Amenorrhea Clinical Management
DX: AMENORRHEA
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DUE DATE JULY 16, 2025
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Amenorrhea Clinical Management
Definition and Types of Amenorrhea
Amenorrhea is the absence of menstruation for three or more months in women of reproductive age. It is classified into two types: primary, where menstruation never begins by age 15 or 16, and secondary, which occurs when menstruation stops for three months or longer after having regular periods. Causes vary widely from hormonal imbalances to structural abnormalities, making accurate diagnosis essential for effective management (Kaur et al., 2021).
Etiology and Pathophysiology
Common causes include hypothalamic dysfunction, polycystic ovary syndrome (PCOS), thyroid disorders, and hyperprolactinemia. Amenorrhea results from disruption in the hypothalamic-pituitary-ovarian axis that regulates menstrual cycles. Stress, extreme weight loss, and excessive exercise may also affect this axis. Understanding the underlying mechanism guides clinicians in tailoring treatment to restore hormonal balance and menstrual function (Patel & Maheshwari, 2023).
Assessment and Diagnostic Approach
A thorough history, physical examination, and laboratory tests are crucial. Evaluation includes pregnancy tests, hormone panels (FSH, LH, prolactin, thyroid hormones), and imaging studies like pelvic ultrasound. These help identify underlying disorders. The diagnostic workup must be systematic to rule out life-threatening conditions such as tumors or severe endocrine disorders (Sharma et al., 2022).
Management and Treatment Strategies
Treatment depends on the cause. Hormonal therapies, lifestyle modifications, and surgical interventions may be necessary. For example, PCOS management involves insulin .
