3. • Amenorrhea is defined as the absence of menstrual
bleeding and may be primary or secondary.
An Overview
4. • Primary Amenorrhea is the absence of menstrual
bleeding and secondary sexual characteristics in a
girl by age 14.
-OR-
• The absence of menstrual bleeding with normal
development of secondary sexual characteristics in
a girl by age 16.
An Overview
5. • For a woman to have a regular menstrual cycle, her
HYPOTHALAMUS, PITUITARY gland, OVARIES
and UTERUS should all be functioning normally.
An overview
6. • The Hypothalamus stimulates the pituitary gland by
releasing follicle stimulating hormones (FSH) and
luteinizing hormone (LH).
• This causes the ovaries to produce the hormones
estrogen and progesterone.
An overview
7. • Estrogen and progesterone are responsible for the
cyclical changes in the endometrium ( uterine
lining), including menstruation.
An overview
10. • Craniopharyngioma- a brain tumor near the pituitary
gland.
• Teratoma-a tumor made up of a mixture of tissues.
• Sarcoidosis- the formation of nodules in different
parts of the body.
Hypothalamic causes
11. • Kallmann Syndrome- Deficiency of gonadotropins,
which are hormones capable of promoting growth
and function of reproductive hormones.
• Nutritional Deficiency
• Low Body Weight
Hypothalamic causes
12. • Prolactinemia- High blood levels of prolactin, a
hormone that stimulate the secretion of breast milk.
• Pituitary Tumors
• Postpartum Pituitary Necrosis- Death of pituitary
cells after a woman delivers a baby.
Pituitary Causes
13. • Autoimmune Hypophysitis- Cells of the pituitary
gland destroyed by the body’s own defense system
• Pituitary Radiation
Pituitary causes
14. • Anovulation- Lack of the release of an egg
• Hyperandrogenemia- High blood levels of male
hormones
• Polycystic ovary syndrome
• Premature Ovarian Failure
• Turner Syndrome-Genetic disorder characterized by
underdeveloped ovaries, short stature.
Ovarian Causes
15. • Pure Gonadal Dysgenesis- Defective development
of the ovary
• Autoimune Oophoritis- Cells of the ovaries
destroyed by the body’s own defense system
• Radiation or Chemotherapy
• Abnormalities of the genital tract
Ovarian Causes
18. • Amenorrhea is a symptom of an underlying disorder.
Symptoms
19. • Galactorrhea- Production of breast milk in women
who are not pregnant
• Headache
• Reduced Peripheral Vision
These could be signs of an intracranial tumor.
Symptoms
20. • Noticeable weight gain/ loss
• Excessive anxiety
• Hot Flashes
• Night Sweats
• Disrupted Sleep
These can be signs of Ovarian Insufficiency or
Premature Ovarian Failure.
Symptoms
22. • Blood Tests to determine hormone levels
• CT or MRI of the head to exclude pituitary and
hypothalamic causes
• Thyroid Function Tests
• Hysteroscopy-Visual inspection of uterus
Exams and Tests
24. • Hormone Replacement Therapy
• Radiation Therapy for tumor-related
• Contraceptives to restore menstrual cycle
Medical Treatment
25. Amenorrhea. (2002). In Britanica (15th ed., Vol. 1, p. 324). Chicago: Encyclopedia Britanica Inc. (Original
work published 1768)
Slap, G., M.D. (2005). Amenorrhea. In K. Krapp & J. Wilson (Eds.), The Gale Encyclopedia of Children's
Health (Vol. 1, pp. 88-92). Michigan: Thomson Gale.
The Tale of 4 Hormones- Normal Menstrual Cycle. (n.d.). Retrieved February 23, 2012, from
http://pcosjournal.com/hormones-normal-menstrual-cycle/
Turkington, C. A. (2002). Amenorrhea. In J. L. Longe (Ed.), The Gale Encyclopedia of Medicine (2nd ed., Vol.
1, pp. 146-148). Michigan: Gale Group.
Nelson, L. M., M.D. (n.d.). Amenorrhea. Retrieved from WEB M.D, LLC website:
http://www.emedicinehealth.com/script/main/art.asp?articlekey=59246&pf=3&pa
Slide 8 Image: http://img.medscape.com/pi/emed/ckb/obstetrics_gynecology/252558-1336968-276110-
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