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. Primary amenorrhea is basically refers to a young girl who have not experienced menarche, at all, classified as hypergonadotropic hypogonadism, hypogonadotropic hypogonadism, and eugonadotropic state. Secondary Amenorrhea is a Symptom. (Fertil Steril 2008;90:S219–25. Secondary amenorrhea is arbitrarily defined as the absence of menses for 6 months or the equivalent of three previous cycle intervals, whichever is longer, in women who previously had menses. What are the symptoms of secondary amenorrhea? For example, the most common cause of secondary amenorrhea is pregnancy. Medications and therapies. Amenorrhea means no menstruation.. It’s normal before puberty, during pregnancy and lactation, and after menopause.. Post menopausal. (b) Secondary Amenorrhea, when it stops in a menstruating woman. The main … Just in three situations amenorrhea is considered physiological: during pregnancy, lactation and menopause. 1. An algorithm for evaluating secondary amenorrhea is shown in Fig. Treatment of Secondary Amenorrhea To aid in diagnosis, laboratory studies, such as a pregnancy test, blood studies of hormone levels and Pap smear are usually necessary. Abstract PIP: The study was designed to investigate the epidemiology of secondary amenorrhea within a county of Sweden. An adolescent patient with secondary amenorrhea should get a pregnancy test to exclude pregnancy, the most common cause of secondary amenorrhea.The presence of acne, hirsutism, deepening of voice and clitoromegaly is suggestive of hyperandrogenism, another common cause of secondary amenorrhea. [Effect of prostigmine and sex hormones in therapy of secondary amenorrhea and in early diagnosis of pregnancy]. (ii) Pathological Amenorrhea. Secondary amenorrhea can affect fertility because if your menstrual cycle has ceased it is very likely that you are not ovulating. Amenorrhoea caused by weight loss, excessive exercise, stress, or chronic illness should be managed in primary care after an endocrinologist has assessed and excluded other hypothalamic or pituitary causes (such as a tumour). Characteristics related to early secondary amenorrhoea and pregnancy among women diagnosed with systemic lupus erythematosus: an analysis using the GOAL study. Even if you don't have periods, you could still get pregnant. Initial workup of primary and secondary amenorrhea includes a pregnancy test and serum levels of luteinizing hormone, follicle-stimulating hormone, prolactin, and thyroid-stimulating hormone. Women who take birth control pills or who receive hormone shots such as Depo-Provera may not have any monthly bleeding. Secondary amenorrhea is estimated to affect about 4 percent of women in the U.S. over their lifetime. Primary and secondary amenorrhea describe the occurrence of amenorrhea before and after menarche, respectively. Prepubertal; Pregnancy; Lactation. This problem is seen in about 1% of women of reproductive age. Normally, ovarian failure occurs with menopause, but when it occurs before age 40 it is premature and occurs with an incidence of 0.9%. There are many causes of secondary amenorrhea: A. 31.1. Surgical diagnostic procedures such as laparoscopy or hysteroscopy may be recommended. Pathological is again of 2 types (a) Primary Amenorrhea, when the woman has never menstruated. Most secondary amenorrhea results from anovulation. Secondary amenorrhea: when a girl or woman has been having periods but then stops having them for at least 3 months. Hypothalamic amenorrhea is due to a disruption in the regulator hormones produced by the hypothalamus in the brain. Other physiologic causes include breastfeeding and menopause. It is the time period between the end of pregnancy and the resumption of menstruation after delivery, and it is considered to be the temporary infecundable period of women's reproductive life-span. ... Pseudocyesis or false pregnancy is a condition in which a woman believes that she is pregnant and subconsciously suppresses her menstruation. Med Klin. Claim Your 20 Free Pregnancy Tests – […] Secondary Amenorrhea Testing INDICATIONS FOR TESTING Amenorrhea with negative pregnancy test ORDER Prolactin Luteinizing Hormone and Follicle Stimulating Hormone In women with regular menstrual cycles, a delay of menses for as little as one week may require the exclusion of pregnancy; secondary amenorrhea lasting three months and oligomenorrhea involving less than nine cycles a year require investigation. Amenorrhea is defined as the complete absence or anomalous cessation of menstrual cycles in females during reproductive years. Pregnancy is