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Amenorrhea (Secondary
(regular period) misses 3 cycles
(irregular…
Amenorrhea
Secondary
- (regular period) misses 3 cycles
- (irregular period) > 6 months #
Uterus
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Hormonal use (patch, injection, oral, uterine)
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Hypothalamus
Lifestyle
- stress
- malnutrition (vegan)
- exercise
- dieting/ LOW
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Exogenous drugs (chemo, OCP, antipsychotic)
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Karyotype (turner's syndrome) - genetics, CLOWNS
Primary
True primary amenorrhea
- 14yo --> no secondary sexual traits
- 16yo --> with secondary sexual traits (allow 2 years after sexual trait)
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Progestin challenge (provera 10mg OM or 10mg BD if overweight x 1 week)
- withdrawal bleed within 1 week: anovulation
- no withdrawal bleed: no estrogen (POF, PCOS) or obstruction of outflow tract
Complications:
- endometrial hyperplasia/cancer
- osteoporosis, IHD (due to increase LDL)
- infertility
- CVRF (only PCOS)