What is amenorrhea?

Primary amenorrhea refers to women over 14 years old without menstrual cramps and secondary sexual characteristics development, or at least 16 years old, although there are secondary sexual characteristics development, but no menstruation, called primary amenorrhea, prior to menstruation, but menopause for more than 6 months or more than or equal to the original 3 menstrual cycles, called secondary amenorrhea. According to reproductive axis pathological changes and functional disorders, it can be divided into hypothalamic amenorrhea, pituitary amenorrhea, ovarian amenorrhea, uterine amenorrhea and hypogenital dysplasia amenorrhea; amenorrhea can be divided into primary and secondary, physiological and pathological. Physiological amenorrhea refers to pregnancy, lactation and menopause after the absence of menstruation, according to the level of gonadotropin classification, can be divided into high gonadotropin amenorrhea (FSH greater than or equal to 30 units per liter), indicating lesions in the ovary, low gonadotropin amenorrhea (FSH less than five units per liter), suggesting that the lesion in the center; according to ovarian dysfunction classification, can be divided into first degree amenorrhea, that is, withdrawal bleeding after progesterone, second degree amenorrhea, that is, no withdrawal bleeding after progesterone. The causes of amenorrhea include pathological amenorrhea is directly or indirectly by the central nervous system, hypothalamus, pituitary, ovarian axis and uterus functional or organic lesions of amenorrhea. Symptoms of amenorrhea include, in addition to amenorrhea, decreased libido, obesity, breast atrophy, thinning or shedding of pubic and axillary hair, dull skin, vaginal dryness, infertility, etc. The treatment of amenorrhea is first of all, the cause of treatment, for the treatment of amenorrhea, first of all to find the cause of amenorrhea, for primary amenorrhea patients need to check sex hormones, internal and external reproductive organs anatomical structure and sex chromosomes, distinguish chromosome abnormalities, sexual development abnormalities, anatomical abnormalities or other diseases, such as congenital adrenal hyperplasia, some patients after removing the cause, can resume menstruation. Secondary amenorrhea is mostly physiological or systemic diseases, such as excessive weight loss or postpartum hemorrhage, affecting pituitary function and stimulating a manifestation of Sheehan syndrome. Second, sex hormone treatment, except for anatomical abnormalities and other diseases, for amenorrhea, generally choose progesterone withdrawal bleeding, such as estrogen in the body is not enough, progesterone withdrawal without bleeding, such as adolescent infantile or adult hypoestrogenemia caused by amenorrhea, can be treated by artificial cycle. 3. Endocrine therapy: patients with congenital adrenal hyperplasia should be treated with glucocorticoids for a long time. Patients with polyovoid ovary syndrome with obvious hyperandrogenism signs can choose contraceptives with androgen lowering effect. Patients with PCOS complicated with insulin resistance can choose insulin sensitizers.