Amenorrhea & Etiology |Disorders Of Sex hormone | PCOS In Females

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Amenorrhea Definition | What Is Amenorrhea?

Amenorrhea is the absence of a menstrual period in a woman of reproductive age. It may be either primary (woman never developed menstrual periods) or secondary (absence of menstrual periods in a woman who was previously menstruating). Outside of the reproductive years there is absence of menses during childhood and after menopause. Physiological states of amenorrhea are seen during pregnancy and lactation.

  • [I] Primary Amenorrhea

It is the absence of secondary sexual characteristics by age 14 with no menarche or normal secondary sexual characteristics but no menarche by 16 years of age occur with or without other signs of puberty.

Etiology Primary Amenorrhea

Primary amenorrhea is typically the result of a genetic or anatomic condition in young females that never develop menstrual periods (by age 16) and is not pregnant. Diseases of the pituitary gland and hypothalamus can also cause primary amenorrhea since these areas play a critical role in the regulation of ovarian hormones. Gonadal dysgenesis, a condition in which the ovaries are prematurely depleted of follicles and oocytes (egg cells), leads to premature failure of the ovaries. It is one of the most common cases of primary
amenorrhea in young women. Another genetic cause is Turner syndrome, in which women are lacking all or part of one of the two X chromosomes normally present in the female. In Turner syndrome, the ovaries are replaced by scar tissue and estrogen production is minimal, resulting in amenorrhea. Estrogen-induced maturation of the external female genitalia and sex characteristics also fails to occur in Turner syndrome. Other conditions include androgen insensitivity (in which individuals have XY [male] chromosomes but do not develop the external characteristics of males due to a lack of response to testosterone and its effects), congenital adrenal hyperplasia, and polycystic ovary syndrome (PCOS).
Being born with poorly formed genital or pelvic organs can lead to primary amenorrhea. Some of these defects include: blockages or narrowing of the cervix, imperforate hymen, missing uterus or vagina and vaginal septum.

  • [II] Secondary Amenorrhea

Secondary amenorrhea is ceasing of menstruation cycles. Secondary amenorrhea is the absence of menses for three months in a woman with previously normal menstruation or nine months for women with a history of irregular periods (oligomenorrhea). It is often caused by hormonal disturbances from the hypothalamus and the pituitary gland, from
premature menopause or intrauterine scar formation. Women who are pregnant,
breastfeeding, or in menopause are not considered to have secondary amenorrhea.

Etiology Secondary Amenorrhea

Pregnancy is an obvious cause of amenorrhea and is the most common reason for secondary amenorrhea. Other causes are varied and may include conditions that affect the ovaries, uterus, hypothalamus, or pituitary gland.


Disorders Of Sex hormone Definition | What Is It Exactly?

The sex hormones are a group of hormones responsible for controlling puberty,
reproduction, birth and lactation. Sex hormone disorders, also referred to as reproductive
hormone disorders, medical conditions that affect the different glands and organs of the
body responsible for the production of the sex hormones.

The sex hormones, which include testosterone (male) and estrogen (female) are
substances that are essential in almost every body function, but more so in sexual functions and reproduction. Both testosterone and estrogen are present in males and females, but the levels differ according to sex. Males have higher levels of testosterone and females have higher levels of estrogen.

Sex hormone disorders disrupt the normal production of hormones, which results in
a reduced sex drive (libido), vaginal dryness, infertility, or excessive body hair, alopecia (hair loss) and may have long-term effects on metabolic, cardiovascular and bone health.


Disorders of Sex Hormones In Females

Polycystic Ovarian Syndrome (PCOS)

This disorder is characterized by oligomenorrhea (irregular menstrual cycles)
or amenorrhea (no menstrual cycles) with symptoms of hyperandrogenism (extra male like hormones) such as acne and hirsutism (extra male like hair growth). This is the most
common endocrine disorder in young females. Blood tests which may be elevated
in this condition are testosterone and DHEAS. The underlying cause of this disorder is thought to be insulin resistance (poor response of body tissues to insulin). Therefore, blood sugar and insulin levels may also be evaluated. PCOS can result in obesity, infertility, diabetes, heart disease and uterine cancer. Exercise, weight loss and medications can be used to improve insulin sensitivity. Menstrual cycles can also be regulated with birth control pills.



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