregnancy and lactation (lactation), the latter also being the basis for the type of contraception, called the lactational amenorrhea method. Absence of menstruation outside the reproductive years, in childhood and after menopause.
Amenorrhea is a symptom with many potential causes. Primary amenorrhea is defined as the absence of secondary sexual characteristics at age 14, with or without secondary sexual symptoms less than age 16, but not at age 16. It can be caused by developmental problems such as the absence of the uterus at birth, the ovary that receives or maintains the eggs, or the delay in the development of puberty.
Secondary amenorrhea (cervical cysts) is often caused by hormonal disturbances of the hypothalamus and pituitary gland, premature menopause, or uterine scarring. Previously defined as three months in a woman with normal structural menstruation, or six months in women with a history of oligomenorrhea.
Symptoms of amenorrhea
In addition to the absence of menopause, patients may have the following signs and symptoms of amenorrhea:
- Acne and / or excess body hair increase in the male pattern distribution caused by polycystic ovary syndrome
- Symptoms of premature menopause (premature ovarian failure) such as hot flashes, vaginal dryness, poor sleep, or decreased libido.
- If premature ovarian failure is caused by a genetic condition, Turner syndrome, Tel is short stature and lack of secondary sexual characteristics (for example, breast development)
- Fatigue due to headache, visual disturbances, or diseases that affect the pituitary gland.
Types of amenorrhea
Primary amenorrhea when periods do not start in adolescence.
According to the National Institutes of Health, if periods do not start before age 16, the person should seek medical help.
Primary amenorrhea is very rare. In the United States, it affects less than 0.1 percent of people.
This happens when periods start, but they don't happen.
It is common during pregnancy or breastfeeding, but it also means there is a problem.
US. Secondary amenorrhea is expected to affect 4 percent of women in their lifetime.
Missing a period is not usually a sign of a health problem; however, many people request a pregnancy test if this happens.
The doctor will diagnose secondary amenorrhea if a person has:
- You have regular periods and don't last more than 3 months.
- You have irregular periods and then it doesn't last for 6 months.
Causes of amenorrhea
Many things can cause amenorrhea.
Causes of primary amenorrhea (when a woman misses her first period):
- Ovarian failure
- Central nervous system (brain and spinal cord) or pituitary gland (problems with hormones involved in the secretion of a gland in the brain)
- Problems with the reproductive organs.
In most cases, doctors don't know why a girl didn't have her first period.
Common causes of secondary amenorrhea (when a woman with normal periods stops having them):
- The pregnancy
- Stop using birth control
- Some birth control methods, such as Depo-Provera or certain types of intrauterine devices (IUDs)
Other causes of secondary amenorrhea:
- Poor nutrition
- Some prescription drugs
- Excess weight loss
- Excessive exercise
- Ongoing illness
- Sudden weight gain or overweight (balance)
- Hormonal imbalance due to polycystic ovary syndrome (PCOS)
- Thyroid gland disorders
- Tumors of the ovaries or brain (rare)
A woman who has had her uterus or ovaries removed will also stop menstruation.
Diagnosis of amenorrhea
At the time of your infertility doctor appointment, your doctor will do a pelvic exam to check if there are any problems with your reproductive organs. If you don't have it for a long time, your doctor may examine your breasts and genitals to see if you are experiencing the usual puberty changes.
Amenorrhea is a sign of complex hormonal problems. It can take time to find the underlying cause and may require more than one type of test.
Various blood tests may be required, including:
- Ovarian function test. Measuring the amount of follicle-stimulating hormone (FSH) in your blood can help determine if your ovaries are working properly.
- Prolactin test. Low levels of a hormone called prolactin can be a sign of a pituitary gland tumor.
- Pregnancy test. This may be the first test prescribed by your doctor to rule out or confirm a pregnancy.
- Male hormone test. If you experience increased facial hair and a low voice, your doctor may want to monitor the level of male hormones in your blood.
- Thyroid function test. Measuring the amount of thyroid stimulating hormone (TSH) in your blood can help determine if your thyroid is working properly.
Hormone challenge test:
For this test, you take hormonal medications for seven to 10 days to induce structural bleeding. The results of these tests can tell your doctor if your periods have stopped due to a lack of estrogen.
Depending on your signs and symptoms, and the result of any blood tests you have, your doctor may recommend one or more imaging tests, including:
- Magnetic resonance imaging (MRI): MRI uses radio waves with a strong magnetic field to create exceptionally detailed images of soft tissues in the body. Your doctor may order an MRI to examine the pituitary tumor.
- Ultrasound: This test uses sound waves to create images of internal organs. If you never have a period, your doctor may prescribe an ultrasound test to detect abnormalities in your reproductive organs.
- Computed tomography (CT): CT scans combine multiple X-ray images taken from different directions to create cross-sectional views of internal structures. A CT scan will show if your uterus, ovaries, and kidneys are normal.
If other tests don't reveal a specific cause, your doctor may recommend a hysteroscopy, a thin, lighted camera that passes through your vagina and uterus to view the inside of your uterus.
Treatment of amenorrhea
It is important to determine the cause of amenorrhea to begin proper treatment. Your doctor should ask you for detailed information about your general health, sexual and physical development, diet and exercise habits, as well as any family history of similar problems.Your doctor will need to perform a physical exam, which may include the breasts (to check for normal development) and the pelvis (to see any obvious abnormalities).
In addition, you will need to have a blood test to see the levels of hormones in the blood (including pregnancy hormones, FSH, LH, testosterone, prolactin, and thyroid) and an ultrasound or imaging study of the pelvis or a scan of the pelvis. head or pelvis.
Treatment depends on the underlying cause and may include a combination of medical treatment (such as hormone therapy, nutritional counseling, or other medications) or surgery. The advice of a psychiatrist, psychologist or social worker may also be necessary. Depending on the cause of the amenorrhea, a referral to a fertility clinic can also be made.
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