What is primary amenorrhea?

Any disease that befalls us is not without reason. Sometimes it is because of our eating habits, and sometimes it is because we do not pay attention to rest for a long time. But no matter what the reason is, we must pay attention to the disease and prevent various diseases. So what is primary amenorrhea? It is a disease that mainly occurs in women, so how can we prevent it in our lives?

Primary amenorrhea refers to women who are over 18 years old or whose secondary sexual characteristics have matured for more than 2 years but still have no menstruation. It is seen in congenital reproductive tract abnormalities such as incomplete or absent uterus, congenital ovarian hypoplasia or absence, primary pituitary hypogonadotropism and congenital adrenal hyperplasia. In a few cases, pseudo-amenorrhea caused by lower reproductive tract atresia should be excluded.

Uterovaginal agenesis is mainly caused by the incomplete development of the bilateral paramesonephric ducts. The middle and tail segments of the paramesonephric ducts on both sides are not developed, that is, the paramesonephric ducts stop developing before extending to the midline, and therefore fail to merge into the uterus. Clinically, it manifests as congenital absence of uterus and vagina. If the two mesonephric ducts stop developing shortly after they join, a primordial uterus is formed. This uterus is very small, has no endometrium, and therefore no menstruation. If the two mesonephric ducts join to form the uterus but do not penetrate, a solid uterus is formed without endometrium; or if they stop developing shortly after penetrating, a juvenile uterus is formed. It manifests as primary amenorrhea. If there is partial endometrium, amenorrhea may be accompanied by cyclical abdominal pain. Intelligence, physique and secondary sexual characteristics are developed normally. The hypothalamus-pituitary-ovarian axis functioned normally, and the chromosome karyotype was 46,XX.

Androgen Insensitivity Syndrome

Androgen insensitivity syndrome is also known as testicular feminization or male pseudohermaphroditism. The patient's gonads are male and there are testicles in the body. In the early embryonic period, the testicles secrete testosterone, but due to the lack of androgen receptors in the target organ cells, they do not respond to testosterone, thus hindering the development of external genitalia and male secondary sexual characteristics. After puberty, the testicles develop and can secrete estrogen, which has a feminizing effect and causes breast development, making the appearance similar to that of a female, so it is called male pseudohermaphroditism. Clinically, it is divided into two types: completely insensitive to androgen and partially insensitive.

1. Patients who are completely insensitive to androgens have normal development, are tall, have long arms, large feet, developed breasts, but small nipples, pale areolas, and sparse pubic and axillary hair. The external genitalia are female, with poorly developed labia minora, a short vagina with a blind upper end, no uterus, and the testicles may be in the abdominal cavity or groin.

2. Partial insensitivity to androgens may manifest as clitoromegaly or a short penis, often accompanied by hypospadias. Therefore, the presence of testicular feminization syndrome should be considered in patients with primary amenorrhea, blind vagina and no uterus. The diagnosis of this disease is based on an XY chromosome type, elevated blood FSH (follicle-stimulating hormone) and LH (luteinizing hormone), and testosterone within the normal male range or elevated.

Toner syndrome

The above explains what primary amenorrhea is. Even people with normal menstruation should pay attention to this issue to avoid having no good treatment when similar diseases occur in themselves. This is very bad for us and will definitely make our physical fitness worse and worse.