Dong Quai

Hypothalamic amenorrhea

Amenorrhoeas are those that occur after stimulation with estrogen and progestin. No galactorrhea, prolactin remains normal pituitary gonadotropins decline or are normal, the sella is also normal.

Hypogonadism amenorrhea is more frequent. They are due to a loss of pulsatile secretion of GnRH below normal. There are several types:

The anguish and stress coupled with malnutrition in the camps meant that women lose their periods.

• Psychic: From anguish to the economic, psychological, sexual ... can eventually produce amenorrhea. CRH is released that inhibits gonadotropin secretion by increased secretion of endogenous opioids. In 72% of cases menstruation reappears spontaneously.
• Malnutrition: There may be both a very strict diet as anorexia nervosa. There is a decrease in both FSH and LH is amenorrhea hypogonadism. Weight gain restores the pulsatile secretion of gonadotropins.
• Obesity: In this case amenorrhea may be associated with anovulation. Hypogonadism, amenorrhea is not, unless there are psychological factors.
• Exercise: Women who play sports in high competition and the dancers are under great pressure, as well as undergo a loss of body fat, this leads to frequent changes in their menstrual cycle. There is an increase of prolactin, growth hormone, testosterone, ACTH, adrenal steroids and endorphins, along with a decrease in gonadotropins, probably caused by an increase in endogenous opiates.
• Hypothalamic Lesions: Different types of lesions produce amenorrhea, gums, tuberculomas, hydrocephalus, internal carotid artery aneurysms, meningitis, trauma ... In women between the lesions also highlights the SSHE hypothalamic syndrome in which a result of myocardial ischemia or motivated by bleeding occurs during labor total failure of the hypothalamic-pituitary.
• Genetic defects: They are very rare. Amenorrhea occurs in the syndrome of Laurence-Moon-Biedl although the picture is so severe that often goes unnoticed.
• Iatrogenic for contraceptives: Because the inhibition produced in the hypothalamus, decreasing consequently the production of gonadotropins.
• Olfativogenital Dystrophy: In Duchenne olfativogenital or Kallmann's syndrome is an atrophy of the olfactory cortex with sexual infantilism, female karyotype is normal. There anosmia, primary amenorrhea and lack of development of secondary sexual characteristics. The ovary responds to gonadotropin stimulation of external (endogenous are decreased).

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