ovarian amenorrhea
Introduction
Introduction If the ovary is absent or dysplastic, ovarian damage or premature aging, so that the body does not produce sex hormones, the endometrium can not grow, nor can it periodically change and exfoliate, menstruation can not come, this amenorrhea, called ovarian amenorrhea. The ovaries are organs that provide eggs. There is a cycle of follicular development, the genital tract is smooth, and menstruation can occur. Without the development of the egg, there is no menstruation. This type of amenorrhea is called ovarian amenorrhea. The reason may be due to congenital ovarian hypoplasia without egg, or amenorrhea due to exhaustion of the egg after many reasons. The former is primary ovarian amenorrhea; the latter is secondary ovarian amenorrhea, also known as premature ovarian failure.
Cause
Cause
Causes are usually: premature ovarian failure, ovarian resection or tissue destruction, ovarian functional tumors, polycystic ovary syndrome.
1. Genetics: Genetic abnormalities are also heterogeneous and multifactorial, including FSH receptor abnormalities, translocations of X and Y chromosome homologous sequences, and FSH structural abnormalities (which cannot bind to receptors).
2, autoimmune process: Among them, the most common research on premature ovarian failure and autoimmunity, the abnormalities found include FSH antibody, FSH receptor antibody, parathyroid gland, thyroid and adrenal antibodies, etc. Some patients after immunosuppressive therapy There is recovery of ovarian function. Autoimmune diseases include blood calcium, phosphorus, fasting blood glucose, morning cortisol, free T4, TSH, thyroid antibodies (such as thyroid dysfunction), whole blood count, erythrocyte sedimentation rate, total protein, albumin/globulin ratio, rheumatism Factor, anti-nuclear antibody, etc.
3, infection and other related: infection factors include mumps, viral infections and so on. Normal women's ovarian function begins to decline when they are 45 to 50 years old. If there is a sign of decline before the age of 40, it is medically called premature ovarian failure. This type of female is often accompanied by amenorrhea or oligos, gonadotropin levels and estrogen levels, clinical manifestations of varying degrees of hot flashes, sweating, vaginal dryness, decreased sexual desire and other premenopausal symptoms.
Examine
an examination
Related inspection
Luteinizing hormone ovarian function test gynecological examination gynecological routine examination progesterone test
A syndrome caused by dysregulation of ovarian closure via a sex hormone feedback regulation mechanism. The cause is still unclear and is currently considered to be the final outcome of ovarian persistent anovulation. The clinical manifestations of ovarian amenorrhea are mainly caused by persistent anovulation and hyperandrogenism. Its clinical manifestations are summarized as follows:
First, menstrual disorders: mainly amenorrhea, the vast majority of secondary amenorrhea, often have menstrual scarcity or too few before menopause, occasionally see more amenorrhea and menstruation.
Second, infertility: usually after the onset of menarche, after marriage with infertility, due to menstrual disorders and no ovulation.
Third, post-puberty multi-hair sign: If the eyebrows are thicker, the upper lip, arms, lower limbs, vulva and perianal hair increase, or accompanied by masculine phenomenon, such as acne and clitoris hypertrophy. This is due to excessive androgen secretion.
Fourth, the black spine skin sign: This is another sign of excessive androgen, often in the neck, underarms and groin of the patient's skin appears taupe color home, symmetry, caress like velvet.
Five, bilateral ovarian enlargement: about 1-3 times larger than the normal ovary, thick capsule, tough.
Diagnosis
Differential diagnosis
Differential diagnosis
Physiological amenorrhea: Physiological amenorrhea is a normal phenomenon. In the early stage of puberty, in the second or third year of the first menstrual period, the ovarian function is still unstable, and the menstrual cycle is often irregular. After the conception, the ovarian corpus luteum produces a large amount of lutein, which stimulates the endometrium to proliferate without falling off. Therefore, it will not come to menstruation; after childbirth, ovarian function recovery takes a certain time, combined with breast-feeding inhibition of the ovary, menstrual recovery is later; after the age of 40, due to the gradual decline of ovarian function, menstruation often several months until menopause . This amenorrhea, which occurs during development, pregnancy, lactation, and menopause, is called physiological amenorrhea and is a normal phenomenon.
Secondary amenorrhea: The case of menstruation but later menopause is called secondary amenorrhea. Secondary amenorrhea refers to those who have menopause for more than 6 months after menstrual cramps, or those who have menopause in menstrual thinning to reach 3 normal intervals.
Pituitary amenorrhea: amenorrhea caused by pituitary tumors may be accompanied by headache, unclear vision, or lactation; amenorrhea in the anterior pituitary, occurs in postpartum hemorrhage, manifested as loss of libido, genital atrophy, fatigue, cold, hair loss.
Sports amenorrhea: Light female athletes, amenorrhea that occurs during sports competitions or intense training, is called "sports amenorrhea." Some young women may also have amenorrhea during their travels or intense work and study. The pathogenesis is similar to this disease, and can also be treated with reference to exercise amenorrhea. The disease is often associated with excessive mental stress, leading to endocrine dysfunction. Chinese medicine believes that due to excessive mental stress, the movement of air-conditioners is reversed, and the dysfunction of the rushing function is caused by the bloody sea.
Ovarian amenorrhea: a syndrome caused by a disorder of the sex hormone feedback regulation mechanism. The cause is still unclear and is currently considered to be the final outcome of ovarian persistent anovulation. The clinical manifestations of ovarian amenorrhea are mainly caused by persistent anovulation and hyperandrogenism.