the most common cause of secondary amenorrhea in women of reproductive age Functional hypothalamic anovulation (e.g., due to excessive exercise, eating disorders, or stress) is common and FSH levels will be normal or low Secondary amenorrhea can occur due to natural changes in the body. There are certain situations in which secondary amenorrhea occurs and your ability to get pregnant is not affected. In all other situations, amenorrhea can be due to many pathological conditions and merits a careful assessment. Possible causes include pregnancy, hormonal changes, … Pathological Amenorrhea. How Common Is Secondary Amenorrhea? The production of menstrual flow requires an intact outflow tract, a hormonally responsive uterus, and an integrated hypothalamic-pituitary-ovarian (HPO) axis. Differential Diagnoses Further causes are varied and may include conditions that affect the ovaries, uterus, hypothalamus, or pituitary gland. 4 2o Amenorrhea: Hypothalamic Amenorrhea • Athlete's amenorrhea – Critical ratio of muscle to body fat exceeded – Despite exercise, risk osteoporosis (and fracture) • Female athlete triad: disordered eating, amenorrhea, and osteoporosis – Preoccupation with food and weight, frequent bathroom use during and after meals, laxative use, By means of questionnaire data regarding the occurrence of secondary amenorrhea of more than 3 months duration were collected together with background variables such as age, marital status, pregnancy history, use of oral contraceptives, and smoking habits. One missed day is typically not a sign of a health concern, but if it occurs, many people will ask for a pregnancy test. This fact sheet focuses on secondary amenorrhea that is not due to pregnancy. Diseases in the Midbrain. Exclude physiologic amenorrheas, such as pregnancy, the immediate postpartum state, lactation, and menopause. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic evaluation, ... pregnancy terminations, history or treatment of infertility . Pregnancy is the most common natural cause of secondary amenorrhea. Although premature ovarian failure is a well-defined cause of amenorrhea, accounting for 10% of cases of secondary amenorrhea, 45 in most cases its etiology is unknown. 1951 Jul 27;46(30):821-2. Secondary amenorrhea is the cessation of previously regular menses for three months or previously irregular menses for six months and warrants evaluation. The most common causes of secondary amenorrhea are the physiological events of pregnancy, lactation, and menopause. Amenorrhea is the absence or abnormal cessation of the menses. Women with secondary amenorrhoea due to PCOS, hypothyroidism, menopause, or pregnancy should be managed in primary care, where appropriate. It occurs in 3–5% of women in any specific year. You may not know what caused your periods to stop. 2008 by American Society for Reproductive Medicine.) Secondary amenorrhea means you have had periods, and then they stop, especially for more than 3 months. Pregnancy is an obvious cause of amenorrhea and is the most common reason for secondary amenorrhea. (i) Physiological Amenorrhea. The etiologies of primary and secondary amenorrhea often overlap. Amenorrhea is a medical condition that represents the lack of a menstrual cycle. Symptoms vary according to the cause. Secondary amenorrhea can result from abnormal hypothalamus, pituitary, ovary, uterus, or outflow tract. Amenorrhea is the absence or abnormal cessation of the men-ses (1). Secondary amenorrhea (missing three menstrual periods in a row or not having periods for at least 6 months after menstruating normally) can result from various causes, such as: Natural causes. Breastfeeding and menopause are also common, but natural causes. The most common reason is pregnancy; this etiology should be evaluated before considering any other cause. What are the causes of Amenorrhea? 1. Amenorrhea may be classified according to etiology into three subtypes, including primary amenorrhea, secondary amenorrhea, and functional amenorrhea. For a woman of reproductive age who is trying to conceive, this disorder can be devastating, because without a period, there can be no ovulation occurring either, meaning that your female fertility is seriously impaired. Post-partum amenorrhea is an important event for females' reproductive life and their health. Those more commonly associated with primary amenorrhea are discussed in Chapter 30. Secondary amenorrhea is defined by the absence of menstruation for at least 3 months after a previously regular cycle without an existing pregnancy. Knight JH(1), Howards PP(1), Spencer JB(2), Tsagaris KC(3), Lim SS(3).