Menopause
Introduction
Introduction Amenorrhea refers to menstruation stopped for at least 6 months. Amenorrhea can be divided into two categories: one is physiological amenorrhea. That is, women have a period of menstrual cramps due to certain physiological reasons, such as pregnancy, lactation, postmenopausal, etc., and the other type is pathological amenorrhea, which means that menstrual cramps may be caused by certain pathological reasons. Caused by systemic or localized lesions. Lean menstruation is also a manifestation of menstrual disorders, and is closely related to amenorrhea. Menstrual scarcity can be divided into two cases of less menstruation and thin menstruation. The normal menstrual cycle is regulated by the endocrine function of the hypothalamic-pituitary-ovarian axis. If any link occurs, menstrual disorders will occur, sometimes leading to amenorrhea.
Cause
Cause
Menopause caused by environmental factors: It is a temporary endocrine dysfunction, which usually recovers naturally within 6 months of menstruation.
Pituitary menstruation: In addition to amenorrhea, there are other symptoms, such as Xi'an syndrome caused by postpartum hemorrhage, in addition to amenorrhea with pubic hair loss, vulvar atrophy, etc., caused by pituitary prolactinoma, in addition to amenorrhea, accompanied by Breast milk and so on.
Ovarian amenorrhea: This type of amenorrhea is very common, such as sputum syndrome, ovarian cysts, ovarian tumors, polycystic ovary syndrome, premature ovarian failure and various causes of endocrine dysfunction caused by ovarian non-ovulation.
Examine
an examination
Related inspection
Hysteroscopy
Examination of uterine function:
1. Drug test. The progesterone test can be used as an estrogen test if it does not respond to progesterone.
2. Diagnostic curettage.
3. Hysteroscopy.
Examination of ovarian function:
1. Cervical mucus crystallization examination, see a row of ellipsoids on the smear, suggesting that there is progesterone at the estrogen level.
3. Vaginal exfoliation cell examination, twice a week vaginal smear, dynamic indirect observation of ovarian estrogen levels.
4. The basal body temperature is biphasic, suggesting that the ovarian function is normal, there are ovulation and corpus luteum formation.
5. Determine the content of estrogen and progesterone in the blood. If the content is low, it indicates that the ovarian function is abnormal or depleted.
Examination of pituitary function:
1. Sella film to exclude pituitary tumors.
2. Determine the levels of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL). FSH higher than normal (2.5 g / liter) suggesting hyperfunction of the pituitary, ovarian function is low, LH is lower than normal (6 units / liter), indicating hypogonadism, if the FSH, LH content is low, suggesting pituitary or subthalamic The function is low, and the PRL content exceeds the normal value, suggesting that the amenorrhea amenorrhea syndrome.
Diagnosis
Differential diagnosis
The diagnosis should be differentiated from the following symptoms:
1. Stopping through early stoppage refers to the early closure of women due to various diseases and other factors, and the age of menopause is earlier than that of normal women. Stopping is one of the clinical manifestations of premature ovarian failure.
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 called premature ovarian failure. There are many reasons for premature aging, including immune factors, cytogenetic factors, and physical and chemical factors such as surgery and infection. Premature ovarian function affects women's quality of life. At present, the clinical supplementation of exogenous estrogen and progesterone is mainly used to compensate for the deficiency of ovarian function and delay the pathological process.
2. Menopause and eclipse amenorrhea refers to menstruation stopped for at least 6 months. Amenorrhea can be divided into two categories: one is physiological amenorrhea. That is, women have a period of menstrual cramps due to certain physiological reasons, such as pregnancy, lactation, postmenopausal, etc., and the other type is pathological amenorrhea, which means that menstrual cramps may be caused by certain pathological reasons. Caused by systemic or localized lesions.
The galactorrhea is an abnormal phenomenon in which the emulsion is secreted during non-breastfeeding. It may be caused by some physiological diseases, or it may be caused by drugs or bad stimuli. Therefore, when this condition occurs, in addition to paying attention to breast health, it should also identify the cause and target treatment. She continued lactation during her non-partum lactation or after she stopped breastfeeding for one year, indicating that she developed galactorrhea. If lactation is accompanied by amenorrhea, it is called galactorrhea. In most patients, serum prolactin exceeds the normal high limit (1-25 mg/L) and is hyperprolactinemia.
