Many adult women are happy to forgo the inconvenience of a monthly period. Secondary amenorrhea is the absence of menses for three months in women with previously normal menstruation and for nine months in women with previous oligomenorrhea. Secondary amenorrhea 1 free download as powerpoint presentation. Secondary amenorrhea occurs when the normal established menstrual cycle is shut down for 6 or more months due to a condition other than pregnancy. Ppt secondary amenorrhea powerpoint presentation free. Secondary aldosteronism is increased adrenal production of aldosterone in response to nonpituitary, extraadrenal stimuli such as renal hypoperfusion. Download amenorrhea an approach to diagnosis and management ppt for free. Current evaluation of amenorrhea the practice committee of the american society for reproductive medicine birmingham, alabama amenorrhea is the absence or abnormal cessation of the menses.
Amenorrhea is the absence or abnormal cessation of the menses. Secondary amenorrhea district i acog medical student education module 2009 definitions amenorrhea. Secondary amenorrhea occurs when youve had at least one menstrual period and you stop menstruating for three months or longer. The pathophysiology of amenorrhea in the adolescent neville h. Learning objectives and cmedisclosure information this activity is intended for healthcare providers delivering care to women and their families. Current evaluation of amenorrhea fertility and sterility. Au practice committee of the american society for reproductive medicine so fertil steril. Oct 14, 2019 amenorrhea can be due to pregnancy, anatomic defects of the outflow tract, ovarian disorders, and pituitary or hypothalamic disorders. In some cases, the cause is functional, meaning that the hypothalamic gonadotropinreleasing hormone gnrh pulse generator has shut down the reproductive system in its role as an integrator of metabolic and psychogenic stress. The pathophysiology of amenorrhea in the adolescent. Amenorrhea absence of menses can be a transient, intermittent, or permanent condition resulting from dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina table 1 and table 2.
Choose when to start an evaluation for secondary amenorrhea2. Secondary amenorrhea testing algorithm arup consult. An approach to diagnosis and management xpowerpoint. Abnormal genital bleeding and secondary amenorrhea. It is often classified as either primary absence of menarche by age 15 years or thereafter or secondary absence of menses for more than three. Secondary amenorrhea is defined as 3 months of amenorrhea after the achievement of menarche. Secondary amenorrhea 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 without any physiological reasons. Secondary amenorrhea is due to pregnancy, stress, illness or other causes.
Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Premenstrual hormonal and affective state evaluation phase project. Katherine pereira is an associate professor at duke university school of nursing, durham, n. Evaluation of amenorrhea, anovulation, and abnormal bleeding. This chapter considers the various causes of amenorrhea and their treatment. Further, high levels of prolactin stimulated by an overactive anterior pituitary gland or by a pituitary tumor can produce secondary amenorrhea. Amenorrhea is the lack of menstrual flow and can be a normal occurrence or a sign of malfunction or disease.
Secondary amenorrhea absence of menstruation for 3 or more. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Amenorrhea absence of menses can be a transient, intermittent, or permanent condition resulting from dysfunction of the hypothalamus. Genital tuberculosis tb destroys the endometrium thereby causing secondary amenorrhea. A definition primary amenorrhea it is defined as absence of menstruation by the age of 16 years in the presence of, developed secondary sexual characteristics, or 14 years in the absence of secondary sexual characteristics.
The menstrual cycle is a highly regulated, physiological process that makes conception and pregnancy possible. Possible causes include pregnancy, hormonal changes, or losing or gaining a lot of weight quickly. Displaying powerpoint presentation on amenorrhea an approach to diagnosis and management available to view or download. The two types of amenorrhea are primary amenorrhea and secondary amenorrhea. Secondary amenorrhoea absence of menses for more than three cycles or 6 months in women who previously had menses. Carlson division of adolescent medicine, stanford university school of medicine, mountain view, california, usa menstrual irregularity is a common occurrence during adolescence, especially within the. Amenorrhea pediatrics clerkship the university of chicago. There are two types of amenorrhea primary or secondary. Diagnosis includes measurement of plasma aldosterone levels and plasma renin activity. This is a corrected version of the article that appeared in print. It also considers the diagnosis and treatment of abnormal uterine bleeding at all stages of life. An initial secondary amenorrhea workup includes thyroid stimulating hormone tsh, prolactin, follicle stimulating hormone fsh, and luteinizing hormone. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic evaluation, with referral considerations.
