Secondary amenorrhea is due to pregnancy, stress, illness or other causes. Abnormal genital bleeding and secondary amenorrhea. Primary amenorrhea is due to changes in organs, glands, and hormones related to menstruation. It also considers the diagnosis and treatment of abnormal uterine bleeding at all stages of life. Underlying conditions may overlap in primary and secondary amenorrhea. Current evaluation of amenorrhea the practice committee of the american society for reproductive medicine birmingham, alabama amenorrhea is the absence or abnormal cessation of the menses. Secondary amenorrhea secondary amenorrhea district i acog medical student education module 2009 definitions amenorrhea. Secondary amenorrhea is defined as 3 months of amenorrhea after the achievement of menarche. The adobe flash plugin is needed to view this content. Premenstrual hormonal and affective state evaluation phase project. Secondary amenorrhea may be due either to complete obliteration of the uterine cavity or to stenosis or atresia of the internal os, as proved by radiologic studies.
Secondary amenorrhoea cause % ovarian 40 hypothalamic 35 pituitary 19 uterine 5 other 1. Genital tuberculosis tb destroys the endometrium thereby causing secondary amenorrhea. Secondary amenorrhea district i acog medical student education module 2009 definitions amenorrhea. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. This is a corrected version of the article that appeared in print. Even if you dont have periods, you could still get pregnant. The pathophysiology of amenorrhea in the adolescent. Carlson division of adolescent medicine, stanford university school of medicine, mountain view, california, usa menstrual irregularity is a common occurrence during adolescence, especially within the. Primary amenorrhea international journal of reproduction. Winner of the standing ovation award for best powerpoint templates from presentations magazine. If amenorrhea happens at other times, it may be the symptom of a treatable medical condition. View and download powerpoint presentations on primary amenorrhoea ppt.
Amenorrhea is the absence or abnormal cessation of the menses. Secondary amenorrhea occurs when the normal established menstrual cycle is shut down for 6 or more months due to a condition other than pregnancy. Secondary amenorrhea is the absence of menses for three months in women with previously normal menstruation and for nine months in women with previous oligomenorrhea. Natural changes in the body can cause your periods to stop. There are two types of amenorrhea primary or secondary. Secondary aldosteronism msd manual professional edition. Find powerpoint presentations and slides using the power of, find free presentations research about primary amenorrhoea ppt. Further, high levels of prolactin stimulated by an overactive anterior pituitary gland or by a pituitary tumor can produce secondary amenorrhea. Details on treatments and causes of amenorrhea the absence of a monthly period are provided. Secondary amenorrhea absence of a period amenorrhea is the medical term for the lack of menstrual periods, including on a permanent or temporary basis.
Au practice committee of the american society for reproductive medicine so fertil steril. The pathophysiology of amenorrhea in the adolescent neville h. Secondary amenorrhea testing algorithm arup consult. Secondary amenorrhea absence of menstruation for 3 or more months in a previously menstruating women of reproductive age. Secondary amenorrhoea is absence of periods for at least 3 months if the patient has previously had regular periods, and 6 months if she. Download amenorrhea an approach to diagnosis and management ppt for free. The most common etiologies are pregnancy and polycystic ovarian syndrome pcos.
Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Evaluation of amenorrhea, anovulation, and abnormal bleeding. Evaluation and management of secondary amenorrhea uptodate. Secondary amenorrhea is the absence of menses for 3 months in a woman with previously normal menses or 9 months in a woman with oligomenorrhea light or infrequent menses. Oct 14, 2019 amenorrhea can be due to pregnancy, anatomic defects of the outflow tract, ovarian disorders, and pituitary or hypothalamic disorders. Amenorrhea differential diagnoses medscape reference. Amenorrhoea cause primary % secondary % hypothalamic 20 35.
Secondary amenorrhea absence of menstruation for 3 or more. Oct 14, 2019 secondary amenorrhea is defined as the cessation of menstruation for at least 6 months or for at least 3 of the previous 3 cycle intervals. Ppt amenorrhea powerpoint presentation free to download. Secondary amenorrhea means you have had periods, and then they stop, especially for more than 3 months. Many adult women are happy to forgo the inconvenience of a monthly period. Secondary amenorrhea secondary amenorrhea is the absence of menstrual periods for 6 months in a woman who had previously been regular, or for 12 months in a woman who had irregular periods without any physiological reasons. The two types of amenorrhea are primary amenorrhea and secondary amenorrhea.
