Amenorrhoea

Amenorrhoea is absense of a menstrual period in a women of reproductive age. However, it presents in two key ways: at the onset of periods, and during reproductive years:

Primary amenorrhoea

Definition

Menarche is delayed; the onset of periods hasn't happened by the age of 16, even though secondary sexual characteristics, thelarche (growth of breasts) and adrenarche (growth of pubic hair), have occured.

Common Causes

They are mostly odd, genetic and rare, except for the first one

• Anorexia nervosa - this is the most common by quite a long way.
• Congenital genital tract malformations - Turners, Mullerian agenesis, etc.
• Androgen insufficiency

Management

Basically, if they have anorexia, sort that out. Otherwise, if the problem is an obscure genetic problem, there may not be much that can be done to restore normal fertility. Ultimately though, management of the problem will be the way to deal with the amenorrhoea.

Secondary amenorrhoea

Absense of a menstrual period in a women of reproductive age.

Pathophysiology

• Secondary -