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Secondary amenorrhea's most common and most easily diagnosable causes are pregnancy, thyroid disease, and hyperprolactinemia. [50] A pregnancy test is a common first step for diagnosis. [50] Similar to primary amenorrhea, evaluation of secondary amenorrhea also begins with a pregnancy test, prolactin, FSH, LH, and TSH levels. [13]
The diagnosis is based on age less than forty, amenorrhea, and two elevated serum follicle-stimulating hormone (FSH) and decreased estrogen measurements at one-month intervals. [10] The anterior pituitary secretes FSH and LH at high levels to try to increase the low estrogen levels that are due to the dysfunction of the ovaries.
However, if no bleeding occurs after progesterone withdrawal, then the patient's amenorrhea is likely to be due to either a) low serum estradiol (i.e. premature ovarian failure), b) hypothalamic-pituitary axis dysfunction (such as low GNRH or low FSH that lead to low estrogen level ), c) a nonreactive endometrium, or d) a problem with the ...
Exercise amenorrhoea is a diagnosis of exclusion. Girls who exercise at a young age may have primary amenorrhoea. The differential diagnosis are androgen excess, pituitary tumors (rare), tumors of the third ventricle (rare) or other conditions leading to chronic malnutrition. Diet history and bone density investigations should also be done to ...
In the case of RED-S, the majority of secondary amenorrhea cases are attributed to functional hypothalamic amenorrhea (FHA), an adaptive mechanism to preserve energy for survival and vital processes rather than reproduction when energy balance is low. [17] [18] Primary amenorrhea is characterized by delayed menarche (the onset of menses during ...
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.
The diagnosis can be made at various ages, from neonates presenting with hydrocolpos to young women presenting with primary amenorrhea and pelvic pain due to the development of hematocolpos. Often, women might have a normal hymeneal opening but this wall of tissue might be blocking the access to the vaginal canal.
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 ...