Eisenhardt S, Heiman DL. Follow the links to read common uses, side effects, dosage details and read user reviews for the drugs listed below. A genetic basis for functional hypothalamic amenorrhea. This is a corrected version of the article that appeared in print. Amenorrhea can be treated with drugs and/or surgery. Nattiv A, Klibanski A, Dewailly D, J Clin Endocrinol Metab. Clinical practice. 17. 1990;53(5):804–810. 38. Specchia C. Folch M, 1986;155(3):531–543. Hum Reprod. Hagerman RJ, Diagnosis and management of pituitary tumors: recent advances. Diagnosis and management of pituitary tumors: recent advances. Primary ovarian insufficiency.      Print, A diagnostic approach to primary amenorrhea. Choose a single article, issue, or full-access subscription. Welt CK, et al. Women who take birth control pills or who receive hormone shots such as Depo-Provera may not have any monthly bleeding. Enlarge Effects of an oral contraceptive (norgestimate/ethinyl estradiol) on bone mineral density in adolescent females with anorexia nervosa: a double-blind, placebo-controlled study. Treatment of the underlying condition often resolves amenorrhea. Fertil Steril. et al. et al. Sim LA, 46. Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure. 2009;161(1):179–187. 2011;95(2):804.e1–e5. Azziz R, Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure. Li TC. Practice Committee of American Society for Reproductive Medicine. Delayed sexual development: a study of 252 patients. 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 hormone levels can usually identify the underlying cause. Gordon CM. Hagerman RJ, 15. Capito C, Tho SP, Age at natural menopause in a population-based screening cohort: the role of menarche, fecundity, and lifestyle factors. Bachelot A, Amenorrhea is the absence or abnormal cessation of the menses. Seminara SB, J Pediatr Urol. 1999;13(6):394–400. Alper MM, Asherman syndrome (intrauterine synechiae), Gonadal dysgenesis (other than Turner syndrome), Other pituitary or central nervous system tumor, Gonadotropin deficiency (e.g., Kallmann syndrome), Infection (e.g., meningitis, tuberculosis, syphilis), Polycystic ovary syndrome (multifactorial). Spaczynski RZ, Biller BM, Int J Eat Disord. 46,XY pure gonadal dysgenesis: clinical presentations and management of the tumor risk. Age at natural menopause in a population-based screening cohort: the role of menarche, fecundity, and lifestyle factors. Reindollar RH, Douchi T, Carmina E, Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Abiven-Lepage G, Philibert P, Müllerian agenesis: etiology, diagnosis, and management. Gordon CM. Randeva HS. Women who have missed at least three menstrual periods in a row have amenorrhea, as do girls who haven't begun menstruation by age 15.The most common cause of amenorrhea is pregnancy. Metabolism. Herzog DB, … Viallon V, Sieve-Smith L. Specchia C. If abdominal pain is present, ectopic pregnancy should be considered. To see the full article, log in or purchase access. Bouchard P, Welt CK, This is when normal menstrual bleeding stops occurring for 3 months or more. Connolly HV. 2011;108(16):6585–6590. Menopause. Don't miss a single issue. Warren MP; 12. 43. Primary amenorrhea in four adolescents revealed 5α-reductase deficiency confirmed by molecular analysis. Tang T, 41. Although the differential diagnosis for amenorrhea is broad, most patients who present in an outpatient setting with primary or secondary amenorrhea have 1 of 5 common medical problems: PCOS, hypothalamic amenorrhea, hyperprolactinemia, ovarian failure, or thyroid dysfunction. Pregnancies after premature ovarian failure. Duleba AJ. 108: polycystic ovary syndrome. Initial workup of primary and secondary amenorrhea includes a pregnancy test and serum levels of luteinizing hormone, follicle-stimulating hormone, prolactin, and thyroid-stimulating hormone. Duleba AJ. Hypothalamic amenorrhea. Secondary amenorrhea is defined as the cessation of regular menses for three months or the cessation of irregular menses for six months. 1. Most cases of secondary amenorrhea can be attributed to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, or primary ovarian insufficiency. et al. Cessation of menses for 6 months, in a female who was previously menstruating. Papaioannou S, Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Adamson SC, 7th ed. Pregnancy is the most common natural cause of secondary amenorrhea. Turner's syndrome. Tracy T, RX. 2011;96(3):E566–E576. 31. Pregnancy should be excluded in all patients presenting with amenorrhea. Impairment of specific organ (e.g., brain, pituitary, ovary), Family history of early or delayed menarche, Hyperandrogenism, PCOS, ovarian or adrenal tumor, CAH, Cushing syndrome, Primary versus secondary amenorrhea; new disease, Central nervous system tumor, empty sella syndrome, Temperature intolerance, palpitations, diarrhea, constipation, tremor, depression, skin changes, Primary ovarian insufficiency, natural menopause, Weight loss, excessive exercise, poor nutrition, psychosocial stress, diets, Anthropomorphic measurements; growth charts, Multiple; Turner syndrome, constitutional delay of puberty, Dysmorphic features (webbed neck, short stature, low hairline), Male pattern baldness, increased facial hair, acne, Absence or abnormalities of cervix or uterus, Presence of transverse vaginal septum or imperforate hymen, Striae, buffalo hump, central obesity, hypertension, Turner syndrome, constitutional delay of puberty, rare causes, Laboratory testing (refer to local reference values), Complete blood count and metabolic panel abnormalities, Low: Poor endogenous estrogen production (suggestive of poor ovarian function), Follicle-stimulating hormone and luteinizing hormone, High: Primary ovarian insufficiency, Turner syndrome, Normal: PCOS, Asherman syndrome, multiple others, Free and total testosterone; dehydroepiandrosterone sulfate, High: Hyperandrogenism, PCOS, ovarian or adrenal tumor, CAH, Cushing syndrome, Abnormal: Turner syndrome, rare chromosomal disorders, High: Pituitary adenoma, medications, hypothyroidism, other neoplasm, Magnetic resonance imaging of head or sella. Pawelczyk L, A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Kakuno Y, Effects of oral dehydroepiandrosterone on bone density in young women with anorexia nervosa: a randomized trial. Nelson LM. et al. Obstet Gynecol. Sieve-Smith L. (DHEA-S = dehydroepiandrosterone sulfate; FSH = follicle-stimulating hormone; LH = luteinizing hormone; MRI = magnetic resonance imaging; TSH = thyroid-stimulating hormone. Hum Reprod Update. 6. et al. 53. Pediatrics. Xia E, Androgen Excess Society. Kamin M. Primary and secondary amenorrhea describe the occurrence of amenorrhea before and after menarche, respectively. 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. Secondary Amenorrhea signs and symptoms. Proc Natl Acad Sci USA. Obstet Gynecol Surv. Prescription drug use. Nattiv A, Tan BK, Erwin PJ, 19. Clinical practice. Incidence of premature ovarian failure. Azziz R, Author disclosure: No relevant financial affiliations. American Academy of Pediatrics Committee on Adolescence; American College of Obstetricians and Gynecologists Committee on Adolescent Health Care. Wang P, Primary amenorrhea, which by definition is failure to reach menarche, is often the result of chromosomal irregularities leading to primary ovarian insufficiency (e.g., Turner syndrome) or anatomic abnormalities (e.g., Müllerian agenesis).
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