Evaluation of amenorrhea, anovulation, and abnormal. Secondary amenorrhea may be due either to complete obliteration of the uterine cavity or to stenosis or atresia of the internal os, as proved by radiologic studies. Secondary amenorrhea is defined as the cessation of menstruation for at least 6 months or for at least 3 of the previous 3 cycle intervals. Oct 14, 2019 secondary amenorrhea is defined as the cessation of menstruation for at least 6 months or for at least 3 of the previous 3 cycle intervals. Amenorrhea can be the initial presentation of female athlete triad. Although irregular menstruation is quite common in the first year or two following menarche, the absence of menstruation for more than 3 consecutive cycles merits.
Magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. Secondary amenorrhea absence of a period amenorrhea is the medical term for the lack of menstrual periods, including on a permanent or temporary basis. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation breastfeeding, the latter also forming the basis of a form of contraception known as the lactational amenorrhoea method. The menstrual cycle and menstrual cycle abnormalities. Ppt amenorrhea powerpoint presentation free to download id. Primary amenorrhea is the absence of menarche in a girl aged 16 years or older. Secondary amenorrhea secondary amenorrhea is typically defined as the absence of menses for a consecutive period of 3 cycles or 6 months in a woman who has previously menstruated. Even if you dont have periods, you could still get pregnant. A free powerpoint ppt presentation displayed as a flash slide show on id. Underlying conditions may overlap in primary and secondary amenorrhea. An approach to diagnosis and management a more recent article on amenorrhea is available. Primary and secondary amenorrhea describes the occurrence of amenorrhea before and after menarche. Pituitary causes secondary amenorrhea etiology pituitary failure it is usually the acquired type as the result of trauma, treatment of. Causes of primary amenorrhea include pregnancy, hormone imbalances, stress, thyroid conditions, ovarian cysts, being too thin, and longterm illness.
Abnormal genital bleeding is the most common reason for a gynecological office visit and a leading indication for dilatation of the cervix and curettage of the uterus. View and download powerpoint presentations on primary amenorrhoea ppt. The adobe flash plugin is needed to view this content. Lack of any secondary sexual characteristics by age years also is abnormal and should be investigated. Outside the reproductive years, there is absence of menses during childhood and after menopause. Secondary amenorrhoea is absence of periods for at least 3 months if the patient has previously had regular periods, and 6 months if she has previously had oligomenorrhoea. Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Secondary amenorrhoea is absence of periods for at least 3 months if the patient has previously had regular periods, and 6 months if she. Primary amenorrhea is due to changes in organs, glands, and hormones related to menstruation.
Hyperprolactinaemia is the commonest pituitary cause of amenorrhoea, although it is not a common presentation in adolescents with primary. If amenorrhea happens at other times, it may be the symptom of a treatable medical condition. Because only 3 diagnoses are unique to primary amenorrhea and never cause secondary amenorrhea, differentiating primary from secondary amenorrhea does little to enhance the clinicians understanding of the etiology. Secondary amenorrhea is defined as the cessation of menses sometime. However, patients with previously regular cycles are evaluated for secondary amenorrhea if menses have been absent for. Jan 15, 2018 amenorrhea not due to pregnancy, lactation, or menopause is a relatively common abnormality of the reproductive years and indicative of a defect somewhere in the hypothalamicpituitaryovarianuterine axis. Amenorrhoea amenorrhoea is the absence of menses in a woman of reproductive age. Secondary amenorrhoea cause % ovarian 40 hypothalamic 35 pituitary 19 uterine 5 other 1. Even the smallest changes in hormone levels can result in menstrual cycle abnormalities. Secondary amenorrhea secondary amenorrhea district i acog medical student education module 2009 definitions amenorrhea. Secondary amenorrhea is the absence of menses for 3 months in a woman with previously normal menses or 9 months in a woman with oligomenorrhea light or infrequent menses. Symptoms are similar to those of primary aldosteronism. From the start of menstruation menarche to its cessation menopause, monthly menstrual bleeding menses is regulated by hypothalamic and pituitary hormones. List the most common causes of secondary amenorrhea in women of reproductive age estimated time.