The menstrual cycle is a highly regulated, physiological process that makes conception and pregnancy possible. Although irregular menstruation is quite common in the first year or two following menarche, the absence of menstruation for more than 3 consecutive cycles merits. Secondary amenorrhea occurs when youve had at least one menstrual period and you stop menstruating for three months or longer. In some cases, the cause is functional, meaning that the hypothalamic gonadotropinreleasing hormone gnrh pulse generator has shut down the reproductive system in its role as an integrator of metabolic and psychogenic stress. Abnormal genital bleeding and secondary amenorrhea cessation of menses are common gynecologic complaints that can indicate serious physical problems. Amenorrhea is the lack of menstrual flow and can be a normal occurrence or a sign of malfunction or disease. Secondary aldosteronism is increased adrenal production of aldosterone in response to nonpituitary, extraadrenal stimuli such as renal hypoperfusion. Jan 15, 2018 amenorrhea not due to pregnancy, lactation, or menopause is a relatively common abnormality of the reproductive years and indicative of a defect somewhere in the hypothalamicpituitaryovarianuterine axis. It is often classified as either primary absence of menarche by age 15 years or thereafter or secondary absence of menses for more than three. Katherine pereira is an associate professor at duke university school of nursing, durham, n. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation breastfeeding, the latter also forming the basis of a form of contraception known as the lactational amenorrhoea method. Primary and secondary amenorrhea describe the occurrence of amenorrhea before and after menarche, respectively. Mar 17, 2011 secondary amenorrhea secondary amenorrhea is the absence of menstrual periods for 6 months in a woman who had previously been regular, or for 12 months in a woman who had irregular periods without any physiological reasons.
Abnormal genital bleeding is the most common reason for a gynecological office visit and a leading indication for dilatation of the cervix and curettage of the uterus. Primary amenorrhea is the absence of menarche in a girl aged 16 years or older. Displaying powerpoint presentation on amenorrhea an approach to diagnosis and management available to view or download. Diagnosis includes measurement of plasma aldosterone levels and plasma renin activity.
Secondary amenorrhea secondary amenorrhea is typically defined as the absence of menses for a consecutive period of 3 cycles or 6 months in a woman who has previously menstruated. The menstrual cycle and menstrual cycle abnormalities. An approach to diagnosis and management xpowerpoint. A free powerpoint ppt presentation displayed as a flash slide show on id. Amenorrhea pediatrics clerkship the university of chicago. Magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. Choose when to start an evaluation for secondary amenorrhea2. An approach to diagnosis and management a more recent article on amenorrhea is available. Secondary amenorrhoea absence of menses for more than three cycles or 6 months in women who previously had menses. Although premature ovarian failure is a welldefined cause of amenorrhea, accounting for 10% of cases of secondary amenorrhea, 45 in most cases its etiology is unknown. Primary amenorrhea is defined either as absence of menses by age 14 years with no development of secondary sexual characteristics or as. Pregnancy could be the cause for primary amenorrhea. Mar 30, 2019 common causes of secondary amenorrhea when a woman who has had normal periods stops getting them include. Menstrual disorders american academy of pediatrics.
Carlson division of adolescent medicine, stanford university school of medicine, mountain view, california, usa menstrual irregularity is a common occurrence during adolescence, especially within. Lack of any secondary sexual characteristics by age years also is abnormal and should be investigated. Amenorrhea absence of menses can be a transient, intermittent, or permanent condition resulting from dysfunction of the hypothalamus. Possible causes include pregnancy, hormonal changes, or losing or gaining a lot of weight quickly. Hyperprolactinaemia is the commonest pituitary cause of amenorrhoea, although it is not a common presentation in adolescents with primary. Amenorrhoea amenorrhoea is the absence of menses in a woman of reproductive age. Evaluation of amenorrhea, anovulation, and abnormal. It is often classified as either primary absence of menarche by age 15 years or thereafter or secondary absence of menses for more than three months in girls or women who previously. Outside the reproductive years, there is absence of menses during childhood and after menopause. Nov 30, 2015 magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. Even the smallest changes in hormone levels can result in menstrual. Scribd is the worlds largest social reading and publishing site. Normally, ovarian failure occurs with menopause, but when it occurs before age 40 it is premature and occurs with an incidence of 0.
