What Are the Causes of Secondary Amenorrhea?

Discussion The first sign of puberty in females is breast budding (Tanner stage II) which normally occurs from 8-13 years. Menarche usually occurs within 2 years of breast budding occurring usually at Tanner stage III-IV breast development. Menarche occurs for most girls from 10-15 years. Most cycles range between 21-45 days. Age > 13 years without acquisition of secondary sexual characteristics, > 15 years before menarche or 5 years after acquisition of secondary sexual characteristics or cycles longer than 45 days are indications for evaluation. After menarche is it not uncommon to have anovulatory cycles that are irregular but generally they still occur within 45 days. Primary amenorrhea is the absence of menses. Secondary amenorrhea is defined as no menses for 3 or more cycles or irregular menses for 6 months or more after regular menses are established. Secondary amenorrhea occurs in about 2-5% of college women but is more common in certain populations such as dancers and distance runners (65-69%). First characterized in 1992, female athlete triad (FAT) includes “…low energy availability, menstrual dysfunction, and low bone mineral density.” Prevalence is 1-14% with highest frequency in professional ballet dancers. The cause of menstrual dysfunction in FAT is functional hypothalamic amenorrhea (FHA). A review of FAT can be found here. FHA is caused by suppression of the gonadotropin-releasing hormone pulsatility in an otherwise normal (anatomicall...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news