Amenorrhea history and symptoms: Difference between revisions

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Revision as of 15:56, 3 November 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

The hallmark of primary amenorrhea is absence of menarche until 15 years of age, in the presence of other secondary sexual characteristics; or lack of menarche after 5 years of thelarche, if thelarche occurred before 10 years of age. The hallmark of secondary amenorrhea is menstrual cycle interruption for at least 3 months, however were regular before; or menstrual cycle interruption for at least 6 months, however were irregular before.

History and Symptoms

The hallmark of primary amenorrhea is:
- Absence of menarche until 15 years of age, in the presence of other secondary sexual characteristics.
- Absence of menarche after 5 years of thelarche, if thelarche occurred before 10 years of age.^[1]

The hallmark of secondary amenorrhea is:
- Menstrual cycle is interrupted for at least 3 months, however were regular before.^[2]
- Menstrual cycle is interrupted for at least 6 months, however were irregular before.^[3]

Patients history and symptoms that are suggestive of different causes of amenorrhea are as following table:^[4]^[5]

Groups	Elements		Underlying cause of amenorrhea
Patient history	Stress		Functional amenorrhea
	Exercise
	Weight loss
	Chronic illness	Crohn disease
		Cystic fibrosis
		Sickle cell disease
		Thalassemia major
	Illicit drug use	Alcohol
		Cocaine
		Marijuana
		Opioids
	Lack of menarche		Primary amenorrhea
	Menstrual history		Secondary amenorrhea
	Prescription drug use	Androgens	Multiple, depending on medication
		Antidepressants
		Danazol
		High-dose progestins
	Previous central nervous system chemotherapy or radiation		Hypothalamic amenorrhea
	Previous pelvic radiation		Premature ovarian failure
	Psychosocial stressors		Anorexia or bulimia nervosa
	Nutritional problems
	Exercise history
	Sexual activity		Pregnancy
Family history	Genetic defects	Congenital gonadotropin-releasing hormone deficiency	Multiple causes of primary amenorrhea
		GnRH receptor gene mutations
		Prader-Willi syndrome
		Congenital thymic aplasia
		Fragile X syndrome
		Idiopathic accelerated ovarian follicular atresia
	Pubic hair pattern		Androgen insensitivity syndrome
	Infertility		Multiple causes of primary amenorrhea
	Menarche and menstrual history (mother and sisters)		Constitutional delay of growth and puberty
	Pubertal history (e.g., growth delay)		Constitutional delay of growth and puberty
Review of systems	Anosmia		Kallmann syndrome
	Cyclic abdominal pain		Outflow tract obstruction or müllerian agenesis
	Breast changes		Outflow tract obstruction or müllerian agenesis
	Galactorrhea		Pituitary tumor
	Headache
	Visual disturbances
	Hirsutism		Polycystic ovary syndrome
	Acne		Polycystic ovary syndrome
	Signs and symptoms of hypothyroidism or hyperthyroidism	Temperature intolerance	Thyroid disease
		Palpitations
		Diarrhea
		Constipation
		Tremor
		Depression
		Skin changes
	Vasomotor symptoms		Premature ovarian failure

References

↑ Herman-Giddens, M. E.; Slora, E. J.; Wasserman, R. C.; Bourdony, C. J.; Bhapkar, M. V.; Koch, G. G.; Hasemeier, C. M. (1997). "Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatric Research in Office Settings Network". PEDIATRICS. 99 (4): 505–512. doi:10.1542/peds.99.4.505. ISSN 0031-4005.
↑ Chiavaroli, Valentina; DAdamo, Ebe; Diesse, Laura; de, Tommaso; Chiarelli, Francesco; Moh, Angelika (2011). "Primary and Secondary Amenorrhea". doi:10.5772/17675.
↑ Fritz, Marc (2011). Clinical gynecologic endocrinology and infertility. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 978-0781779685.
↑ Klein DA, Poth MA (2013). "Amenorrhea: an approach to diagnosis and management". Am Fam Physician. 87 (11): 781–8. PMID 23939500.
↑ Master-Hunter T, Heiman DL (2006). "Amenorrhea: evaluation and treatment". Am Fam Physician. 73 (8): 1374–82. PMID 16669559.

Template:WH Template:WS

[Herman-GiddensSlora1997-1] Herman-Giddens, M. E.; Slora, E. J.; Wasserman, R. C.; Bourdony, C. J.; Bhapkar, M. V.; Koch, G. G.; Hasemeier, C. M. (1997). "Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatric Research in Office Settings Network". PEDIATRICS. 99 (4): 505–512. doi:10.1542/peds.99.4.505. ISSN 0031-4005.

[ChiavaroliDAdamo2011-2] Chiavaroli, Valentina; DAdamo, Ebe; Diesse, Laura; de, Tommaso; Chiarelli, Francesco; Moh, Angelika (2011). "Primary and Secondary Amenorrhea". doi:10.5772/17675.

[3] Fritz, Marc (2011). Clinical gynecologic endocrinology and infertility. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 978-0781779685.

