Dong Quai

Amenorrhea

Amenorrhea is defined as the absence of menstruation for a period of time longer than 90 days. It may be normal (physiological) or be indicative of disease (pathological).

According to the period of establishment and its pathophysiology are classified into three groups.

• Physiological amenorrhoea.
• Primary amenorrhea.
• Secondary amenorrhea.

Physiologic amenorrhea

The lack of menstruation is physiological:

• Before puberty, menarche (first menstruation) usually occurs between 10 and 14.
• In pregnancy, amenorrhea is always present in pregnancy. Therefore, in a young woman, previously well menstruating, amenorrhoeic a few months and having sex without using contraception pregnancy should be considered as a possible etiology.
• In the lactation amenorrhea that occurs during breastfeeding is the hypothalamic-pituitary origin and of variable duration. The endometrium does not grow or develop due to decreased production of estrogen and progesterone. This is because with the release of prolactin is a decrease in gonadotropin release is not the maturation of ovarian follicles.
• At menopause begins between 45 and 55. This is because the ovary loses functionality. Begins to occur when the hormone secretion is no longer rhythmic.

Among the physiological amenorrhea only due to menopause, due to possible complications and symptoms such amenorrhea may decrease the patient's quality of life. The rest must always be considered in the differential diagnosis.

Amenorrhea in the nursing period may be pathological if it continues after the end of lactation. In this case studies will be required of the role of the hypothalamic-pituitary.

Primary amenorrhea

Primary amenorrhea is considered in all cases in which menarche has not occurred before 16 years (97% of women with menarche before age 15 years) or before age 14 if no sexual characters side. The most common cause of primary amenorrhea is gonadal dysgenesis (defective formation of the ovaries).

Primary amenorrhea occurs when there is an alteration in the normal functioning of the ovaries and is manifested by delayed menarche, or the first menstruation, as well as the appearance of secondary sexual characters, which are the outbreak of pubic hair and in axillae, breast development or breasts and lack of definition in the female body structure, such as waist, hips.

This is caused by the lack of production of hormones such as progesterone, estrogens, androgens and corticosteroids or by the presence of ovarian cysts. It can also be caused by abnormal development of the uterus and vagina or the presence of an imperforate hymen and very closed, hindering the elimination of blood flow.

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