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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]
Diagnosis of anovulation cause involves hormone level tests, in conjunction with an assessment of associated symptoms. A patient history and physical exam should include history of onset and pattern of oligomenorrhea or amenorrhea , signs of PCOS such as hyperandrogenism and obesity , eating disorders, causes of excessive physical or mental ...
The progestogen challenge test, or progesterone withdrawal test, is a test used in the field of obstetrics and gynecology to evaluate a patient who is experiencing amenorrhea. Due to readily available assays to measure serum estradiol levels, this test is now rarely used. [1]
Signs and Symptoms Individuals with XX gonadal dysgenesis appear phenotypical female with normal internal and external genitalia, bilateral streak gonads, and normal stature. Diagnosis commonly occurs in adolescence due to delayed puberty or amenorrhea.
In older children, cystic ovarian masses may cause a visible change in body shape, chronic pain, and precocious puberty; complications with these cysts cause acute, severe abdominal pain. Transabdominal ultrasonography can be used to diagnose and image pediatric ovarian cysts, because transvaginal probes are not recommended for use in children.
In adolescent females, the most common symptoms of an imperforate hymen are cyclic pelvic pain and amenorrhea; other symptoms associated with hematocolpos include urinary retention, constipation, low back pain, nausea, and diarrhea. [2] Other vaginal anomalies can have similar symptoms to an imperforate hymen.
Patients experiencing amenorrhea due to hypothyroidism may be started with thyroid replacement therapy. Dopamine agonists such as bromocriptine are used in patients with pituitary adenomas . Amenorrhea associated with gonadal dysgenesis or a hypoestrogenic state may be treated with oral contraceptives, patches, or vaginal rings.
Oligoamenorrhea, also known as irregular infrequent periods or irregular infrequent menstrual bleeding, is a collective term to refer to both oligomenorrhea (infrequent periods) and amenorrhea (absence of periods). [1] It is a menstrual disorder in which menstrual bleeding occurs on an infrequent and irregular basis.