Carlson division of adolescent medicine, stanford university school of medicine, mountain view, california, usa menstrual irregularity is a common occurrence during adolescence, especially within. Ppt amenorrhea powerpoint presentation free to download. Pregnancy could be the cause for primary amenorrhea. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. One of four women with abnormal genital bleeding may have serious physical. Natural changes in the body can cause your periods to stop.
Amenorrhea can be due to pregnancy, anatomic defects of the outflow tract, ovarian disorders, and pituitary or hypothalamic disorders. Rule out with a urine or serum hcg before proceeding. Primary amenorrhea international journal of reproduction. Abnormal genital bleeding and secondary amenorrhea cessation of menses are common gynecologic complaints that can indicate serious physical problems. After completing this activity, the participant should be better able to.
Secondary amenorrhea absence of menstruation for 3 or more months in a previously menstruating women of reproductive age. Up to 50% of competitive runners training 80 miles per week and up to 44% of ballet dancers have amenorrhea. Primary amenorrhea is when a girl does not start her period by age 15 or 3 years after she begins puberty. Menstrual disorders american academy of pediatrics. Secondary amenorrhea district i acog medical student education module 2011 definitions amenorrhea. The most common etiologies are pregnancy and polycystic ovarian syndrome pcos. Evaluation and management of secondary amenorrhea uptodate. Nov 30, 2015 magnitude of the problem secondary amenorrhea prevalence about 3% primary amenorrhea prevalence about 0. Primary amenorrhea is defined either as absence of menses by age 14 years with no development of secondary sexual characteristics or as. Scribd is the worlds largest social reading and publishing site.
It is often classified as either primary absence of menarche by age 15 years or thereafter or secondary absence of menses for more than three months in girls or women who previously. Secondary amenorrhea is defined as the absence of menstrual flow in women with previously normal menstruation. Secondary aldosteronism msd manual professional edition. Physicians should initiate antibiotic treatment in women with tb. Careful history and physical examination are crucial to diagnosis. Mar 17, 2011 secondary amenorrhea 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 without any physiological reasons. Primary amenorrhea is the absence of a first period in a young woman by the age of 16. Even the smallest changes in hormone levels can result in menstrual. Details on treatments and causes of amenorrhea the absence of a monthly period are provided. Secondary amenorrhea is present when a young woman ceases to menstruate after she has had one or more menstrual periods. Mar 30, 2019 common causes of secondary amenorrhea when a woman who has had normal periods stops getting them include. Find powerpoint presentations and slides using the power of, find free presentations research about primary amenorrhoea ppt.
Secondary amenorrhea means you have had periods, and then they stop, especially for more than 3 months. Amenorrhea not due to pregnancy, lactation, or menopause is a relatively common abnormality of the reproductive years and indicative of a defect somewhere in the hypothalamicpituitaryovarianuterine axis. Amenorrhoea cause primary % secondary % hypothalamic 20 35. Amenorrhea differential diagnoses medscape reference. An initial secondary amenorrhea workup includes thyroid stimulating hormone tsh, prolactin, follicle stimulating hormone fsh, and luteinizing hormone lh tests.
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