What does secondary amenorrhea mean?

Secondary amenorrhea is a gynecological disease, which means that women originally had regular menstruation, but due to some special reasons, they stopped menstruating for a long time (usually for more than 6 months). If this happens, you need to go to a regular hospital for examination in time, and pay attention to the cleanliness of your private parts in your life.

Secondary amenorrhea

Secondary amenorrhea refers to a condition in which a woman who once had regular menstruation stops having menstruation for more than 6 months due to some reason, or stops having menstruation for more than 3 cycles according to her original menstrual cycle. After secondary amenorrhea occurs, you should go to the hospital for examination in time.

Causes

1. Hypothalamic amenorrhea

The most common ones include mental stress (sudden or long-term mental depression, tension, depression, environmental changes, overwork, etc.), weight loss (excessive dieting, rapid weight loss), long-term strenuous exercise, drugs (long-term use of steroid contraceptives), and craniopharyngioma.

2. Pituitary amenorrhea

Pituitary infarction, pituitary tumor, empty sella syndrome.

3. Ovarian amenorrhea

Premature ovarian failure, functional ovarian tumors, polycystic ovary syndrome.

4. Uterine amenorrhea

Asherman syndrome, puerperal infection, endometrial tuberculosis infection and various hysteroscopic surgery-induced infections, intrauterine adhesions, post-hysterectomy or radiotherapy.

5. Abnormal endocrine function of thyroid, adrenal glands, pancreas, etc.

Clinical manifestations

Those who used to have regular menstruation, but later stopped having menstruation for more than 6 months due to some reason. May be accompanied by symptoms of the primary disease.

examine

1. Full body examination

Pay attention to general development and nutritional status, mental state, intelligence level, and whether there are physical deformities. If necessary, measure height and weight, and check the development of secondary sexual characteristics, such as obesity, hirsutism, galactorrhea, etc.

2. Gynecological examination

Pay attention to the development of the vulva, whether the clitoris is enlarged, whether the vagina is normally developed, whether the vagina is obstructed, deformed, or atrophied, and whether the ovaries are enlarged.

3. Uterine examination

(1) Hysteroscopy: can accurately diagnose intrauterine adhesions.

(2) Laparoscopic examination: The shape of the ovaries and the size of the uterus can be directly observed.

(3) Hysterosalpingography: to determine whether there are any uterine cavity lesions and uterine cavity adhesions.

(4) Pelvic B-ultrasound: to understand the size of the uterus and the condition of the ovaries.

(5) Drug trials: including progesterone and estrogen-progesterone sequential trials and pituitary stimulation tests.

1. Treatment of the cause

Find the organic disease that causes amenorrhea and give appropriate treatment. For example, tuberculous endometritis is treated with anti-tuberculosis drugs. Patients with intrauterine adhesions should have their uterine cavity dilated and an IUD placed to prevent recurrence of adhesions. After the diagnosis of pituitary or ovarian tumors is confirmed, the treatment plan is determined according to the location, size, and nature of the tumor, and surgery, radiotherapy, chemotherapy, or other comprehensive measures may be selected.

2. Hormone therapy

After clarifying the pathological link and cause, appropriate hormone therapy is given to supplement the hormone deficiency or antagonize the excess in the body. Artificial cyclical therapy with sex hormones is generally used. After the application of sex hormones, menstrual-like periodic withdrawal bleeding occurs, which corrects the patient's physiological and psychological state and promotes and maintains the patient's secondary sexual characteristics and menstruation.

(1) Estrogen replacement therapy: suitable for those without a uterus.

(2) Estrogen and progesterone artificial cycle method: suitable for those with a uterus.

(3) Progestin therapy: Suitable for women with grade I amenorrhea who have a certain level of estrogen in their bodies.

3. Induce ovulation

If the ovarian function is not exhausted and there is a desire to have children, hormones or their analogues can be used to induce ovulation.

(1) Clomiphene: Suitable for anovulators with a certain level of estrogen in their bodies.

(2) Gonadotropin: Follicle-stimulating hormone (HMG) combined with human chorionic gonadotropin (HCG) promotes follicle development and induces ovulation.

(3) Gonadotropin-releasing hormone (GnRH): suitable for hypothalamic amenorrhea.