What is Amenorrhea?
Amenorrhea refers to the absence of menstrual periods. In the context of pediatrics, it is essential to distinguish between primary and secondary amenorrhea.
Primary amenorrhea is when a girl aged 15 or older has not yet begun menstruating, despite having other signs of puberty.
Secondary amenorrhea occurs when a girl who previously had regular menstrual cycles stops menstruating for three months or more.
Polycystic ovary syndrome (PCOS), which can disrupt normal menstrual cycles.
Stress and significant changes in weight.
Thyroid disorders, both hyperthyroidism and hypothyroidism.
Hyperprolactinemia, an excessive production of prolactin hormone.
Use of certain medications, such as contraceptives or antipsychotics.
How is Amenorrhea Diagnosed?
Diagnosis of amenorrhea involves a thorough medical history, physical examination, and laboratory tests. Key steps include:
Taking a detailed history of the patient's
menstrual cycle, diet, exercise habits, and family history.
Conducting a physical exam to check for signs of puberty and any anatomical abnormalities.
Running blood tests to measure hormone levels, such as FSH, LH, TSH, and prolactin.
Imaging studies like
ultrasound or MRI to evaluate reproductive organs.
Genetic testing if a chromosomal abnormality is suspected.
For hormonal imbalances or thyroid disorders, medications to correct hormone levels may be prescribed.
PCOS may be managed with
lifestyle changes and medications like oral contraceptives or metformin.
Nutritional counseling and therapy for eating disorders.
Stress management techniques and reducing excessive physical activity.
Surgical intervention if there are anatomical abnormalities.
A girl is 15 years old and has not started menstruating.
There are signs of puberty, but menstruation hasn't begun within three years.
A previously menstruating girl misses her periods for three consecutive months.
There are symptoms like excessive hair growth, sudden weight loss or gain, or signs of a thyroid disorder.
Conclusion
Amenorrhea in pediatrics requires careful evaluation to identify and treat the underlying cause. Early diagnosis and appropriate management are vital for the overall health and well-being of affected adolescents. If you suspect amenorrhea, seeking medical advice promptly can lead to better outcomes and help address any potential health issues.