[pmid23939500-4] Klein DA, Poth MA (2013). "Amenorrhea: an approach to diagnosis and management". Am Fam Physician. 87 (11): 781–8. PMID 23939500.

[pmid16669559-5] Master-Hunter T, Heiman DL (2006). "Amenorrhea: evaluation and treatment". Am Fam Physician. 73 (8): 1374–82. PMID 16669559.

[1]

[2]

[3]

[4]

[5]

@@ Line 15: / Line 15: @@
 ** [[Menstrual cycle]] is interrupted for at least 3 months, however were regular before.<ref name="ChiavaroliDAdamo2011">{{cite journal|last1=Chiavaroli|first1=Valentina|last2=DAdamo|first2=Ebe|last3=Diesse|first3=Laura|last4=de|first4=Tommaso|last5=Chiarelli|first5=Francesco|last6=Moh|first6=Angelika|title=Primary and Secondary Amenorrhea|year=2011|doi=10.5772/17675}}</ref>
 ** [[Menstrual cycle]] is interrupted for at least 6 months, however were irregular before.<ref>{{cite book | last = Fritz | first = Marc | title = Clinical gynecologic endocrinology and infertility | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia | year = 2011 | isbn = 978-0781779685 }}</ref>
+<div style="text-align: center;">'''Patients history and symptoms that are suggestive of different causes of amenorrhea are as following table:'''<ref name="pmid23939500">{{cite journal |vauthors=Klein DA, Poth MA |title=Amenorrhea: an approach to diagnosis and management |journal=Am Fam Physician |volume=87 |issue=11 |pages=781–8 |year=2013 |pmid=23939500 |doi= |url=}}</ref><ref name="pmid16669559">{{cite journal |vauthors=Master-Hunter T, Heiman DL |title=Amenorrhea: evaluation and treatment |journal=Am Fam Physician |volume=73 |issue=8 |pages=1374–82 |year=2006 |pmid=16669559 |doi= |url=}}</ref></div>
-=== Patients history and symptoms that are suggestive of different causes of amenorrhea are as following table.<ref name="pmid23939500">{{cite journal |vauthors=Klein DA, Poth MA |title=Amenorrhea: an approach to diagnosis and management |journal=Am Fam Physician |volume=87 |issue=11 |pages=781–8 |year=2013 |pmid=23939500 |doi= |url=}}</ref><ref name="pmid16669559">{{cite journal |vauthors=Master-Hunter T, Heiman DL |title=Amenorrhea: evaluation and treatment |journal=Am Fam Physician |volume=73 |issue=8 |pages=1374–82 |year=2006 |pmid=16669559 |doi= |url=}}</ref> ===
 {| class="wikitable"
 ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Groups
@@ Line 23: / Line 22: @@
 |-
 | rowspan="23" style="background:#DCDCDC;" align="center" + |'''Patient history'''
-| colspan="2" |'''''[[Stress]]'''''
+| colspan="2" |'''[[Stress]]'''
 | rowspan="11" |Functional amenorrhea
 |-
-| colspan="2" |'''''[[Exercise]]'''''
+| colspan="2" |'''[[Exercise]]'''
 |-
-| colspan="2" |'''''[[Weight loss]]'''''
+| colspan="2" |'''[[Weight loss]]'''
 |-
-| rowspan="4" |'''''Chronic [[illness]]'''''
+| rowspan="4" |'''Chronic [[illness]]'''
 |[[Crohn disease]]
 |-
@@ Line 39: / Line 38: @@
 |[[Thalassemia major]]
 |-
-| rowspan="4" |'''''[[Drug use|Illicit drug use]]'''''
+| rowspan="4" |'''[[Drug use|Illicit drug use]]'''
 |[[Alcohol]]
 |-
@@ Line 48: / Line 47: @@
 |[[Opioids]]
 |-
-| colspan="2" |'''''Lack of [[menarche]]'''''
+| colspan="2" |'''Lack of [[menarche]]'''
 |Primary amenorrhea
 |-
-| colspan="2" |'''''[[Menstrual cycle|Menstrual]] history'''''
+| colspan="2" |'''[[Menstrual cycle|Menstrual]] history'''
 |Secondary amenorrhea
 |-
-| colspan="1" rowspan="4" |'''''[[Prescription]] drug use'''''
+| colspan="1" rowspan="4" |'''[[Prescription]] drug use'''
 |[[Androgens]]
 | rowspan="4" |Multiple, depending on [[medication]]
@@ Line 64: / Line 63: @@
 |High-dose [[progestins]]
 |-
-| colspan="2" rowspan="1" |'''''Previous [[central nervous system]] [[chemotherapy]] or [[radiation]]'''''
+| colspan="2" rowspan="1" |'''Previous [[central nervous system]] [[chemotherapy]] or [[radiation]]'''
 | colspan="1" rowspan="1" |[[Hypothalamic]] amenorrhea
 |-
