Primary Amenorrhea Quiz

The main sign of amenorrhea is missing a period. Amenorrhea refers to the absence of menstrual periods in women of reproductive age. It can be caused by various factors such as pregnancy, hormonal imbalances, stress, excessive exercise, or certain medical conditions. Missing a period is a significant indication of amenorrhea as it signifies a disruption in the normal menstrual cycle. Other symptoms like facial hair, hair loss, or headache may be present in some cases, but missing a period is the primary and most common sign.

Amenorrhea refers to the absence of menstrual periods, and it can be caused by various factors. Early menopause, which is the cessation of menstruation before the age of 40, can lead to amenorrhea. Genetic defects, such as Turner syndrome or androgen insensitivity syndrome, can also cause this condition. Additionally, being severely over or underweight can disrupt the hormonal balance in the body, leading to amenorrhea. Therefore, all of the mentioned causes - early menopause, genetic defects, and severe weight fluctuations - can contribute to the occurrence of amenorrhea.

Estrogen is the hormone required for breast development. During puberty, estrogen stimulates the growth and development of breast tissue, leading to the enlargement of the breasts. It promotes the proliferation of mammary gland cells and increases the deposition of fat in the breasts, resulting in their development and enlargement. Estrogen also plays a crucial role in the regulation of the menstrual cycle and the development of secondary sexual characteristics in females.

A karyotype is a laboratory test that examines the number and structure of an individual's chromosomes. In this case, the absence of a uterus and cervix suggests a developmental abnormality, which may be caused by a chromosomal disorder. Therefore, performing a karyotype would be most helpful in determining the underlying cause of the patient's problem. This test can identify any chromosomal abnormalities, such as Turner syndrome (45,X), which is characterized by the absence or underdevelopment of certain reproductive structures and can lead to primary amenorrhea (lack of menstruation).

Oligomenorrhea is a condition characterized by infrequent or irregular menstrual bleeding. This means that the menstrual cycle lengths are greater than 35 days. It is not associated with regular bleeding occurring more frequently than every 21 days or with prolonged or excessive uterine bleeding occurring at regular intervals.

Polymenorrhea is the term that best matches the condition described. Polymenorrhea refers to the condition in which a woman experiences menstrual cycles that are shorter than the average 28-day cycle, typically occurring every 21 days or less. In this case, the woman's cycles are only 19 days long, indicating a shorter interval between her periods. Menorrhagia refers to excessive or prolonged menstrual bleeding, metrorrhagia refers to irregular bleeding between periods, and hypermenorrhea refers to abnormally heavy menstrual flow.

In patients with 2° sexual characteristics (breast development, etc), primary amenorrhea is considered normal until the age of 16. This means that if a patient has not started menstruating by the age of 16, it is still within the normal range. After the age of 16, primary amenorrhea would be considered abnormal and further evaluation would be required to determine the cause.

Want to establish the presence of mullerian structures: uterus, fallopian tubes, upper portion of vagina etc

In cases of primary amenorrhea, a "wait and see" approach is typically taken when patients do not have secondary sexual characteristics such as breast development. However, this approach is no longer appropriate when the patient reaches the age of 14. At this point, further evaluation and intervention may be necessary to determine the cause of the amenorrhea and initiate appropriate treatment.

Want to look for pituitary abnormalities, tumor etc as potential causes