Amenorrhea

16,614views

00:00 / 00:00

Videos

Notes

Amenorrhea

Reproductive system

Male and female reproductive system disorders

Precocious puberty

Delayed puberty

Klinefelter syndrome

Turner syndrome

Androgen insensitivity syndrome

5-alpha-reductase deficiency

Kallmann syndrome

Male reproductive system disorders

Hypospadias and epispadias

Bladder exstrophy

Priapism

Penile cancer

Prostatitis

Benign prostatic hyperplasia

Prostate cancer

Cryptorchidism

Inguinal hernia

Varicocele

Epididymitis

Orchitis

Testicular torsion

Testicular cancer

Erectile dysfunction

Male hypoactive sexual desire disorder

Female reproductive system disorders

Amenorrhea

Ovarian cyst

Premature ovarian failure

Polycystic ovary syndrome

Ovarian torsion

Krukenberg tumor

Sex cord-gonadal stromal tumor

Surface epithelial-stromal tumor

Germ cell ovarian tumor

Uterine fibroid

Endometriosis

Endometritis

Endometrial hyperplasia

Endometrial cancer

Choriocarcinoma

Cervical cancer

Pelvic inflammatory disease

Urethritis

Female sexual interest and arousal disorder

Orgasmic dysfunction

Genito-pelvic pain and penetration disorder

Mastitis

Fibrocystic breast changes

Intraductal papilloma

Phyllodes tumor

Paget disease of the breast

Breast cancer

Hyperemesis gravidarum

Gestational hypertension

Preeclampsia & eclampsia

Gestational diabetes

Cervical incompetence

Placenta previa

Placenta accreta

Placental abruption

Oligohydramnios

Polyhydramnios

Potter sequence

Intrauterine growth restriction

Preterm labor

Postpartum hemorrhage

Chorioamnionitis

Congenital toxoplasmosis

Congenital cytomegalovirus (NORD)

Congenital syphilis

Neonatal conjunctivitis

Neonatal herpes simplex

Congenital rubella syndrome

Neonatal sepsis

Neonatal meningitis

Miscarriage

Gestational trophoblastic disease

Ectopic pregnancy

Fetal hydantoin syndrome

Fetal alcohol syndrome

Reproductive system pathology review

Disorders of sex chromosomes: Pathology review

Prostate disorders and cancer: Pathology review

Testicular tumors: Pathology review

Uterine disorders: Pathology review

Ovarian cysts and tumors: Pathology review

Cervical cancer: Pathology review

Vaginal and vulvar disorders: Pathology review

Benign breast conditions: Pathology review

Breast cancer: Pathology review

Complications during pregnancy: Pathology review

Congenital TORCH infections: Pathology review

Disorders of sexual development and sex hormones: Pathology review

Amenorrhea: Pathology Review

Testicular and scrotal conditions: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

HIV and AIDS: Pathology review

Penile conditions: Pathology review

Assessments

Amenorrhea

Flashcards

0 / 20 complete

USMLE® Step 1 questions

0 / 9 complete

High Yield Notes

9 pages

Flashcards

Amenorrhea

of complete

Questions

USMLE® Step 1 style questions USMLE

of complete

A 17-year-old girl comes to the office for the evaluation of amenorrhea. The patient’s menarche was at the age of 13, and her menstrual cycle has been regular with menses occurring every 28 days. For the past 8 months, the patient has not menstruated. She is sexually active with her boyfriend and uses condoms consistently. The patient plays on the high school soccer team and frequently competes in local beauty pageants. She follows a calorie-restricted dietary regimen and exercises 3 hours every day. Temperature is 37°C (98.6°F), pulse is 95/min, respirations are 18/min and blood pressure is 90/55 mmHg. BMI is 16 kg/m2. Physical examination shows a pale, thin girl of normal stature with fine hair and Tanner stage III breast and pubic hair growth. Rest of the examination is within normal limits. Urine pregnancy test is negative. Which of the following set of hormonal changes will be observed in this patient?  

External References

First Aid

2022

2021

2020

2019

2018

2017

2016

Amenorrhea

antiandrogens p. 682

cirrhosis p. 398

Cushing syndrome p. 354

cystic fibrosis p. 58

ectopic pregnancy and p. NaN

menopause p. 652

Müllerian agenesis p. 646

PCOS p. 670

pituitary adenoma and p. 544

pituitary prolactinomas p. 335

Turner syndrome p. 661

Transcript

Content Reviewers

Contributors

Alex Aranda

Amenorrhea means no menstruation.

It’s normal before puberty, during pregnancy and lactation, and after menopause.

Sometimes though, menstruation either never starts, which is called primary amenorrhea, or suddenly stops in a person who’s previously menstruating, which is called secondary amenorrhea.

Now, menstruation, and the menstrual cycle as a whole are controlled by the hypothalamus and the pituitary gland, all the way up in the brain.

The hypothalamus secretes gonadotropin-releasing hormone, or GnRH, which makes the nearby anterior pituitary gland release follicle-stimulating hormone, or FSH, and luteinizing hormone, or LH.

In the first two weeks of a normal 28-day cycle, the ovaries go through the follicular phase, meaning that out of the many follicles scattered throughout the ovaries, a couple of them enter a race to become the dominant follicle, that will be released at ovulation.

All the developing follicles secrete loads of estrogen, which negatively inhibits pituitary FSH.

In the meantime, the uterus goes through two phases: the menstrual and proliferative phase.

During the menstrual phase, the functional layer of the endometrium is shed and eliminated through the vagina, leading to menstruation, which lasts an average of five days.

Summary

Amenorrhea is the absence of menstrual periods in women during reproductive years. There are two types of amenorrhea: primary and secondary. Primary amenorrhea is when periods have never started by the time a girl reaches 16 years old. Secondary amenorrhea is when periods have stopped for at least three months, even if they had started in the past.

There are many possible causes of amenorrhea, including pregnancy, hormone problems, problems with the ovaries or uterus, eating disorders, excessive exercise, and stress.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Luteinizing Hormone Pulsatility Is Disrupted at a Threshold of Energy Availability in Regularly Menstruating Women" The Journal of Clinical Endocrinology & Metabolism (2003)
  6. "Evaluation of extended and continuous use oral contraceptives" Therapeutics and Clinical Risk Management (2008)
  7. "Role of leptin in energy-deprivation states: normal human physiology and clinical implications for hypothalamic amenorrhoea and anorexia nervosa" The Lancet (2005)
Elsevier

Copyright © 2023 Elsevier, except certain content provided by third parties

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.

RELX