Amenorrhea

From WikiMD
Jump to navigation Jump to search

Amenorrhoea (BE) or amenorrhea (AmE) is the absence of a menstrual period in a woman of reproductive age. Physiologic states of amenorrhoea are seen during pregnancy and lactation (breastfeeding). Outside of the reproductive years there is absence of menses during childhood and after menopause.

Female athletes or women who perform considerable amounts of exercise on a regular basis are at risk of developing 'athletic' amenorrhoea. It is suspected that low body fat levels and exercise related chemicals (such as beta endorphins and catecholamines) disrupt the interplay of the sex hormones oestrogen and progesterone.

HIGH RISK SPORTS:

  • Track and Field
  • Swimming
  • Cycling
  • Gymnastics
  • all other intense and strenuous sports

Etymology and definition

The term is derived from Greek: a = negative, men = month, rhoia = flow. Derived adjectives are amenorrhoeal and amenorrheic. The opposite is the normal menstrual period.

There are two types of amenorrhoea, primary and secondary amenorrhoea. Primary amenorrhoea is the absence of menstruation in a woman by the age of 16. Also, as pubertal changes precede the first period, menarche, women who have no sign of thelarche or pubarche and thus are without evidence of iniation of puberty by the age of 14 have primary amenorrhoea. (Reference: Speroff L et al, Clinical Gynecologic Endocrinology and Infertility, 1999)

Secondary amenorrhoea is where an established menstruation has ceased for about six months or the time of three menstrual cycles.

Overview

Amenorrhoea is a symptom with many potential causes. Primary amenorrhoea may be caused by developmental problems such as the congenital absence of the uterus, or failure of the ovary to receive or maintain egg cells. Also, delay in pubertal development will lead to primary amenorrhoea. Secondary amenorrhoea is often caused by hormonal disturbances from the hypothalamus and the pituitary gland or from premature menopause, or intrauterine scar formation.

Classification

Hypogonadotropic amenorrhoea refers to conditions where there are very low levels of serum FSH and LH. Generally, inadequate levels of these hormones lead to inadequately stimulated ovaries who then fail to produce enough estrogen to stimulate the endometrium (uterine lining), hence amenorrhoea. This is typical for conditions of pubertal delay, hypothalamic or pituitary dysfunction. In general women with hypogonadotropic amenorrhoea are potentially fertile.

Hypergonadotropic amenorrhoea refers to conditions with high levels of FSH (and LH). FSH levels are typically in the menopausal range. This implies that the ovary or gonad does not respond to pituitary stimulation. Gonadal dysgenesis or premature menopause are possible causes. Chromosome testing is usually indicated in younger individuals with hypergonadotropic amenorrhoea.

In normogonadotropic amenorrhea, FSH levels are in the nomal range. This would suggest that the hypothalamic-pituitary-ovarian axis is functional. Amenorrhea may be due to outflow obstruction, or abnormal ovarian regulation or excess androgens as seen in polycystic ovary syndrome.

Causes

Primary amenorrhoea

  1. Gonadal dysgenesis, including Turner Syndrome.
  2. Mullerian agenesis (Muller-Rokitansky-Kustner-Hauser syndrome (MRKH)).
  3. Androgen insensitivity syndrome.
  4. Delay in hypothalamic-pituitary maturation.
  5. Olfacto-genital dysplasia, Kallmann syndrome.
  6. Vaginal obstruction, cryptomenorrhea.
  7. Receptor abnormalities for FSH, LH.
  8. Specific forms of congenital adrenal hyperplasia
  9. Swyer syndrome.
  10. Galactosemia.
  11. Aromatase deficiency
  12. Prader-Willi syndrome

Secondary amenorrhoea

  1. Pregnancy
  2. Anovulation
  3. Menopause
  4. Premature menopause
  5. Hypothalamic-pituitary dysfunction, including exercise amenorrhoea, stress amenorrhoea, and eating disorders (including anorexia nervosa)
  6. Hyperprolactinemia (elevated prolactin levels)
  7. Polycystic ovary syndrome (PCO-S)
  8. Androgen producing tumor (i.e arrhenoblastoma)
  9. Intrauterine adhesions (Asherman's Syndrome)
  10. Thyroid dysfunction
  11. Hemochromatosis


MAIN CAUSES:

Treatments

Treatments vary based on the underlying condition. Key issues are problems of surgical correction if appropriate, estrogen therapy (if estrogen levels are low), and fertility.

For those who do not plan to have biological children, treatment may be unnecessary if the underlying cause of the amenorrhea is not threatening to her health.

A woman is unable to conceive whilst she is amenorrhoeic, but 'athletic' amenorrhoea has no effect on long term fertility once menstruation recommences. The best way to treat 'athletic' amenorrhoea would be to decrease the amount of, and the intensity of exercise.

History

Historically, the term amenorrhoea has often been used as a euphemism for "unwanted pregnancy" and many folk treatments for this condition are in fact abortifacients.

External links

Disability Online's athletic amenorrhoea page


Topics related to Amenorrhea

See other topics, articles and terms related to Amenorrhea on WikiMD.

Frequently Asked Questions

Faq-icon.png

External articles

Wikipedia


Recent Articles

Most recent articles for Amenorrhea:

Most Cited:

Review Articles:

Magazine Articles:

In the NEWS:

Media & Blogs

Media articles for Amenorrhea:

Books and news:

BLOGS:


Health Topics: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Wellness

Scientific Articles

Evidence based medicine for Amenorrhea:

Clinical trials for Amenorrhea:

Resources & Links

Patient resources for Amenorrhea:

Sponsored links - W8MD weight loss, sleep & medspa centers

Social media - Amenorrhea
Reddit
Quora.png
Pins
Instagram
YouTube videos
Bing.png

Help WikiMD

Find something you can improve? Join WikiMD as an an editor and help improve this page or others.

Apple bitten.svg

WikiMD is a free medical encyclopedia and wellnesspedia moderated by medical professionals.


W8MD logo

Ad. Tired of being overweight?. W8MD's insurance weight loss can HELP*

Lose weight King of Prussia, PA | Lose weight NYC | Lose weight NJ | Lose weight Philadelphia | Advertise
Other languages:
English

Quick links: Medicine Portal | Encyclopedia‏‎‏‎ | Gray's Anatomy‏‎ | Topics‏‎ |‏‎ Diseases‏‎ | Drugs | Wellness | Obesity‏‎ | Metabolic syndrome | Weight loss*
Disclaimer: The entire contents of WIKIMD.ORG are for informational purposes only and do not render medical advice or professional services. If you have a medical emergency, you should CALL 911 immediately! Given the nature of the wiki, the information provided may not be accurate, misleading and or incorrect. Use the information on this wiki at your own risk! See full Disclaimer.
Link to this page: <a href="http://www.wikimd.org/wiki/Amenorrhea">Amenorrhea</a>

  • Individual results may vary for weight loss from our sponsors.

Our sponsors WikiMD is supported by W8MD weight loss, sleep and medical aesthetic centers.