Lec 2 amenorrhea.pdf

Amenorrhoea Dr.Aqeela Haidar Amenorhoea:- is defined as absence of menstruation; it may be classified as Primary amenorrhoea: this condition relates to female who fail to menstruate by 16 years. Secondary amenorrhoea:is defined as the cessation of menstruation fo...

Amenorrhoea Dr.Aqeela Haidar Amenorhoea:- is defined as absence of menstruation; it may be classified as Primary amenorrhoea: this condition relates to female who fail to menstruate by 16 years. Secondary amenorrhoea:is defined as the cessation of menstruation for more than six months in a normal female of reproductive age that is not due to pregnancy, in a woman of fertile age , and oligomenorrhoea is defined as irrigular periods at intervals of more than 35 days with only 4 to 9 periods a year. Etiology: Classification of the etiologies of primary amenorrhoea based on the presence or absence of secondary sexual characteristics: Secondary sexual characteristics normal (present): 1-Imperforated hymen. 2-Transverse vaginal septum. 3-Absent vagina & functioning uterus. 4-Absent vagina & non-functioning uterus. 5-XY female- androgen insensitivity. 6-Resistant ovary syndrome. 7-Constitutional delay. Secondary sexual characteristics absent: Normal stature: Hypogonadotrophic hypogonadism: -Isolated gonadotrophin- releasing hormone deficiency. (Olfactogenital syndrome/ Kallmann syndrome. Hypergonadotrophic hypogonadism: 1-Weight loss/anorexia. 2-Excessive exercise. 3-Hyperprolactinemia. 4-Gonadal dysgenesis. 5-Turner mosaic. 6-Other x deletion or mosaic 7-XY enzymatic failure. 8-Ovarian failure. 9-Galactosaemia. Short stature. Hypogonadotrophic hypogonadism: Congenital infection. Acquired: 1-Trauma ( head injury). 2-Empty sella syndrome 3-Tumors. Hypergonadotrophic hypogonadism: 1-Turner syndrome 2-Other X deletions or mosaic Secondary sexual characteristics normal: Reproductive outflow tract abnormalities: Mullerian agenesis: congenital absence of the vagina or uterus or both. It is called (Mayer-rokitansky- kuster- huaser syndrome), the ovarian function is usually normal as well as the secondary sexual characteristics, the diagnosis may be suspected by the absence of the vagina & uterus (blind & vaginal dimple