-| colspan="2" rowspan="1" |'''''Previous [[pelvic]] [[radiation]]'''''
+| colspan="2" rowspan="1" |'''Previous [[pelvic]] [[radiation]]'''
 | colspan="1" rowspan="1" |[[Premature ovarian failure]]
 |-
-| colspan="2" rowspan="1" |'''''[[Psychosocial]] stressors'''''
+| colspan="2" rowspan="1" |'''[[Psychosocial]] stressors'''
 | colspan="1" rowspan="3" |[[Anorexia]] or [[bulimia nervosa]]
 |-
-| colspan="2" |'''''[[Nutritional]] problems'''''
+| colspan="2" |'''[[Nutritional]] problems'''
 |-
-| colspan="2" |'''''[[Exercise]] history'''''
+| colspan="2" |'''[[Exercise]] history'''
 |-
-| colspan="2" rowspan="1" |'''''[[Sexual activity]]'''''
+| colspan="2" rowspan="1" |'''[[Sexual activity]]'''
 | colspan="1" rowspan="1" |[[Pregnancy]]
 |-
 | rowspan="10" style="background:#DCDCDC;" align="center" + |'''Family history'''
-| colspan="1" rowspan="6" |'''''[[Genetic defects]]'''''
+| colspan="1" rowspan="6" |'''[[Genetic defects]]'''
 |Congenital [[gonadotropin-releasing hormone]] deficiency
 | colspan="1" rowspan="6" |Multiple causes of primary amenorrhea
@@ Line 95: / Line 94: @@
 |Idiopathic accelerated [[ovarian]] [[follicular atresia]]
 |-
-| colspan="2" rowspan="1" |'''''[[Pubic hair]] pattern'''''
+| colspan="2" rowspan="1" |'''[[Pubic hair]] pattern'''
 | colspan="1" rowspan="1" |[[Androgen insensitivity syndrome]]
 |-
-| colspan="2" rowspan="1" |'''''[[Infertility]]'''''
+| colspan="2" rowspan="1" |'''[[Infertility]]'''
 |Multiple causes of primary amenorrhea
 |-
-| colspan="2" rowspan="1" |'''''[[Menarche]] and [[menstrual]] history (mother and sisters)'''''
+| colspan="2" rowspan="1" |'''[[Menarche]] and [[menstrual]] history (mother and sisters)'''
 | colspan="1" rowspan="1" |[[Constitutional delay of puberty|Constitutional delay of growth and puberty]]
 |-
-| colspan="2" rowspan="1" |'''''[[Pubertal]] history (e.g., [[growth delay]])'''''
+| colspan="2" rowspan="1" |'''[[Pubertal]] history (e.g., [[growth delay]])'''
 | colspan="1" rowspan="1" |[[Constitutional delay of puberty|Constitutional delay of growth and puberty]]
 |-
 | rowspan="16" style="background:#DCDCDC;" align="center" + |'''Review of systems'''
-| colspan="2" rowspan="1" |'''''[[Anosmia]]'''''
+| colspan="2" rowspan="1" |'''[[Anosmia]]'''
 | colspan="1" rowspan="1" |[[Kallmann syndrome]]
 |-
-| colspan="2" rowspan="1" |'''''Cyclic [[abdominal pain]]'''''
+| colspan="2" rowspan="1" |'''Cyclic [[abdominal pain]]'''
 | colspan="1" rowspan="2" |Outflow tract obstruction or [[müllerian agenesis]]
 |-
-| colspan="2" |'''''[[Breast]] changes'''''
+| colspan="2" |'''[[Breast]] changes'''
 |-
-| colspan="2" rowspan="1" |'''''[[Galactorrhea]]'''''
+| colspan="2" rowspan="1" |'''[[Galactorrhea]]'''
 | colspan="1" rowspan="3" |[[Pituitary tumor]]
 |-
-| colspan="2" |'''''[[Headache]]'''''
+| colspan="2" |'''[[Headache]]'''
 |-
-| colspan="2" |'''''[[Visual impairment|Visual disturbances]]'''''
+| colspan="2" |'''[[Visual impairment|Visual disturbances]]'''
 |-
-| colspan="2" rowspan="1" |'''''[[Hirsutism]]'''''
+| colspan="2" rowspan="1" |'''[[Hirsutism]]'''
 | colspan="1" rowspan="2" |[[Polycystic ovary syndrome]]
 |-
-| colspan="2" |'''''[[Acne]]'''''
+| colspan="2" |'''[[Acne]]'''
 |-
-| rowspan="7" |'''''Signs and symptoms of [[hypothyroidism]] or [[hyperthyroidism]]'''''
+| rowspan="7" |'''Signs and symptoms of [[hypothyroidism]] or [[hyperthyroidism]]'''
 |[[Temperature]] intolerance
 | colspan="1" rowspan="7" |[[Thyroid disease]]
@@ Line 144: / Line 143: @@
 |[[Skin changes]]
 |-
-| colspan="2" rowspan="1" |'''''[[Vasomotor]] symptoms'''''
+| colspan="2" rowspan="1" |'''[[Vasomotor]] symptoms'''
 | colspan="1" rowspan="1" |[[Premature ovarian failure]]
 |}

Amenorrhea history and symptoms: Difference between revisions

Revision as of 15:56, 3 November 2017

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