| ID | 305 |
|---|---|
| Name | TRUE AMENORRHOEA |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | Investigation: A. History B. General examination C. Special investigations- 1. X-Ray chest and sella turcica 2. Hysterosalpingography 3. Laboratory tests - a. blood & urine sugar b. tests for thyroid function c. hormone assay d. pregnancy test e. chromosomal study. 4. Vaginal cytology 5. Endometrial curettage 6. Pelvic examination under G/A. 7. Laparoscopy |
| Management | |
| Introduction | In this condition menstrual function is suppre-ssed due to physiological or pathological causes. |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | Treatment of amenorrhoea: Primary amenorrhoea: 1. Hymenotomy in case of imperforated hymen. 2. Faulty uterine development-Improvement of diet for unhealthy lady. Diet controll for obese patient. 3. Reconstruction operation for vaginal & cervical atresia. 4. Cyclical oestrogen therapy for gonadal dysgene-sis. 5. Treatment of other causes as - Endocrine abnormalities, Anorexia nervosa, T.B. Secondary amenorrhoea: 1. Reduce weight by dieting if obese. 2. Improve health by improved diet if the pt. is unhealthy. 3. Problem of environment, diet, work conditions to be solved. 4. Treatment of other causes. 5. Drug induced amenorrhoea- offending drug should be stopped. 6. Hormone therapy- a. Oestrogen-progesterone cyclical treatment when cause is ovarian- - 1st 21 days: Diethylstilbestrol Img tablet b.d. - Next 7 days: norethisterone 5mg tablet b.d. b. Pituitary amenorrhoea: FSH/LHRH c. Amenorrhoea with sterility- gonadotrophins. d. When hypothalamic and pituitary system is capable of functioning-clomiphene citrate 50mg tablet 2 times daily for 5 days for induction of ovulation (and thus menstruation). |
| Complications | |
| Prognosis | |
| Types | Types of Pathological Amenorrhoea : 1. Primary amenorrhoea- menstruation does not start even at the age of 18 is considered as primary amenorrhoea. The patient has no experience of menstruation. 2. Secondary amenorrhoea- absence of menstrua-tion for six months or more in a woman who has regular menstrual cycle previously. |
| Classification | |
| Observation | |
| Pathology |
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