Primary amenorrhea is defined as the absence of menses by 16 years of age in the presence of normal secondary sexual characteristics, or by 14 years of age when there is no visible secondary sexual characteristic development.
Secondary amenorrhea - absence of menses for 6 months in a previously menstruating female
Amenorrhea as a symptom of adiposogenital dystrophy
It is usually associated with tumours of the hypothalamus , causing increased appetite and depressed secretion of gonadotropin . It seems to affect males mostly.
Is a condition characterized by
Growth retardation and retarded sexual development , atrophy or hypoplasia of the gonads , and altered secondary sex characteristics ,
mental retardation , problems with vision
polyuria , polydipsia .
tumours of the hypothalamus Diagrammatic representation of empty sella syndrome. A, Normal anatomic relationship. B, C, and D, Progression in development of empty sella syndrome. Note thinning of floor and symmetric enlargement of sella turcica.
Amenorrhea as a symptom of the Laurence-Moon-Barde-Bidle syndrome
Laurence-Moon syndrome comprises
Onset in childhood.
Inheritance is autosomal recessive.
retinitis pigmentosa, initially, problem of night vision; then central vision and then peripheral vision loss progressing to blindness.
Spinocerebellar ataxia and progressive spastic paraplegia
The complete syndrome is seldom observed in the same individual, but the features are often scattered among the siblings of one family or generation. Members of these families have an increased number of miscarriages and early deaths.
Amenorrhea as a symptom of the Morghani-Stuart syndrome
The main features of this hereditary syndrome are:
-other pituitary or hypothalamic tumors that may distort the portal circulation and thereby prevent effective delivery of hypothalamic dopamine (the putative prolactin inhibitory factor or hormone)
-a variety of drugs that lower dopamine levels or inhibit dopamine action (amphetamines, benzodiazepines, butyrophenones, metoclopramide, methyldopa, opiates, phenothiazines, reserpine, and tricyclic antidepressants)
-breast or chest wall surgery, cervical spine lesions, or herpes zoster (activation of the afferent sensory neural pathway that stimulates prolactin secretion, in a manner similar to suckling)
Disease develops in prenatal period or during the first months of life due to infectious diseases or traumatic damages of anterior part of pituitary. Insufficiency of all its hormones including somatotropin appears as a result.
Treatment mainly is in an endocrinologist competence. One should begin treatment in childhood with grows stimulation. Further replacement hormonal therapy is indicated
Amenorrhea in case of gigantism and acromegalia
Diseases are caused by Somatotropin hyperprodaction, production of gonadothropic hormones is decreased. Amenorrhea has a secondary character.
Treatment. At pituitary tumors rhoentgenotherapy is indicated. For Patients with gigantism estrogen therapy for stopping of excessive growth is prescribed.
Acute infarction and necrosis of the pituitary gland due to postpartum hemorrhage and shock is known as Sheehan's syndrome.
The symptoms of hypopituitarism are usually seen early in the postpartum period, especially failure of lactation and loss of pubic and axillary hair.
Deficiencies in growth hormone and gonadotropins are most common, followed by ACTH, and last, by TSH in frequency. Diabetes insipidus is not usually present. This can be a life-threatening condition, but fortunately, because of good obstetrical care, this syndrome is never encountered by most of us.
Diseases affecting the kidneys, heart, lungs or intestines
Learning problems( esp. in maths)
Gonadal failure Internal genitalia of patient with gonadal dysgenesis (Turner syndrome), featuring normal but infantile uterus, normal fallopian tubes, and pale, glistening "streak" gonads in both broad ligaments.
Normal secondary development & external female genitalia
Normal female range testosterone level
Absent uterus and upper vagina & normal ovaries
15-30% renal, skeletal and middle ear anomalies
X-ray film of patient with Asherman syndrome. Patient (33 years, gravida 3, para O, abortus 3) had been amenorrheic for 6 months after D&C for most recent therapeutic abortion (TAB). Filling of endocervical canal and nonvisualization of endometrial cavity are consistent with complete obliteration of cavity by adhesions or with obstruction at internal os level by adhesions in lower endometrial cavity. This appearance may also be seen with advanced endometrial tuberculosis. Asherman syndrome
Postmenopausal bleeding may be defined as bleeding that occurs after 12 months of amenorrhea in a middle-aged woman. When amenorrhea occurs in a younger person for 1 year and premature ovarian failure or menopause has been diagnosed, episodes of bleeding may be classified as postmenopausal, although resumption of ovulatory cycles can occur.