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Physiologic amenorrhea is present before menarche, during pregnancy and breastfeeding, and after menopause. [3] Breastfeeding or lactational amenorrhea is also a common cause of secondary amenorrhoea. [26] Lactational amenorrhea is due to the presence of elevated prolactin and low levels of LH, which suppress ovarian hormone secretion. [27]
In adolescents, this is called "adolescence crisis" and can occur during, or post, puberty. This crisis can cause young adults to develop behavioral or eating disorders (mentioned below), and, if severe and prolonged enough, can result in the menstrual irregularities seen in FHA. [7]
In primary amenorrhea, in which there is a failure to menstruate by the age of 16 with normal sexual development or by 14 without normal sexual development, causes can be from developmental abnormalities of the uterus, ovaries, or genital tract, or endocrine disorders.
The treatment is determined based on the cause of menorrhagia. In case of puberty menorrhagia due to immaturity of hypothalamic axis, hormonal therapy is beneficial. Treatment for blood loss should be done simultaneously with iron therapy in mild to moderate blood loss and blood transfusion in severe blood loss.
Hypoprolactinemia can result from autoimmune disease, [2] hypopituitarism, [1] growth hormone deficiency, [2] hypothyroidism, [2] excessive dopamine action in the tuberoinfundibular pathway and/or the anterior pituitary, and ingestion of drugs that activate the D 2 receptor, such as direct D 2 receptor agonists like bromocriptine and pergolide, and indirect D 2 receptor activators like ...
Gonadotropin-releasing hormone (GnRH) modulators, including both GnRH agonists and GnRH antagonists, are associated with amenorrhea, and have been used to induce therapeutic amenorrhea. Among oncologists caring for adolescents with cancer, GnRH modulators were the most commonly recommended treatment for menstrual suppression to prevent or treat ...
The treatment choices of those referred to hospital in the UK for heavy menstrual bleeding. [20] The first line treatment option for those with HMB and no identified pathology, fibroids less than 3 cm in diameter, and/or suspected or confirmed adenomyosis is the levonorgestrel-releasing intrauterine system (LNG-IUS). [16]
Other anomalies that can cause amenorrhea include Müllerian agenesis affecting the uterus, cervix, and/or vagina; obstructed uterine horn; OHVIRA syndrome; and the presence of a transverse vaginal septum. OHVIRA and uterine horn obstruction can also cause increasingly painful menstruation (dysmenorrhea) in the months following menarche. [3]