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Amenorrhea

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  1. Read book excerpt
  2. Pregnancy: Introduction
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Amenorrhea: Excerpt from A Pocket Manual of Differential Diagnosis

Hypothalamic and Pituitary Causes


Androgen excess
Chorionic gonadotropin-secreting tumors
Chronic debilitating diseases (e.g., liver disease, uremia, regional ileitis)
Congenital hypothalamic hypogonadism
   Idiopathic
   With anosmia or hyposmia (Kallman's syndrome)
Cushing's syndrome
Defects in gonadotropin synthesis
Estrogen-secreting ovarian or adrenal tumors
Gonadotropin-secreting pituitary tumors
Hypopituitarism
Hypothalamic-pituitary dysfunction due to extrinsic factors
   Anovulation
       Hypothyroidism
       Obesity
       Perimenopause
   Hyperprolactinemia
   Lactation
   Nutritional
       Acute weight loss
       Malnutrition (including anorexia nervosa)
       Underweight
   Post-pill amenorrhea
   Pregnancy
   Pseudocyesis
   Strenuous exercise
   Stress
   Thyrotoxicosis
   Idiopathic delayed puberty
   Secretion of biologically inactive gonadotropin

Ovarian Causes


   Acquired (premature ovarian failure)
       Autoimmune
       Chemotherapy
       Idiopathic (premature menopause)
       Myotonic dystrophy
       Postinfection
          Mumps oophoritis
          Severe pelvic inflammatory disease
       Radiation
       Surgical castration
       Trauma
   Congenital
       Congenital thymic aplasia
       Galactosemia
       Gonadal agenesis
       Gonadal dysgenesis (including Turner's syndrome)
       Ovarian enzymatic deficiency
       17α-Hydroxylase deficiency
          17,20-Lyase deficiency
       Resistant ovary syndrome (Savage syndrome)
       Sex chromosome mosaicism
       Trisomy X
       True hermaphroditism
       XY gonadal dysgenesis
   Menopause

Uterine and Outflow Tract Abnormalities


   Female pseudohermaphroditism
       Congenital adrenal hyperplasia
   Exposure to maternal androgens in utero

   Hysterectomy
   Male pseudohermaphroditism
   5α-Reductase deficiency
       Complete and incomplete androgen insensitivity
       Enzymatic defects in testosterone biosynthesis
   Müllerian agenesis
   Müllerian anomalies
       Absence or anomalies of vagina, cervix, endometrium, or endometrial cavity
       Imperforate hymen
       Labial agglutination or fusion
   Trauma (including surgical)
       Cervical stenosis
       Sclerosis of the uterine cavity (Asherman's syndrome)
          Abortion
          After uterine surgery (caesarian section, metroplasty, myomectomy)
          Repeated or overzealous uterine curettage
          Severe, generalized pelvic infections
          Tuberculous endometritis
          Uterine schistosomiasis
       Vaginal stenosis

References


1. Speroff L, Glass RH, Kase NG: Amenorrhea. pp. 418–445. See Bibliography, 8.
2. McIver B, Romanski SA, Nippoldt TB: Evaluation and Management of Amenorrhea. Mayo Clin Proc   72:1161–1169, 1997.

Book Source Details

  • Book Title: A Pocket Manual of Differential Diagnosis
  • Author(s): Stephen N. Adler, Dianne B. Gasbarra
  • Year of Publication: 1999
  • Copyright Details: A Pocket Manual of Differential Diagnosis, Copyright © 1999 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.



More About This Book:
Title: A Pocket Manual of Differential Diagnosis
Authors: Stephen N. Adler, Dianne B. Gasbarra
Publisher: Lippincott Williams & Wilkins
Copyright: 1999
ISBN: 0-78171-943-7

 » Next page: Abortion (Professional Guide to Diseases (Eighth Edition))

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