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