the absence of menstruation. As a physiological phenomenon it is found in girls until the time of sexual maturity, among pregnant and lactating women, and in older women after the climacteric. In all other cases, the condition indicates some form of illness.
A distinction is made between primary amenorrhea, in which no menstruation has ever occurred in the individual, and secondary amenorrhea, in which menstruation previously took place and has ceased. Amenorrhea is associated with disruption of the ripening of the follicle and formation of the corpus luteum; it may be brought on by acute or chronic infection, disease of the endocrine glands, neuro-psychiatric disorders (“war amenorrhea,” for example), cardiovascular or blood disease, and so forth. The condition may result from X-ray or radioactive irradiation of the ovaries, chronic poisoning (for example, by alcohol, nicotine, or lead), exhaustion (from hunger, undereating, or malnutrition), extreme adiposis, and so forth. In some women amenorrhea makes its appearance accompanied by extreme fatigue, either physical or mental, as in the case of students at the time of examinations. Amenorrhea may be the result of artificial abortion or of cauterization of the uterine mucous membrane with iodine or other remedies.
The condition may ensue from developmental defects in the reproductive organs (such as lack of an opening in the hymen) or from scars of the vagina or cervix uteri following trauma. Menstrual blood accumulates in the vagina, uterus, and uterine tubes and then cannot be expelled from the body; this is known as false amenorrhea.
Frequently amenorrhea produces no marked subjective disorders, but severe cases may lead to metabolic changes (adiposis or sometimes loss of weight), depression, or unpleasant sensations such as congestion or vertigo.
Finding proper treatment requires determination of the basic causes of the condition, and treatment is directed toward elimination or mollification of the causes. Effective diet, long rest periods in the fresh air, climatotherapy, and therapeutic exercises are the prescribed forms of therapy. Emotional disturbances should be removed. Hormone preparations are frequently prescribed.
A. L. KAPLAN