Secondary amenorrhea

Introduction Secondary amenorrhea refers to women who have had regular menstrual cramps, but who have stopped menstruating for more than 6 months for some pathological reasons. Common causes are endometrial damage or adhesion (common in multiple curettage and excessive curettage of the endometrium, causing intrauterine adhesions) and tuberculous endometritis, premature ovarian failure and polycystic ovary, ovarian functional tumors, environmental changes , changes in external factors such as trauma and malnutrition, injection of long-acting injectables or oral contraceptives, amenorrhea, and Sheehan's syndrome (due to postpartum hemorrhage, shock, anterior pituitary tissue ischemia, necrosis, hypopituitarism Amenorrhea occurs.) After the occurrence of secondary amenorrhea, you should go to the hospital for examination in time, according to the medical history and physical examination, related auxiliary examination, hormone determination, etc., to find the cause of amenorrhea. The treatment is treated according to different reasons. Some patients can naturally recover from menstruation after physical or mental adjustment or discontinuation of contraceptives. Some patients can recover after treatment with progesterone, artificial cycle and ovulation induction. The use of hormone replacement therapy, such as impaired ovarian function or destruction, leading to premature ovarian failure.

Cause

The most common cause of secondary amenorrhea is pregnancy. Sometimes breastfeeding mothers do not come to menstruation.

1, systemic diseases and other stimuli can cause amenorrhea:

(1) Malnutrition is too thin to cause amenorrhea: Women who were locked up in concentration camps during the Second World War almost all had amenorrhea due to malnutrition, and once released, their menstruation gradually returned to normal. Some women eat too little, and have anorexia for amenorrhea in order to lose weight; others are due to digestive tract dysfunction, which causes nutrients but is difficult to absorb (such as severe gastrointestinal diseases) can also cause amenorrhea.

(2) Chronic wasting diseases: such as severe anemia, tuberculosis, etc.

(3) Diabetes: It is reported that 50% of young women with diabetes have amenorrhea. The incidence of diabetes is gradually increasing after the age of 40. For women who have "three more and one less" (multiple drinks, more food, more urine, and weight loss), diabetes should be considered when amenorrhea occurs.

(4) Other environmental factors: such as overwork, cold stimulation (such as eating too much cold drink during the menstrual period, cold water).

(5) Mental factors: such as fear, nervousness, fear of pregnancy, and hopefulness (false pregnancy) may cause amenorrhea. The aforementioned women in the concentration camps during the World War II period suffered from amenorrhea, and mental factors also played a significant role.

2, hypothalamus, pituitary disease caused by amenorrhea: because menstruation is completed by the central nervous system and women's reproductive organs close "cooperation", resulting in the central nervous system, brain, hypothalamus, pituitary diseases or by certain factors Menstruation can also cause amenorrhea, especially dysfunction or disease of the hypothalamus and pituitary gland can cause amenorrhea, such as meningitis, encephalitis, brain injury, radiation therapy, brain tumors, etc.

an examination

Related inspection

Progesterone withdrawal test Luteinizing hormone progesterone progesterone test progesterone test

Women who have had menstrual cramps for three months or more have not practiced again, and are called secondary amenorrhea. Normal women's menstruation is completed by the normal regulation of endocrine hormones secreted by the hypothalamus, pituitary, and ovary. Pituitary gonadotropins play a leading role in regulating ovarian function and maintaining menstrual cycle. When secondary amenorrhea occurs, it is often accompanied by mental depression, irritability, irritability, weak waist, dizziness, tinnitus, palpitations, shortness of breath, fatigue and other symptoms.

It is easy to suffer from gallstones: there are many components of vegetable fiber in vegetarian diet, which can reduce the reabsorption of bile acid and decrease the concentration of bile salt. In addition, the intake of vitamin A and E in vegetarians is insufficient, and gallbladder epithelial cells are easy to fall off, which leads to the deposition of cholesterol and the formation of gallstones.

Affecting fertility: In order to maintain the beauty of the body, some women are vegetarian for a long time. However, women often have devastating effects on hormone secretion in the body, leading to abnormal hormone secretion and disorder of the menstrual cycle, and even serious infertility. In addition, girls who are often vegetarian are often delayed in menstruation, and female athletes who are vegetarian are prone to secondary amenorrhea.

It can be seen that residents should choose a combination of vegetarian and vegetarian diets. For obesity, diabetes, cardiovascular disease, you can eat more vegetarian food, and for growth and development of children and malnutrition, trace element deficiency, may wish to increase foraging. In short, the scientific diet structure should be a combination of alizarin and appropriate proportions.

Differential diagnosis

1. Physiological amenorrhea: Physiological amenorrhea is a normal phenomenon. In the early stage of puberty, in the second or third year of the first menstrual period, the ovarian function is still unstable, and the menstrual cycle is often irregular. After the conception, the ovarian corpus luteum produces a large amount of lutein, which stimulates the endometrium to proliferate without falling off. Therefore, it will not come to menstruation; after childbirth, ovarian function recovery takes a certain time, combined with breast-feeding inhibition of the ovary, menstrual recovery is later; after the age of 40, due to the gradual decline of ovarian function, menstruation often several months until menopause . This amenorrhea, which occurs during development, pregnancy, lactation, and menopause, is called physiological amenorrhea and is a normal phenomenon.

2, pituitary amenorrhea: the amenorrhea caused by pituitary tumors may be accompanied by headache, blurred vision, or lactation; uterine necrosis before the pituitary, occurs in postpartum hemorrhage, manifested as loss of libido, genital atrophy, fatigue, cold, hair Fall off.

3, sports amenorrhea: light female athletes, amenorrhea in the sports competition or intense training process, known as "sports amenorrhea." Some young women may also have amenorrhea during their travels or intense work and study. The pathogenesis is similar to this disease, and can also be treated with reference to exercise amenorrhea. The disease is often associated with excessive mental stress, leading to endocrine dysfunction. Chinese medicine believes that due to excessive mental stress, the movement of air-conditioners is reversed, and the dysfunction of the rushing function is caused by the bloody sea.

4, ovarian amenorrhea: If the ovary is absent or dysplastic, ovarian damage or premature aging, so that the body does not produce sex hormones, the endometrium can not grow, can not occur cyclical changes and exfoliation, menstruation can not come, this amenorrhea, Known as ovarian amenorrhea.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.