Amenorrhea
By
Asmaa kadhim
2020
Causes of primary amenorrhea
Causes of primary amenorrhea
•
Hypothalamic causes. ( hypogonadotrophic hypogonadism)
•
Constitutional delay
•
Congenital absence of GnRH ( kallman syndrom )
•
Infection ( meningitis ,encephalitis)
•
Hydrocephaly
•
Brain tumour
•
Weight loss ( anorexia nervosa) , malabsorption
•
Pituitary causes
•
Pitutary tumour
•
Irradiation
•
Infltrative disease as sarcoidosis
•
Empty sella turcica syndrome
•
Drugs
•
Antihistamine
•
Antidepressant
•
Antihypertensive
•
Opiods
Ovarian causes ( hypergonadotrophic hypogonadism)
•
Ovarian agenesis
•
Ovarian dysgenesis ( turner syndrome)
•
Ovarian tumour ( hormone secreating tumours )
•
Infection (mumps)
•
Radiation
•
Chemotherapy
•
Autoimmune cause
Outflow abnormalities
•
mullerian agenesis
•
46XX. Rokitansky syndrome
•
46XY. Female
•
Genital tract obstruction
•
Imperforated hymen
•
Transverese vaginal septum
Other endocrine causes
•
Congenital adrenal hyperplasia
•
Adrenal tumour
•
Cushing disease
•
Diabetes
•
Chronic disease
•
Thyroid disease
Management of primary amenorrhea
•
History
•
Examination
•
Progesterone challenge test
•
Estrogen and progesterone challenge test
•
Investigations
•
Treatment
Treatment
•
According to the cause
Secondary amenorrhea
By
Asmaa Kadhim
2020
Secondary amenorrhea
Physiological
Pregnancy
Lactation
Menopause
Pathological
Defect in hypothalamopitutary ovarian axis
Defect in genital tract ( adhesion or outflow obstruction)
Drug induced ( contraceptives , anti depressant ,chemotherapy
,hormones)
Systemic or endocrine diseases
Psychological disorders
