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(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.



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.


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.



Absence of menstruation due to either normal or abnormal conditions.
References in periodicals archive ?
4,5,9,14) The latter is common in female athletes and can be termed functional hypothalamic amenorrhea (FHA).
A recent open-label study that did examine bone mineral density (BMD) in women with hypothalamic amenorrhea before and after 13 cycles of oral contraceptives found a significant increase in BMD in the spine, but not at the hip.
The total testosterone levels were normal in women with hypothalamic amenorrhea, Dr.
Amplification of nocturnal melatonin secretion in women with functional 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.
Results of a "proof of concept" study of eight women with hypothalamic amenorrhea and six controls suggest that leptin--a hormone secreted by adipocytes that regulates energy homeostasis--might help in a range of neuroendocrine disorders, such as anorexia nervosa, infertility, and exercise-induced bone loss, said Dr.
Functional hypothalamic amenorrhea is anovulation that's not attribulate to a discernible organic cause.
Ahima said that the decrease in levels of leptin--which mediates the suppression of reproductive, growth, and thyroid hormones: increases glucocorticoids; and stimulates food retake--may have evolved as a defense against starvation, which hypothalamic amenorrhea closely resembles.
This psychological intervention also reduced the elevated cortisol secretion characteristic of functional hypothalamic amenorrhea, a common disorder also known as stress-induced anovulation.
Ahima said that the decrease in leptin levels during fasting--which mediates the suppression of reproductive, growth, and thyroid hormones, increases glucocorticoids, and stimulates food intake--may have evolved as a defense against starvation, which hypothalamic amenorrhea closely resembles.
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.