amenorrhea

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amenorrhea

(āmĕn'ərē`a, əmĕn'–), cessation of menstruationmenstruation,
periodic flow of blood and cells from the lining of the uterus in humans and most other primates, occurring about every 28 days in women. Menstruation commences at puberty (usually between age 10 and 17).
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. 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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The following article is from The Great Soviet Encyclopedia (1979). It might be outdated or ideologically biased.

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

The Great Soviet Encyclopedia, 3rd Edition (1970-1979). © 2010 The Gale Group, Inc. All rights reserved.

amenorrhea

[¦ā‚men·ə′rē·ə]
(medicine)
Absence of menstruation due to either normal or abnormal conditions.
McGraw-Hill Dictionary of Scientific & Technical Terms, 6E, Copyright © 2003 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
Another pharmacological intervention for athletes suffering from the female athlete triad syndrome and functional hypothalamic amenorrhea (FHA) causing low bone mineral density is the use of bisphosphonates.
Strategies to reverse bone loss in women with functional hypothalamic amenorrhea: a systematic review of the literature.
The potential negative effects of hypothalamic amenorrhea, such as bone loss, are best prevented with measures to restore menses, specifically increased caloric intake and decreased exercise
Once that's done, you can make a presumptive diagnosis of hypothalamic amenorrhea and advise the patient to increase caloric intake or decrease energy expenditure to promote the return of normal menses (strength of recommendation: C, expert consensus).
The levels were normal in women with hypothalamic amenorrhea.
DHEAS levels were normal in women with anorexia nervosa not receiving contraceptives and in women with hypothalamic amenorrhea.
The mean body mass index (BMI), percent ideal body weight, percent fat, total fat mass, and fat-free mass were lower in the anorexia nervosa groups, compared with women who had hypothalamic amenorrhea and the healthy controls.
She reported on 16 patients with functional hypothalamic amenorrhea who participated in a randomized trial in which half were assigned to CBT and half to observation.
She reported on 14 normal-weight women who met stringent criteria for functional hypothalamic amenorrhea, including an absence of psychiatric conditions, eating disorders, or pituitary tumors.
Ringham and her coinvestigators had previously demonstrated that women with functional hypothalamic amenorrhea are distinguishable from women having an organic cause for their amenorrhea as well as from normally menstruating women on the basis of their high levels of subthreshold symptoms of disordered eating, with dysfunctional attitudes, mild undernutrition, and/or excessive energy output.
"Patients with hypothalamic amenorrhea, a disease that was first described in the 1940s and was poorly understood for decades, may finally benefit from a rebirth of investigation leading to rational therapy."
Women with prolonged functional hypothalamic amenorrhea are at increased risk for cardiovascular disease, osteoporosis, cognitive impairment, and depression.