Amenorrhea (redirected from secondary amenorrhea)

amenorrhea (āmĕn'ərē`a, əmĕn'–), cessation of menstruation. Primary amenorrhea is a delay in or a failure to start menstruation; secondary amenorrhea is an unexpected stop to the menstrual cycle. It is caused by dysfunctioning of the pituitary gland, ovaries, uterus, and hypothalamus, by surgical removal of the ovaries or uterus, by medication, or by emotional trauma. The result is an inadequate amount of body fat, calories, and protein to sustain menstruation. Female athletes have a higher than average rate of menstrual dysfunction, particularly amenorrhea, but the long-term effects of the exercise-related disorders are not known. It is also common among anorexics. The lack of estrogen, however, may contribute to the development of osteoporosis. Hormonal deficiencies over prolonged periods of time, particularly in combination with poor diets, may cause luteal phase deficiency and hypoestrogenic amenorrhea, which may last a long time. Methods of treatment include oral contraceptives or estrogen-progestin therapy.

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amenorrhea

Lack of menstruation. Signs of primary amenorrhea (failure to start menstruating by age 16) include infantile reproductive organs, lack of breasts and pubic hair, dwarfism, and deficient muscle development. In secondary amenorrhea (abnormal cessation of cycles once started), the genitals atrophy and pubic hair diminishes. Not itself a disease, amenorrhea reflects a failure in the balance among the hypothalamus, pituitary gland, ovaries, and uterus; tumours, injuries, or diseases of these can lead to amenorrhea. Other causes include systemic diseases, emotional shock, stress, hormone over- or underproduction, anorexia nervosa, absence of ovaries or uterus, pregnancy, lactation, and menopause. Infrequent menstruation or amenorrhea not resulting from organic disease is not harmful.

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amenorrhea [¦ā‚men·ə′rē·ə]

(medicine)

Absence of menstruation due to either normal or abnormal conditions.

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Amenorrhea 

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.

REFERENCES

Vikhliaeva, E. M. “K voprosu gormonoobrazovatel’noi funktsii iaichnikov u zhenshchin v klimaktericheskom periode.” In Fiziologiia i patologiia menstrual’noi funktsii. Moscow, 1960.
Kvater, E. I. Gormonal’ naia diagnostika i terapiia ν akusherstve i ginekologii, 3rd ed. Moscow, 1967. “Osnovnye formy anomalii menstrual’noi funktsii.” In Osnovy en-dokrinologicheskoi ginekologii. Moscow, 1966.

A. L. KAPLAN