Amenorrhea is the absence of menstrual bleeding in a woman of reproductive age. Ppt secondary amenorrhea powerpoint presentation free. Secondary amenorrhea is defined as the cessation of menses sometime. An initial secondary amenorrhea workup includes thyroid stimulating hormone tsh, prolactin, follicle stimulating hormone fsh, and luteinizing hormone lh tests.
List the most common causes of secondary amenorrhea in women of reproductive age estimated time. Because only 3 diagnoses are unique to primary amenorrhea and never cause secondary amenorrhea, differentiating primary from secondary amenorrhea does little to enhance the clinicians understanding of the etiology. Current evaluation of amenorrhea fertility and sterility. Pcos is one of the most common causes of secondary amenorrhea. Pituitary causes secondary amenorrhea etiology pituitary failure it is usually the acquired type as the result of trauma, treatment of. Primary amenorrhea is when a girl does not start her period by age 15 or 3 years after she begins puberty. From the start of menstruation menarche to its cessation menopause, monthly menstrual bleeding menses is regulated by hypothalamic and pituitary hormones. Secondary amenorrhoea is absence of periods for at least 3 months if the patient has previously had regular periods, and 6 months if she has previously had oligomenorrhoea. One of four women with abnormal genital bleeding may have serious physical. A definition primary amenorrhea it is defined as absence of menstruation by the age of 16 years in the presence of, developed secondary sexual characteristics, or 14 years in the absence of secondary sexual characteristics. Causes of primary amenorrhea include pregnancy, hormone imbalances, stress, thyroid conditions, ovarian cysts, being too thin, and longterm illness. Secondary amenorrhea district i acog medical student education module 2011 definitions amenorrhea. Even the smallest changes in hormone levels can result in menstrual cycle abnormalities. Secondary amenorrhea is present when a young woman ceases to menstruate after she has had one or more menstrual periods.
From the start of menstruation to its cessation, monthly menstrual bleeding menses is regulated by hypothalamic and pituitary hormones. Secondary amenorrhea is defined as the cessation of menstruation for at least 6 months or for at least 3 of the previous 3 cycle intervals. Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Primary and secondary amenorrhea describes the occurrence of amenorrhea before and after menarche. Careful history and physical examination are crucial to diagnosis. Amenorrhea can be due to pregnancy, anatomic defects of the outflow tract, ovarian disorders, and pituitary or hypothalamic disorders. Amenorrhea not due to pregnancy, lactation, or menopause is a relatively common abnormality of the reproductive years and indicative of a defect somewhere in the hypothalamicpituitaryovarianuterine axis. The majority of the causes of primary and secondary amenorrhea are similar.
After completing this activity, the participant should be better able to. Learning objectives and cmedisclosure information this activity is intended for healthcare providers delivering care to women and their families. Amenorrhea absence of menses can be a transient, intermittent, or permanent condition resulting from dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina table 1 and table 2. An initial secondary amenorrhea workup includes thyroid stimulating hormone tsh, prolactin, follicle stimulating hormone fsh, and luteinizing hormone. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic evaluation, with referral considerations. Primary amenorrhea is the absence of a first period in a young woman by the age of 16.
In primary amenorrhea, menstruation does not begin when expected by the age of 16. This chapter considers the various causes of amenorrhea and their treatment. Rule out with a urine or serum hcg before proceeding. Symptoms are similar to those of primary aldosteronism. Physicians should initiate antibiotic treatment in women with tb. Ppt secondary amenorrhea powerpoint presentation free to. Up to 50% of competitive runners training 80 miles per week and up to 44% of ballet dancers have amenorrhea.