Amenorrhea

1. Amenorrhea Danielle, Kelsey, Joe, Matt Table 3 Period 3

2. An Overview

3. An Overview Amenorrhea is defined as the absence of menstrual bleeding and may be primary or secondary.

4. An Overview Primary Amenorrhea is the absence of menstrual bleeding and secondary sexual characteristics in a girl by age 14. -OR- The absence of menstrual bleeding with normal development of secondary sexual characteristics in a girl by age 16.

5. An overview For a woman to have a regular menstrual cycle, her HYPOTHALAMUS, PITUITARY gland, OVARIES and UTERUS should all be functioning normally.

6. An overview The Hypothalamus stimulates the pituitary gland by releasing follicle stimulating hormones (FSH) and luteinizing hormone (LH). This causes the ovaries to produce the hormones estrogen and progesterone.

7. An overview Estrogen and progesterone are responsible for the cyclical changes in the endometrium ( uterine lining), including menstruation.

8. A chart illustrating a normal menstrual cycle.

9. Causes

10. Hypothalamic causes Craniopharyngioma - a brain tumor near the pituitary gland. Teratoma -a tumor made up of a mixture of tissues. Sarcoidosis - the formation of nodules in different parts of the body.

11. Hypothalamic causes Kallmann Syndrome- Deficiency of gonadotropins, which are hormones capable of promoting growth and function of reproductive hormones. Nutritional Deficiency Low Body Weight

12. Pituitary Causes Prolactinemia - High blood levels of prolactin, a hormone that stimulate the secretion of breast milk. Pituitary Tumors Postpartum Pituitary Necrosis- Death of pituitary cells after a woman delivers a baby.

13. Pituitary causes Autoimmune Hypophysitis - Cells of the pituitary gland destroyed by the body’s own defense system Pituitary Radiation

14. Ovarian Causes Anovulation- Lack of the release of an egg Hyperandrogenemia - High blood levels of male hormones Polycystic ovary syndrome Premature Ovarian Failure Turner Syndrome-Genetic disorder characterized by underdeveloped ovaries, short stature.

15. Ovarian Causes Pure Gonadal Dysgenesis - Defective development of the ovary Autoimune O ophoritis - Cells of the ovaries destroyed by the body’s own defense system Radiation or Chemotherapy Abnormalities of the genital tract

16. Functional Causes Anorexia/Bulimia Chronic Disease ( Ex: Tuberculosis) Excessive weight gain/loss Malnutrition Psychiatric Disorders Recreational Drug Abuse Excessive Stress Excessive Exercise

17. Symptoms

18. Symptoms Amenorrhea is a symptom of an underlying disorder.

19. Symptoms Galactorrhea - Production of breast milk in women who are not pregnant Headache Reduced Peripheral Vision These could be signs of an intracranial tumor.

20. Symptoms Noticeable weight gain/ loss Excessive anxiety Hot Flashes Night Sweats Disrupted Sleep These can be signs of Ovarian Insufficiency or Premature Ovarian Failure.

21. Exams and Tests

22. Exams and Tests Blood Tests to determine hormone levels CT or MRI of the head to exclude pituitary and hypothalamic causes Thyroid Function Tests Hysteroscopy-Visual inspection of uterus

23. Medical Treatments

24. Medical Treatment Hormone Replacement Therapy Radiation Therapy for tumor-related Contraceptives to restore menstrual cycle

25. Sources Amenorrhea . (2002). In Britanica (15th ed., Vol. 1, p. 324). Chicago: Encyclopedia Britanica Inc. ( Original work published 1768) Slap, G., M.D. (2005). Amenorrhea. In K. Krapp & J. Wilson (Eds.), The Gale Encyclopedia of Children's Health (Vol. 1, pp. 88-92). Michigan: Thomson Gale. The Tale of 4 Hormones- Normal Menstrual Cycle . ( n.d. ). Retrieved February 23, 2012, from http:// pcosjournal.com /hormones-normal-menstrual-cycle/ Turkington , C. A. (2002). Amenorrhea. In J. L. Longe (Ed.), The Gale Encyclopedia of Medicine ( 2 nd ed ., Vol. 1, pp. 146-148). Michigan: Gale Group. Nelson, L. M., M.D. ( n.d. ). Amenorrhea . Retrieved from WEB M.D, LLC website:      http:// www.emedicinehealth.com /script/main/ art.asp?articlekey =59246&pf=3&pa Slide 8 Image: http:// img.medscape.com /pi/ emed / ckb / obstetrics_gynecology /252558-1336968-276110-1622624.jpg