amenorrhea-1 - Amenorrhea Darren Farley, M.D. Department of...

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Amenorrhea Darren Farley, M.D. Department of Obstetrics and Gynecology UKSM-Wichita
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Definitions and Epidemiology Primary amenorrhea absence of normal menstruation in a patient without previously established cycles no periods by age 14 with no secondary sex changes absence of menarche by age 16 regardless of secondary sex changes no periods by 2 years after the start of secondary sex changes < 0.1-2.5% of reproductive age women
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Definitions and Epidemiology Secondary amenorrhea absence of menses for 3 cycle lengths in oligomenorrhea, or for 6 months after having regular menses 1-5% of the population
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Clinical Presentation History milestones, development, diet, exercise, wt change drug use (antipsychotics, hormones, narcs, anti- HTN’s systemic disease (hypothyroidism, adrenal insuff., GH excess) past surgery, glactorrhea, hirsutism genetic history
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Physical ht, wt, vitals signs of thyroid dz (protuberant eyes, enlarged gland, puffy face, heat/cold intolerance) secondary sex changes thelarche (breast devel): avg. age 10.8 yrs; indication of estrogen exposure adrenarche (pubic/axillary hair development): avg. age 11 and indicates ovarian and adrenal androgen production and end organ response
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amenorrhea-1 - Amenorrhea Darren Farley, M.D. Department of...

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